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AHA BLS REAL EXAM WITH ACTUAL QUESTION AND ANSWERS LATEST 2024 A GRADE. In which locations do most out-of-hospital cardiac arrests occur? a. healthcare clinics b. homes c. recreational facilities d. shopping centers - ANSWER- b. homes Which is the most common cause of cardiac arrest in children? a. cardiac problem b. congenital or acquired heart defect c. respiratory failure or shock d. infection and sepsis - ANSWER- c. respiratory failure or shock Which statement best describes sudden cardiac arrest? a. when respiratory distress in adults occurs and the heart rate does not change b. when the heart rate is 40 - 60/min and respirations increase c. when the blood flow to the heart is blocked and the heart rate increases d. when an abnormal rhythm develops and the heart stops beating unexpectedly - ANSWER- d. when an abnormal rhythm develops and the heart stops beating unexpectedly What are the 3 main components of CPR - ANSWER- 1) compressions 2) airway 3) breathing What are 6 steps of the adult cardiac arrest algorithm? - ANSWER- 1) verify scene safety/note time if possible 2) assess responsiveness (tap shoulder and shout "ARE YOU OKAY?" Not okay? [1] shout for help [2] activate ems via cell phone if appropriate [3] get AED/emergency equipment/Narcan (or send someone to do so) 3) look for breathing or only gasping [scan the victims chest for rise/fall] and check pulse (simultaneously). Is pulse definitely felt within 10 seconds? Yes = monitor person until emergency responders arrive No breathing but + pulse = provide rescue breathing with 1 breath every 5 - 6 seconds (total 10 - 12 breaths per minute). Consider triad of opioid OD (1. ask bystanders if know what happened 2) look for track marks 3) look for pill bottles, needles, etc.) Continue rescue breathing doing this while checking for a pulse about every 2 minutes. If not pulse, start CPR. If possible opioid OD, give Narcan No breathing/just gasping & no definitive pulse (after checking for 5 - 10 seconds) = start CPR (step # 4) **By this time in all scenarios, 1) EMS or backup is activated & 2) AED/emergency equipment/Narcan have been retrieved or someone is retrieving them - CONFIRM THESE 2 THINGS HAVE BEEN DONE 4) CPR should begin within 10 seconds of checking for responsiveness/breathing/pulse. Quickly remove clothing for proper hand placement and placement of AED pads. Patient should be on a firm surface (floor/board). Begin cycles of 30 compressions and 2 breaths. Turn on and follow the prompts of AED as soon as it arrives. 5) AED arrives. Turn it on and follow prompts. 6) AED will say whether the rhythm is shockable. SWITCH ROLES IF 2 RESCUERS ARE PRESENT 3) feel for at least 5 but no more than 10 seconds. If you don't definitely feel a pulse, begin CPR, starting with chest compressions (do a 30:2 ratio) What age of people should get the 30:2 ratio of CPR with SINGLE rescuers? - ANSWER- Victims of any age. Should you move the victim during chest compressions? - ANSWER- Do not move the victim while CPR is in progress unless the victim is in a dangerous env't (ie., burning building) or if believe you can't perform CPR effectively in the victim's present position or location. ALS providers may elect to move the patient while CPR is in progress. Where should you place your hand for adult CPR? - ANSWER- Put the heels of each hands in the center of the victim's chest, on the lower half of the sternum. In terms of direct patient care, how can three rescuers be utilized before the AED arrives? - ANSWER- 1) first person does CPR 2) second person holds open the airway 3) third person delivers breaths **During CPR, jaw thrust and bag-mask ventilation are more efficiently performed when 2 or more rescuers are providing ventilation. Do face shields provide the same level of infection risk as pocket masks? - ANSWER- No, rescuers should replace face shields with a pocket mask at the first opportunity. What is the percent of inhaled oxygen content and exhaled oxygen content in the air we breathe? Why is this relevant? - ANSWER- The air we breathe contains about 21% oxygen. The air we breathe out contains about 17% oxygen. Because we use a relatively small amount of the oxygen we breathe, the air that the rescuer breathes out provides the victim with much needed oxygen. Fun fact: how many cycles of CPR (30:2) occurs ~ every 2 minutes (between rhythm checks