CHAPTER 1-8 Flashcards

Question

NOTE

Answer 1

. Ensure that the person is not wet (quickly wipe dry) or in close proximity to water before using the AED. It is safe to use an AED if the person is lying in snow. If the person has an implanted device, such as a pacemaker, you will see a bulge over their chest. Place the defibrillator pads as close to the correct position as possible without being directly over the device. For persons with medication patches, remove the patch, wipe the skin dry, and apply the AED pad.

Answer 2

For children of all age groups, the compression to breaths ratio is 30:2 for one rescuer and 15:2 for two rescuers. * The depth of compression may be different. For children, compress the chest at least one-third the depth of the chest. This may be less than two inches for small children (4 -5cm) but will be approximately two inches for larger children (5 cm). * If you are the only rescuer at the scene and find an unresponsive child, perform CPR for two minutes before you call EMS or before you go look for an AED. The ILCOR emphasizes that cell phones are available everywhere now, and most have a built-in speakerphone, so you can call EMS while being with the child. * In children, primary cardiac events are not common. Cardiac arrest is most commonly preceded by respiratory problems. Survival rates improve with early intervention for respiratory problems. Remember that prevention is the first link in the Pediatric Chain of Survival. * If you witness a cardiac arrest in a child, call EMS and get an AED as you would in the Adult BLS sequence.

Answer 3

If you are alone with a child at the scene, do the following: 1. Tap and talk loudly to the child to determine if they are responsive. 2. If the child does not respond and is not breathing (or only gasping), yell for help. If someone answers, send them to call 911/EMS and to get an AED. 3. Assess for breathing while simultaneously checking for the child’s carotid pulse (on the side of the neck) or femoral pulse (on the inner thigh in the crease between their leg and groin) for 5 but no more than 10 seconds. 4. If you cannot feel a pulse (or if you are unsure), begin CPR by doing 30 compressions followed by two breaths. If you can feel a pulse but the pulse rate is less than 60 beats per minute, you should begin CPR. This rate is too slow for a child. 5. After doing CPR for about two minutes (usually about five cycles of 30 compressions and two breaths), and if other help has not arrived, call EMS while staying with the child. The ILCOR emphasizes that cell phones are available everywhere now and most have a built-in speakerphone. Get an AED if you know where one is. 6. Use and follow AED prompts when available while continuing CPR until EMS arrives or until the child’s condition normalizes.

Answer 4

If you are not alone with a child at the scene, do the following: 1. Tap and talk loudly at the child to determine if they are responsive. 2. If the child does not respond and is not breathing (or if only gasping), have the second rescuer call 911/EMS and get an AED. (The ILCOR emphasizes that cell phones are available everywhere now and most have a built-in speakerphone, so you or the second rescuer can call 911/EMS without leaving the scene). 3. Assess for breathing while simultaneously checking for the child’s carotid pulse (on the side of the neck) or femoral pulse (on the inner thigh in the crease between their leg and groin) for 5 but no more than 10 seconds. 4. If you cannot feel a pulse (or if you are unsure), begin CPR by doing 15 compressions followed by two breaths. If you can feel a pulse but the pulse rate is less than 60 beats per minute, you should begin CPR. This rate is too slow for a child 5. When the second rescuer returns, begin doing CPR by performing 15 compressions by one rescuer and two breaths by the second rescuer. 6. Use and follow AED prompts when available while continuing CPR until EMS arrives or until the child’s condition normalizes.

Answer 5

* Rate at least 100-120 compressions per minute * Compression depth to be one-third depth of the chest * Full chest recoil between compressions * Minimal interruptions during chest compressions * Do not over-ventilate

Answer 6

FIGURE 9. PAGE 20

Answer 7

If masks are available, they should be used in children as in adults; however, you must ensure the mask is the correct size for the child. The mask should cover the child’s mouth and nose without covering the eyes or chin. You will not be able to get a good seal with a mask that is too big. As with an adult, use the head-tilt/chin-lift maneuver to open the child’s airway. Each breath should last one second and should cause the child’s chest to rise. As with an adult, avoid giving breaths too quickly, as this may result in distention of the stomach, vomiting, and possible aspiration of stomach contents.

