Operates the AED and alternates with the Compressor after every 5 cycles or 2 minutes to avoid fatigue
answer
monitor/defibrillator
question
provides ventilation
answer
airway
question
Assigning your team members to individual roles and outlining what each member needs to do during the resuscitation attempt is an example of what element of high-performance team dynamics?
answer
clear roles and responsibilities
question
You and your team have initiated compressions and ventilation. The AED was attached, and "no shock" was advised. Your team has continued CPR for 1 minute. You tell your team in a respectful, clear, and calm voice, "Leslie, during the next analysis by the AED, I want you and Justin to switch positions, and I want you to perform compressions for the next cycle." Leslie replies, "Got it. Next time the AED analyzes, I will switch with Justin and assume the role of Compressor."
This is an example of which element of high-performance team dynamics?
answer
closed-loop communication
question
As Team Leader, you notice that your Compressor is pushing too fast. It is important to correct actions that are incorrect, but it is also important to be tactful when delivering this correction to a colleague.
This is an example of what element of team dynamics?
answer
constructive intervention
question
What action can you take as a team during and after a resuscitation attempt that helps individual team members perform better and brings awareness to system strengths and deficiencies?
answer
debriefing
question
AED special considerations
answer
hairy chest, water, transdermal medicine patch, implanted defibrillator or pacemaker, defibrillation for infants less than 1 year of age
question
Hairy chest
answer
-if your AED has 1 set of pads and a razor, quickly shave the area and then apply the pads
-if your AED has 2 sets of pads, use the first set to remove the hair. Apply the first set of pads, press them down so they stick as much as possible, and quickly pull them off. Then apply the new, second set of pads
question
Water
answer
-if someone is lying in water, quickly move the victim to a dry area; if the victim is lying is snow or a small puddle, use the AED
-if the chest is covered with water or sweat, wipe the chest before attaching the pads
question
Transdermal medicine patch
answer
-do not place the pad directly over a medicine patch
-take the patch off and quickly wipe the chest before you put on the pad
question
Implanted defibrillator or pacemaker
answer
-if you see a lump indicating a device, avoid placing the pad directly over it
question
Defibrillation for infants less than 1 year of age
answer
-a manual defibrillator is preferred rather than an AED
-if a manual defibrillator is not available, an AED with a pediatric does attenuator is preferred
-if neither is available, you may use an AED without a pediatric dose attenuator
question
What are examples of effective team dynamics?
answer
clear roles and responsibilities
debriefing
constructive intervention
knowledge sharing
always take the lead
question
What does a chest compression feedback device monitor?
answer
compression rate
compression depth
chest recoil
question
Mouth-to-mouth breaths: adults, children, and infants
answer
-3 steps
-mouth-to-mouth breathing is a quick and effective way to provide oxygen to a victim when a barrier mask is not available
-each breath you take contains 21% oxygen. When you provide a rescue breath, the air you breathe into a victim contains about 17% oxygen
question
Step 1: mouth-to-mouth breaths: adults, children, and infants
answer
-hold the victim's airway open with a head tilt-chin lift
-pinch the nose closed with your thumb and index finger
question
Step 2: mouth-to-mouth breaths: adults, children, and infants
answer
-take a regular breath and seal your lips around the victim's mouth, creating an airtight seal
-give 1 breath and blow for 1 second
-watch for the chest to rise as you give each breath
question
Step 3: mouth-to-mouth breaths: adults, children, and infants
answer
-give a second breath (blowing for about 1 second) while watching for chest rise
question
Your adult friend suddenly collapse at home, and you determine she needs CPR. You begin CPR, starting with chest compressions, and are about to deliver breaths by using mouth-to-mouth breaths. You open the airway with a head tilt-chin lift.