of the AED? - ANSWER- ~5 cycles of CPR (30:2) If rescuers have to switch roles more often than with the ~ every 2 minute checks from the AED, how long should it take for the rescuers to assume each other's roles? - ANSWER- Less than 5 seconds A 53 yo man suddenly collapses and becomes unresponsive. You witness him collapse and are the first rescuer to arrive at the scene. You find him lying motionless on the floor. What is the first action you should take in this situation? a. activate the ems b. start high-quality CPR, beginning with chest compressions c. start providing rescue breaths d. verify the scene is safe for you and the victim (while trying to make a mental note of the time) - ANSWER- d. verify the scene is safe for you and the victim (while trying to make a mental note of the time) A 53 yo man suddenly collapses and becomes unresponsive. You witness him collapse and are the first rescuer to arrive at the scene. You find him lying motionless on the floor. The man doesn't respond when you touch his shoulders and shout, "ARE YOU OKAY?" What is your best next action? A 53 yo man suddenly collapses and becomes unresponsive. You witness him collapse and are the first rescuer to arrive at the scene. You find him lying motionless on the floor. What are the rate and depth for chest compressions on an adult? a. 60-80 compressions/minute with depth of 1 inch b. 80-100 compressions/minute with depth of 1.5 inches c. 120-140 compressions/minute with depth of 2.5 inches d. 100-120 compressions/minute with depth of 2 inches - ANSWER- d. 100-120 compressions/minute with depth of 2 inches A 53 yo man suddenly collapses and becomes unresponsive. You witness him collapse and are the first rescuer to arrive at the scene. You find him lying motionless on the floor. What action should you take with more rescuers arrive? a. assign tasks to other rescuers and rotate compressors every 2 minutes or more frequently if needed to avoid fatigue b. continue CPR while the AED is attached even if you are fatigued c. wait for the most experienced rescuer to provide direction to the team d. direct the team to assign a team leader and roles while you continue CPR - ANSWER- a. assign tasks to other rescuers and rotate compressors every 2 minutes or more frequently if needed to avoid fatigue A 53 yo man suddenly collapses and becomes unresponsive. You witness him collapse and are the first rescuer to arrive at the scene. You find him lying motionless on the floor. If you suspect that an unresponsive victim has head or neck trauma, what is the preferred method for opening the airway? a. head tilt-chin lift b. jaw thrust c. head tilt-neck lift d. avoid opening the airway - ANSWER- b. jaw thrust Where can you sometimes find a barrier breathing device? - ANSWER- With the AED What are two ways AEDs may be turned on (dependent on the manufacturer)? - ANSWER- 1) some need to be manually turned on 2) some automatically turn on when the lid is opened When should adult pads be used with the AED? - ANSWER- 8 years old or older Should you give rescue breaths when the AED is analyzing? - ANSWER- no Anatomically discuss proper AED pad placement. - ANSWER- 1) Directly below the right collarbone 2) Top edge a few inches below the armpit If you AED only has child pads, should you use them on an adult (greater than 8 years old)? - ANSWER- No. The shock dose delivered by child pads will be too small for an adult and likely be unsuccessful. It's better to provide high-quality CPR than to attempt to shock an adult victim with child pads. a. Power on the AED b. Apply the pads c. Press the the analyze button d. Press the shock button - ANSWER- a. Power on the AED Which step is one of the universal steps for operating an AED? a. placing the pads on the victim's bare chest b. shaving the victim's hairy chest c. removing the victim from water d. finding the victim's implanted pacemaker - ANSWER- a. placing the pads on the victim's bare chest If a victim of cardiac arrest has an AICD or pacemaker, what special steps should be taken? a. avoid placing the AED pad directly over the implanted device b. avoid using the AED to prevent damage to the implanted device c. turn off the implanted device before applying the AED pads d. consider using pediatric pads to decrease the shock dose delivered - ANSWER- a. avoid placing the AED pad directly over the implanted device What action should you take when the AED