Answer 8

PROPER POSITION In the absence of neck injury, tilt the forehead back and lift the chin TIGHT SEAL Use the “E-C clamp,” which is the letters E and C formed by the fingers and thumb over the mask VENTILATE Squeeze the bag over one second until the chest rises Do not over ventilate

Answer 9

Check the pulse in the infant using the brachial artery on the inside of the upper arm between the infant’s elbow and shoulder (Figure 11a). * During CPR, compressions can be performed on an infant using two fingers (Figure 11b), if only one rescuer; or with two thumb-encircling hands (Figure 11c), if there are two rescuers and rescuer’s hands are big enough to go around the infant’s chest. * Compression depth should be one-third of the chest depth; for most infants, this is about 1.5 inches (4 cm). * If you are the only rescuer at the scene and find an unresponsive infant, perform CPR for two minutes before calling 911/EMS or using an AED. * In infants, primary cardiac events are not common. Usually, cardiac arrest will be preceded by respiratory problems. Survival rates improve when you intervene with respiratory problems as early as possible. Remember that prevention is the first step in the Pediatric Chain of Survival. * If you witness a cardiac arrest in an infant, call 911/EMS and get an AED as you would in the BLS sequence for adults or children.

Answer 10

If you are alone with the infant at the scene, do the following: 1. Tap the heel of their foot and talk loudly at the infant to determine if they are responsive. 2. Assess if they are breathing (Figure 11d) while simultaneously checking for the infant’s brachial pulse for 5 but no more than 10 seconds (Figure 11e). If the infant does not respond and is not breathing (only gasping), yell for help. 3. If someone responds, send the second rescuer to call 911/EMS and get an AED. (The ILCOR emphasizes that cell phones are available everywhere now and most have a built-in speakerphone, so rescuers do not have to leave the scene.) 4. If you cannot feel a pulse (or if you are unsure), begin CPR by doing 30 compressions followed by two breaths. If you can feel a pulse but the rate is less than 60 beats per minute, begin CPR. This rate is too slow for an infant. To perform CPR on an infant, do the following: a. Be sure the infant is face-up on a hard surface. b. Using two fingers, perform compressions in the center of the infant’s chest (Figure 11f); do not press on the end of the sternum as this can cause injury to the infant. c. Compression depth should be about 1.5 inches (4 cm) and 100-120 compressions per minute. 5. Perform CPR for about two minutes (using cycles of 30 compressions and two breaths). If help has not arrived, call 911/EMS and get an AED. 6. Use and follow AED prompts when available while continuing CPR until EMS arrives or until the infant’s condition normalizes.

Answer 11

If you are not alone with the infant at the scene, do the following: 1. Tap the bottom of their foot and talk loudly at the infant to determine if they are responsive. 2. If the infant does not respond, have the second rescuer call 911/EMS and get an AED. (The ILCOR emphasizes that cell phones are available everywhere now and most have a built-in speakerphone, so you can call while at the scene.) 3. Assess if they are breathing while simultaneously feeling for the infant’s brachial pulse for 5 but no more than 10 seconds. 4. If you cannot feel a pulse (or if you are unsure), begin CPR by doing 15 compressions followed by two breaths. If you can feel a pulse but the rate is less than 60 beats per minute, begin CPR. This rate is too slow for an infant. 5. When the second rescuer returns, begin CPR by performing 15 compressions by one rescuer and two breaths by the second rescuer. If the second rescuer can fit their hands around the infant’s chest, perform CPR using the two thumb-encircling hands method (Figure 11g). Do not press on the bottom end of the sternum as this can cause injury to the infant. 6. Compressions should be approximately 1.5 inches (4 cm) deep and at a rate of at least 100-120 per minute. 7. Use and follow AED prompts when available while continuing CPR until EMS arrives or until the infant’s condition normalizes.

Answer 12

An AED can be used on children and infants and should be used as early as possible for the best chance of improving the chance of survival. Check the AED when it arrives at the scene. Pediatric pads should be used if the person is less than eight years old or less than 55 pounds (25 kg). Standard (adult) pads may be used if pediatric pads are not available. If using standard (adult) pads, do not let the pads touch. For infants less than a year old, a manual defibrillator should be used if available. If a manual defibrillator is not available, an AED may be used. Some AEDs have a switch that can be set to deliver a pediatric shock. If available, turn the switch on when using on children younger than eight years old. If the AED cannot deliver a pediatric shock, an adult shock should be given. It is important to remember an electric shock may be the treatment for a fatal heart rhythm.