What is the sequence of your next actions?
answer
1. Pinch the nose and seal your lips around the victim's mouth
2. Give 1 breath and blow for about 1 second
3. Watch for chest rise while giving the breath
4. Give a second breath (blowing for about 1 second, watching the chest rise)
give one breath, blowing for about 1 second. Watch for the chest to rise as you give the breath
question
What is a correct approach for AED pad placement for infants and children less than 8 years of age?
answer
as indicated on the pad packages
question
What is the indication for mouth-to-mouth rescue breaths?
answer
when a barrier device is not available
question
Rescue breathing: adults
answer
-give 1 breath every 6 seconds (10 breaths/min)
-give each breath over 1 second and make sure there is visible chest rise with each breath
-during rescue breathing, check the victim's pulse every 2 minutes
question
Rescue breathing: children/infants
answer
-give 1 breath every 2 to 3 seconds (20 to 30 breaths/min)
-give each breath over 1 second, and make sure there is chest rise with each breath
-during rescue breathing, check the victim's pulse every 2 minutes
question
When providing rescue breaths to a child or infant victim, you should give 1 breath every _______ to _______ seconds
answer
2 to 3
question
Advanced airways
answer
-a laryngeal mask airway, supraglottic airway device, and endotracheal tube are types of advanced airways
-when an advanced airway is in place:
perform continuous compressions at 100 to 120/min
give 1 breath every 6 seconds for adults
give 1 breath every 2 to 3 seconds for a child or infant
no pauses in compressions to give breaths
question
When an advanced airway is in place, chest compressions should be provided at a rate of ______ to ______ per minute
answer
100 to 120
question
With an advanced airway in place, rescue breaths should be given at a rate of ______ breath(s) every ______ second(s) for adults
answer
1 & 6
question
How can you achieve a high chest compression fraction?
answer
minimize pauses in chest compressions
question
Opioid-associated life-threatening emergency
answer
-opioid-associated life-threatening emergency is a condition that can cause a person to stop breathing but still have a pulse
-naloxone is a medication that can temporarily reverse the effects of opioid overdose
*common routes of administration for naloxone include intravenous, intramuscular, and intranasal
-for a person who is unresponsive and not breathing normally but has a pulse:
*give 1 rescue breath every 6 seconds in an adult
*give 1 rescue breath every 2 to 3 seconds in a child or infant
*then, if your local protocol allows, give naloxone. Don't delay breaths to give naloxone
question
What is the correct sequence of actions for performing mouth-to-mouth-and-nose breaths for an infant?
answer
1. Perform a head tilt-chin lift
2. Place your mouth over the infant's mouth and nose to create an airtight seal
3. Give one breath, blowing for about 1 second, watching for chest rise
question
How is CPR performed differently when an advanced airway is in place?
answer
no pauses for ventilations
question
A rescuer arrives at the side of an adult victim and suspects an opioid-associated life-threatening emergency. The victim is unresponsive and not breathing normally but has a pulse. What is the next action the rescuer should take?
answer
give 1 rescuer breath every 6 seconds
question
Cardiac arrest in a pregnant patient
answer
High-quality CPR can increase the mother's and the infant's chance of survival
-perform compressions and use an AED as you would for any cardiac arrest victim. Shock from the AED will not harm the infant
-if additional rescuers are present and rescuers are trained, perform continuous lateral uterine displacement, in addition to high-quality BLS
-if the woman is revived, place her on her left side. This may help improve blood flow to her heart and therefore, to the infant
question
Signs of choking: adults and children
answer
-with a severe airway obstruction, the victim will show signs of poor air exchange and difficulty breathing such as
*silent cough
*inability to speak or breathe
*cyanosis (turning blue)
-an adult or older child may clutch the neck with both hands, making the universal choking sign. If the victim nods that they are chocking, you must act
question
What are common administration routes for naloxone?
answer
intramuscular
intranasal
intravenous
question
Abdominal thrusts: adults and children
answer
3 steps
question
Step 1: abdominal thrusts: adults and children
answer
stand or kneel behind the victim and place your arms around the victim's waist; with one hand, locate the navel.
question
Step 2: abdominal thrusts: adults and children
answer
make a fist with the other hand and place the thumb side of your fist against the victim's abdomen, just above the navel and well below the breastbone
question
Step 3: abdominal thrusts: adults and children
answer
-grasp your fist with the other hand and press your fist into the victim's abdomen with a quick, forceful upward thrust
-repeat thrusts until the object is expelled from the airway or the victim becomes unresponsive
question
Choking in obese and pregnant victims
answer
if the victim is too large for you to wrap your arms around the waist:
-wrap your arms around his or her chest
-perform chest thrusts instead of abdominal thrusts
question
When providing rescue breaths to an adult victim, you should give _____ breath(s) every _____ seconds
answer
1 & 6
question
What is a sign of severe airway obstruction?