is analyzing the heart rhythm? a. check the pulse b. continue chest compressions c. give rescue breaths only d. stand clear of the victim - ANSWER- d. stand clear of the victim After performing high-quality CPR for 5 minutes, the team leader frequently interrupts chest compressions to check for a pulse even though the victim has no organized rhythm when the AED analyzed the rhythm. Which action demonstrates constructive intervention? a. ask another rescuer what he thinks should be done b. say nothing that contradicts the the team leader c. suggest to resume chest compressions without delay d. wait until the debriefing sessions afterward to discuss it - ANSWER- c. suggest to resume chest compressions without delay The team leader asks you to perform bag-mask ventilation during a resuscitation attempt, but you have not perfected that skill. What would be an appropriate action to acknowledge your limitations? a. pick up the bag-mask device and give it to another team member b. pretend you did not hear the request and hope the team leader chooses someone else to do it c. tell the team leader you are not comfortable with that task d. try to do it as best you can and hope another team member will see you struggling and take over - ANSWER- c. tell the team leader you are not comfortable with that task What is the appropriate action to demonstrate closed-loop communication when the team leader assigns you a task? a. repeat back to the team leader the task you were assigned b. nod your head as an acknowledgment of the assigned task c. start performing the assigned tasks, but do not speak, to minimize noise d. wait for the team leader to address you by name before acknowledging the task - ANSWER- a. repeat back to the team leader the task you were assigned 4) Was this a witnessed sudden collapse? Yes = Activate EMS (if not already done) and get the AED/emergency equipment No = Quickly remove clothing for proper hand placement and placement of AED pads. Patient should be on a firm surface (floor/board). Start CPR at a 30:2 ratio for 1 rescuer. Use a 15:2 ratio for 2 rescuers. Turn on and follow the prompts of AED as soon as it arrives. 5) After about 2 minutes, if still alone, activate EMS/retrieve AED/emergency equipment/Narcan (if not already done) 6) Turn on the AED and listen for the prompts. AED will say whether the rhythm is shockable. SWITCH ROLES IF 2 RESCUERS ARE PRESENT Yes = Give | shock and follow AED instructions (resume CPR immediately for ~ 2 minutes, until prompted by the AED to do another rhythm check). Continue this cycle until patient becomes responsive or the victim starts to to breathe, move or otherwise react No = Resume CPR immediately for ~ 2 minutes, until prompted by the AED to do another rhythm check. Continue until ALS providers take over or until patient starts to breathe, move or otherwise react What are signs of poor perfusion in a child (6)? - ANSWER- 1) cool extremities 2) cyanosis 3) decreased responsiveness 4) mottling 5) paleness 6) weak pulses How do you assess responsiveness in an adult, child and an infant? - ANSWER- adult = tap shoulder child = tap shoulder infant = tap heel Where should you check for the pulse in an adult? Child? Infant? - ANSWER- Adult = carotid Child = carotid or femoral Infant = brachial T or F? It can be difficult for BLS providers to determine the presence or absence of a pulse in any victim, particularly in an infant or child. So if you do not definitely feel a pulse within 10 seconds, start CPR, beginning with chest compressions. - ANSWER- True How do you check for a brachial pulse? - ANSWER- Place 2 or 3 fingers on the inside of the upper arm, midway between the infant's elbow and shoulder. Then press the fingers to attempt to feel the pulse for at least 5 but no more than 10 seconds. What is the compression technique for adults, children and infants? - ANSWER- adults = two hand on the bottom half of the sternum children = | - 2 hands on the sternum infants = 2-finger chest compressions (one rescuer) 2 thumb-encircling hands technique (more than one rescuer) What is the rate of compressions for adults, children and infants? - ANSWER- The UNIVERSAL rate for all in cardiac arrest is 100 - 120 bpm. oxygen to the heart and brain. In contrast, infants and children often have respiratory failure or shock BEFORE a cardiac arrest which reduces the oxygen content of the blood. Chest compressions for children