Answer 13

1. Retrieve the AED (Figure 12a). a. Open the case. b. Turn on the AED. 2. Expose the person’s chest (Figure 12b). a. If wet, dry the chest. b. Remove any medication patches. 3. Open the Pediatric AED pads (Figure 12c). a. Peel off backing. b. Check for pacemaker or implanted defibrillator. 4. Apply the pads (Figure 12d). a. Apply one pad on the upper right chest above the breast. For infants, apply on front of chest b. Apply the second pad on lower left chest below the armpit. For infants, apply second pad to back (Figure 12e). 5. Ensure wires are attached to the AED box (Figure 12f). 6. Move away from the child (Figure 12g). a. Stop CPR. b. Instruct others not to touch the person. 7. Let AED analyze the rhythm. 8. If AED message reads “Check Electrodes,” then: a. Ensure electrodes make good contact (Figure 12f). 9. If AED message reads “Shock,” then: a. Press and hold flashing shock button until shock is delivered. 10. Resume CPR for two minutes starting with chest compressions (Figure 12h). 11. Repeat steps 1-10.

Answer 14

Until an advanced airway is inserted, the rescue team should use mouth-to-mouth, mouth-to-mask, or bag-mask ventilation. An advanced airway (supraglottic airway, laryngeal mask airway, or endotracheal tube) provides a more stable way of providing breaths and should, therefore, be inserted as early as possible in a resuscitation effort.

Answer 15

The compression rate for all persons is always 100-120 per minute.

Answer 16

NO ADVANCED AIRWAY 30 compressions followed by two breaths ADVANCED AIRWAY One breath every 6 seconds without pauses in compressions

Answer 17

NO ADVANCED AIRWAY 30 compressions followed by two breaths for one rescuer 15 compressions followed by two breaths for two rescuers ADVANCED AIRWAY One breath every 6 seconds without pauses in compressions One breath every 2-3 seconds (20-30 breaths per minute)

Answer 18

When a pocket mask or bag-mask is not available, it may be necessary to give mouth-to-mouth breaths during CPR. Mouth-to-mouth breathing is very effective in delivering oxygen into the person’s lungs without putting the rescuer at a high level of risk. The rescuer’s exhaled air contains approximately 17% oxygen and 4% carbon dioxide. This is in contrast to the 100% oxygen available with ventilation with 100% high flow oxygen and the 21% oxygen that is available in room air that we breathe.

Answer 19

Do not give breaths too rapidly or too forcefully. Doing this may cause air to be forced into the stomach, resulting in distention and less room for lung expansion. It may also cause vomiting. To deliver mouth-to-mouth breaths, do the following: 1. Open the airway using the head-tilt/chin-lift maneuver (Figure 13a). 2. Pinch the person’s nose closed with your hand on the person’s head (Figure 13b). 3. Create a seal when using your lips to surround the person’s mouth (Figure 13c). 4. Blow into the person’s mouth for one full second and watch for chest to rise (Figure 13d). Tilt the victim’s head further back if the chest does not rise. 5. Give an additional breath for over one second. 6. If you cannot see the chest rise in two breaths, continue giving chest compressions.

Answer 20

When performing rescue breathing on an infant, the rescuer should cover the infant’s mouth and nose when possible and do the following: 1. Open the airway using the head-tilt/chin-lift maneuver (Figure 14a). Be sure not to hyper-extend the neck. Aim for a neutral position. 2. Create a seal using your lips to surround the infant’s nose and mouth (Figure 14b). 3. Gently blow into the infant’s nose and mouth for one second(Figure 14c). Keep in mind that an infant’s lungs are smaller than an adult’s and need a smaller volume of air. Watch for the infant’s chest to rise. If you cannot see the chest rise, re-adjust the tilt of their head. 4. Give an additional breath and watch for the infant’s chest to rise. If unable to cover both mouth and nose entirely with your mouth, use the following method for rescue breathing: a. Open the airway using the head-tilt/chin-lift maneuver. b. Pinch the infant’s nose closed. c. Create a seal using your lips to surround the infant’s mouth. d. Gently blow into the infant’s mouth for one second. e. Give an additional breath and watch for the chest to rise.