answer
inability to speak
question
When providing rescue breaths to a child or infant victim, you should give 1 breath every _____ to _____ seconds
answer
2 to 3
question
You respond to a collapsed pregnant female as the only rescuer
You follow the BLS sequence and find that she is unresponsive, is not breathing, and has no pulse
She is visibly pregnant
You activate the emergency response system
What is your next action?
answer
begin chest compressions
question
If a choking victim is too large for you to wrap your arms around the waist, you should perform ________ thrusts
answer
chest
question
Choking: unresponsive adults or children
answer
-if a choking victim becomes unresponsive, send someone to activate the emergency response system
-lower the victim to the ground
-perform CPR with 1 exception: each time you open the airway to give breaths, look for the obstructing object
-if you see an object that can be easily removed, carefully remove with your fingers. Do not do a blind finger swab
question
Choking in infants
answer
3 steps
question
Step 1: choking in infants
answer
-first sit or kneel with the infant in your lap
-hold the infant facedown and resting on your forearm, with the head slightly lower than the chest
-support the head and jaw with your hand
question
Step 2: choking in infants
answer
-rest your forearm on your thigh to provide support
-deliver up to 5 back slaps forcefully between the infant's shoulder blades, using the heel of your hand
*deliver each slap with sufficient force to attempt to remove the foreign body
question
Step 3: choking in infants
answer
-place your free hand on the infant's back, supporting the head with the palm of your hand. This will cradle the infant as you turn the infant over faceup
-keep the infant's head lower than the chest, and deliver up to 5 quick downward chest thrusts
*do this at a rate of about 1 per second, each with the intention of creating enough force to dislodge the foreign body
-repeat the sequence until the object is removed or the infant becomes unresponsive
question
Relief of choking: unresponsive infant
answer
if the infant becomes unresponsive:
-shout for help and send someone to activate the emergency response system
-place the infant on a hard, flat surface
-begin CPR with 1 exception: each time you open the airway to give breaths, look for the obstructing object
-if you see an object that can be easily removed, carefully remove it with your fingers. Do not do a blind finger sweep
-if you are alone, after 2 minutes of 5 cycles of CPR, activate the emergency response system
question
When performing abdominal thrusts on adults and children, in which direction should your thrusts be directed?
answer
upward
question
What are some of the special considerations when using an AED?
answer
excessive chest hair
implanted defibrillators/pacemakers
water
transdermal medicine patches
question
How does CPR differ in an unresponsive adult choking victim?
answer
the airway is checked for the obstructing object
question
What is recommended to minimize interruptions in compressions when using an AED?
answer
-if no shock is advised and after any shock delivery, immediately resume high-quality CPR, starting with chest compressions
-when 2 or more rescuers are present, one rescuer should continue chest compressions while the other prepares the AED
-continue with high-quality CPR until an AED prompts to clear
question
You should deliver _____ back slaps and _____ chest thrusts to a choking infant who is responsive
answer
5 & 5
question
When a chocking infant becomes unresponsive, what is the one thing you need to do differently when performing CPR?
answer
check the airway for the obstructing object
question
You witnessed the collapse of a child
You are the only rescuer and do not have a mobile phone
After confirming no breathing and no pulse, what is your next step?
answer
leave the victim to activate the emergency response system and get the AED
question
What are the special considerations for defibrillation in children less than 8 years of age?
answer
-use smaller-sized pads, if available
-if child pads are not included, use adult pads
-a manual defibrillator is preferred for infants less than 1 year of age
question
What is the correct order of steps of the pediatric out-of-hospital chain of survival?
answer
1. Prevention
2. Activation of emergency response system
3. High-quality CPR
4. Advanced resuscitation
5. Post-cardiac arrest care
6. Recovery
question
What is the correct order of steps in the in-hospital chain of survival for adults?
answer
1. Early recognition and prevention
2. Activation of emergency response
3. High-quality CPR
4. Defibrillation
5. Post-cardiac arrest care
6. Recovery
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