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A victim with a foreign body airway obstruction becomes unresponsive. What is your first course of action? Start CPR beginning with chest compressions When performing CPR on an unresponsive choking victim, what modification should you incorporate? Each time you open the airway, look for the obstructing object An infant is responsive and choking with a severe airway obstruction. How do you relieve the airway obstruction? Give 5 back slaps and 5 chest thrusts Which action would you perform to relieve choking in an unresponsive infant? Perform CPR and look in the mouth for obstructing object After the AED pads are attached to the victim's chest, the AED detects ventricular fibrillation. What is the next step when using an AED? Follow the AED prompts What ratio for compressions to breaths should be used for 1-rescuer infant CPR? 2-rescuer CPR? 30:2 and 15: In a team CPR approach, knowing your boundaries and asking for help before a resuscitation attempt worsens is an example of knowing and understanding your limitations. What are demonstrated when all team members know their positions, functions, and tasks during a resuscitation attempt?
Clear roles and responsibilities When an AED arrives, what is the first step? Turn it on What should you do if you need to use an AED on a wet victim? What are other considerations when you use an AED? Dry them off first then apply the pads; if hairy, shave the hair to get them to stick 2-Rescuers begin CPR and the 3rd leaves to get an AED. When do the 2-rescuers switch roles? Every two minutes or 5 cycles Why is defibrillation important? To restore a normal cardiac rhythm In an adult, chest compressions should be how deep (in inches and cm's)? 2 inches, 5 cm You see your friend, Annie, collapse. Annie is unresponsive and gasping but does not have a pulse. What should you do? Start CPR Why is it important to allow the chest to recoil between compressions? So the heart will adequately refill between compressions What is the correct chain of survival for an adult? recognition & activation, CPR, defibrillation, advanced life support & post-cardiac arrest care How does the chain of survival differ from adult to child? prevention, CPR, activation, advanced life support, post-cardiac arrest care
Knowing your Limitations A victim with a foreign-body airway obstruction becomes unresponsive. What is the first course of action? Start CPR, beginning with chest compressions Why is defibrillation important? It can restore a regular cardia rhythm You witness someone suddenly collapse. The person is unresponsive, you hear gasping sounds, and there is no pulse, What do you do? Begin CPR, the gasps are NOT normal breathing You and a friend see a middle aged man collapse. No breath, no pulse, and is not breathing. What should you do that will have a positive impact on survival? Perform High quality CPR You and a friend begin CPR. The chest compressions rate is slowing. What should you say for feedback? You need to compress at a rate of 100 to 120 per minute How do you perform chest compressions when providing high quality CPR to a child victim? By compressing the chest at least on third the depth of the chest, about 2 inches When performing CPR on an unresponsive choking victim, what modification should you incorporate? Each time you open the airway, look for the obstructing object An 8 month old is eating. Suddenly the baby start to cough and choke. You assess the baby. The baby has a pulse and is breathing. How do you relieve the obstructive airway
Give 5 sets of back slaps and 5 chest thrusts What action do you perform on the baby that was choking if the baby is unresponsive? Perform CPR, and look in the mouth for the obstructing object Which victim requires high quality CPR? A victim that is unresponsive, no pulse, and not breathing For the team to function smoothly each team member must know their positon and function. What is this team element called? Clear roles and responsibilities Why is allowing complete chest recoil important when performing CPR? The heart will adequately refill between compressions How often should rescuers switch during CPR? Every 2 minutes You see a person doing chest compression inappropriately. What do you say to this person? That you are noticing a decreased chest recoil Rapid Defibrillation is a link in the adult chain of survival. Why? It eliminates the abnormal heart rhythm To avoid fatigue, when should team roles alternate providing compressions? every 5 cycles or 2 minutes Which team role keeps track of interruptions in compressions? timer/recorder Which team role makes treatment decisions and assigns roles? team leader
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? closed-loop communication 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? constructive intervention 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? debriefing AED special considerations hairy chest, water, transdermal medicine patch, implanted defibrillator or pacemaker, defibrillation for infants less than 1 year of age Hairy chest -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