Answer 21

In many cases, cardiac arrest is preceded by respiratory arrest. Therefore, it is important to be able to recognize respiratory issues in order to take steps to prevent cardiac arrest. When a person of any age has a pulse but is not breathing (or is not breathing well), immediately open the airway using the head-tilt/chin-lift maneuver and begin rescue breathing. See Table 2 for details on rescue breathing.

Answer 22

HOW OFTEN Every 6 seconds BREATHS PER MINUTE 10 to 12 breaths per minute DURATION Each breath should last one second EVALUATION Check for chest rise and breathing; Check pulse and begin CPR if necessary

Answer 23

HOW OFTEN One rescuer: Every 6 seconds Two rescuers: Every 2 to 3 seconds BREATHS PER MINUTE One rescuer: 10 to 12 breaths per minute Two rescuers: 20 to 30 breaths per minute DURATION Each breath should last one second EVALUATION Check for chest rise and breathing; Check pulse and begin CPR if necessary

Answer 24

PERSON’S RESPONSE * breathing but may also be wheezing * coughing and making noise RESCUER’S ACTION * stay with the person and try to keep them calm * encourage them to cough * call 911/EMS if the person seems to be getting worse

Answer 25

PERSON’S RESPONSE * clutching the neck (universal sign of choking: figure 15) * weak or no cough * unable to make noise or talk; may make high-pitched noise * little or no breathing * may be cyanotic (blue around lips and fingertips) RESCUER’S ACTION * use abdominal thrusts to attempt to remove obstruction * call 911/EMS * begin BLS if the person becomes unresponsive

Answer 26

If you can see a foreign object in the individual’s mouth and can easily remove it, then do it. Watch and feel for breathing to begin. If the individual does not begin breathing, continue to provide CPR and rescue breaths until help arrives.

Answer 27

These steps should only be used when a person is responsive and older than one year of age. To properly perform abdominal thrusts, do the following: 1. Stand behind the responsive person. Wrap your arms around their waist under their ribcage. 2. Put the side of your fist above the person’s navel in the middle of their belly. Do not press on the lower part of the sternum (Figure 16a). 3. With your other hand, hold the first fist and press forcefully into the person’s abdomen and up toward their chest (Figure 16b and 16c). 4. Continue performing these thrusts until the obstruction is relieved or until the person becomes unresponsive.

Answer 28

INFANT’S RESPONSE * breathing but may also be wheezing * may be coughing and making noise RESCUER’S ACTION * stay with the infant and try to keep them calm * do not do a blind finger sweep * call 911/EMS if infant does not quickly clear the obstruction

Answer 29

INFANT’S RESPONSE * weak or no cough * unable to make noise; may make high-pitched noise * little or no breathing * may be cyanotic (blue around lips and fingertips) RESCUER’S ACTION * use back blows/chest thrusts to attempt to remove obstruction * call 911/EMS * begin BLS if infant becomes unresponsive * assess if obstruction is visible; if so, remove it

Answer 30

In a choking but responsive infant less than one-year-old, back blows and chest thrusts are used instead of abdominal thrusts. See Table 4 for rescue actions for choking in infants. To provide back blows and chest thrusts, do the following: 1. Hold the infant in your lap. 2. Put the infant with their face down and their head lower than their chest; they should be resting on your forearm. Put your forearm on your thigh (Figure 17a). 3. Support the infant’s head and neck with your hand and be sure to avoid putting pressure on their throat. 4. Using the heel of your free hand, deliver five back blows between the infant’s shoulder blades (Figure 17b). 5. Using both hands and arms, turn the infant face up so they are now resting on your other arm; this arm should now be resting on your thigh (Figure 17c). 6. Make sure the infant’s head is lower than their chest. 7. Using the fingers of your free hand, provide up to five quick downward chest thrusts over the lower half of the breastbone (Figure 17d). Perform one thrust every second. 8. If the obstruction is not relieved, turn the infant face down on your other forearm and repeat the process (Figure 17b). 9. Continue doing these steps until the infant begins to breathe or becomes unresponsive.

CHAPTER 1-8 Flashcards

(55 cards)