and infants won't be adequate by themselves. Rescue breathing must happen in addition to chest compressions for CPR to be effective. What is the correct compression-to-ventilation ratio for a single rescuer of a 3-year-old child? a. 15:1 b. 15:2 c. 20:2 d. 30:2 - ANSWER- d. 30:2 What is the correct compression-to-ventilation ratio for a 7 yo when 2 or more rescuers are present? a. 15:1 b. 15:2 c. 20:2 d. 30:2 - ANSWER- b. 15:2 For what age victim is the 2 thumb-encircling hands technique recommended when 2 or more rescuers are present? a. a child less than 3 yo b. a child older than 3 yo c. an infant older than 1 yo d. an infant younger than 1 yo - ANSWER- d. an infant younger than 1 yo What is the correct chest compression depth for a child? a. at least 1/4 the depth of the chest, or about | inch b. at least 1/3 the depth of the chest, or about 1.5 inches c. at least 1/3 the depth of the chest, or about 2 inches d. at least 1/2 the depth of the chest, or about 3 inches - ANSWER- c. at least 1/3 the depth of the chest, or about 2 inches What is the correct chest compression depth for an infant? . at least 1/4 the depth of the chest, or about 1 inch . at least 1/3 the depth of the chest, or about 1.5 inches . at least 1/3 the depth of the chest, or about 2 inches . at least 1/2 the depth of the chest, or about 2.5 inches - ANSWER- b. at least 1/3 the depth of the chest, or about 1.5 inches aodape How do AEDs know to deliver an adult dose or peds dose? - ANSWER- If the AED is adult and child compatible, it will deliver the dose based on whether adult pads or children pads are used. Sometimes the AED has a key or switch that will deliver a child shock dose. If so turn that switch on. The AED shock dose may also be reduced by pediatric cables, an attenuator or preprogramming in the device. One commonly used method for reducing a shock dose is a pediatric dose attenuator. When attached to an AED, it reduces the shock dose by about 2/3. Can child AED pads be used on a pulseless infant? - ANSWER- Yes (make sure the pads don't touch or overlap) AED pads if the AED doesn't have child pads If a manual defibrillator is not available for an infant victim, which action should you take? a. perform high-quality CPR b. use an AED equipped with a pediatric dose attenuator c. use an AED without a pediatric dose attenuator d. wait for advanced care to arrive - ANSWER- b. use an AED equipped with a pediatric dose attenuator What is important to remember about AED pad placement on infants? a. ensure that pads overlap each other in very small infants b. place 1 adult pad on the chest c. you may need to place | pad on the chest and | pad on the back, according to the diagram on the pads d. if child AED pads aren't available, don't use the AED - ANSWER- c. you may need to place | pad on the chest and | pad on the back, according to the diagram on the pads What is the compression-to-breath ratio in BLS with an advanced airway in place? - ANSWER- Continuous compressions 1 breath every 6 seconds (10 breaths per minute) for adults, children and infants What should you do if you can't ventilate a patient after 2 attempts (repeating the head tilt-chin lift in-between)? - ANSWER- Return to chest compressions What basic ventilation strategy is preferred in infants (ie., no airway device available)? - ANSWER- mouth-to-mouth-and-nose However, if you can't cover the infant's nose and mouth with your mouth, use the mouth-to-mouth technique instead What are two methods to decrease the risk of gastric inflation? - ANSWER- 1) deliver each breath just over 1 second 2) deliver just enough air to make the victim's chest rise Which victim would need only rescue breathing? a. agonal gasping with no pulse b. breathing with a weak pulse c. no breathing and a pulse d. no breathing and no pulse - ANSWER- c. no breathing and a pulse How often should rescue breaths be given in infants and children when a pulse is present? a. | breath every 2 - 3 seconds b. 1 breath every 3 - 5 seconds c. | breath every 5 - 6 seconds d. 1 breath every 8 - 10 seconds - ANSWER- b. | breath every 3 - 5 seconds Which action can rescuers perform to potentially reduce the risk of gastric inflation? a. delivering each breath over 1 second b. giving rapid, shallow breaths c. using a bag-mask device for delivering ventilation d. using the mouth-to-mask breathing technique - ANSWER- a. delivering each breath over 1 second 