Water -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 Transdermal medicine patch -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 Implanted defibrillator or pacemaker -if you see a lump indicating a device, avoid placing the pad directly over it Defibrillation for infants less than 1 year of age -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 What are examples of effective team dynamics? clear roles and responsibilities debriefing constructive intervention knowledge sharing always take the lead What does a chest compression feedback device monitor? compression rate compression depth chest recoil
Mouth-to-mouth-and-nose breathing: infants 3 steps Step 1: mouth-to-mouth-and-nose breathing: infants open the infant's airway with a head tilt-chin lift Step 2: mouth-to-mouth-and-nose breathing: infants place your mouth over the infant's mouth and nose to create an airtight seal Step 3: mouth-to-mouth-and-nose breathing: infants give one breath, blowing for about 1 second. Watch for the chest to rise as you give the breath What is a correct approach for AED pad placement for infants and children less than 8 years of age? as indicated on the pad packages What is the indication for mouth-to-mouth rescue breaths? when a barrier device is not available Rescue breathing: adults -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 Rescue breathing: children/infants -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 When providing rescue breaths to a child or infant victim, you should give 1 breath every _______ to _______ seconds
2 to 3 Advanced airways -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 When an advanced airway is in place, chest compressions should be provided at a rate of ______ to ______ per minute 100 to 120 With an advanced airway in place, rescue breaths should be given at a rate of ______ breath(s) every ______ second(s) for adults 1 & 6 How can you achieve a high chest compression fraction? minimize pauses in chest compressions Opioid-associated life-threatening emergency -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:
-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 Signs of choking: adults and children -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 What are common administration routes for naloxone? intramuscular intranasal intravenous Abdominal thrusts: adults and children 3 steps Step 1: abdominal thrusts: adults and children stand or kneel behind the victim and place your arms around the victim's waist; with one hand, locate the navel. Step 2: abdominal thrusts: adults and children 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 Step 3: abdominal thrusts: adults and children -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 Choking in obese and pregnant victims 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 When providing rescue breaths to an adult victim, you should give _____ breath(s) every _____ seconds 1 & 6 What is a sign of severe airway obstruction? inability to speak When providing rescue breaths to a child or infant victim, you should give 1 breath every _____ to _____ seconds 2 to 3 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? begin chest compressions If a choking victim is too large for you to wrap your arms around the waist, you should perform ________ thrusts chest Choking: unresponsive adults or children -if a choking victim becomes unresponsive, send someone to activate the emergency response system
-repeat the sequence until the object is removed or the infant becomes unresponsive Relief of choking: unresponsive infant 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 When performing abdominal thrusts on adults and children, in which direction should your thrusts be directed? upward What are some of the special considerations when using an AED? excessive chest hair implanted defibrillators/pacemakers water transdermal medicine patches How does CPR differ in an unresponsive adult choking victim? the airway is checked for the obstructing object What is recommended to minimize interruptions in compressions when using an AED?
-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 You should deliver _____ back slaps and _____ chest thrusts to a choking infant who is responsive 5 & 5 When a chocking infant becomes unresponsive, what is the one thing you need to do differently when performing CPR? check the airway for the obstructing object 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? leave the victim to activate the emergency response system and get the AED What are the special considerations for defibrillation in children less than 8 years of age? -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 What is the correct order of steps of the pediatric out-of-hospital chain of survival?
- Prevention
- Activation of emergency response system
- High-quality CPR
- Advanced resuscitation
You have an unconscious choking victim and 911 has been called. You just gave 30 compressions, what should you do next? check the mouth for an object You see someone who is standing at a restaurant near his table looking panicked. He appears to be gagging but not making any sound. The scene is safe and you move towards the victim, what do you do next? ask if he is choking to see if he can respond verbally What is the best way to stop an arterial bleed when there is no object in the wound? apply direct pressure to the laceration When is a head injury an automatic 911 call? when the victim is unconscious at any point What is the best pad placement on an adult when using an AED? place one pad on the upper right side of the chest and the other on the left lower outer chest wall below the left breast, centered on the middle of the arm pit
