High performance CPR

Question 1

When would you use the Paed defib pads

Answer 1

< 25 kg or upto and including 8yo

Question 2

When would you use adult non CPR feedback defib pads

Answer 2

Patients presenting with a STEMI or requiring cardioversion

Question 3

when checking the defib what are you checking

Answer 3

Check for and replace
- Damaged cables
- Dry Pads
- Expired or damaged pads
- Replace battery if RFU is flashing or ⌀ is showing

Question 4

What safety conditions prohibit Defib use

Answer 4

• Highly flammable environment or O2 concentrated area
• Patient in water
• patient on metal

Question 5

What patient preparations need to happen prior to Defib

Answer 5

• Clipper (dont shave) chest
• Dry chest with towel (dont use alcohol or betadine)

Question 6

SGA sizes

Answer 6

1. 2-5 kg
   1.5. 5 -12 kg
2. 10 - 25 kg
   2.5. 25 - 35 kg
3. 30 - 60 kg
4. 50 - 90 kg
5. 90+ kg

Question 7

ECG dot locations

Answer 7

4 limb leads RA RL LA LL
Chest leads
- V1 4th ICS right sternal margin
- V2 4th ICS left sternal margin
- V3 between V2 and V4
- V4 5th ICS mid clavicular line
- V5 5th ICS anterior auxillary line
- V6 5th ICS mid auxillary line

Question 8

KJ per KG fpr Paed patient

Answer 8

4 joules per KG
- Weight is age x2 plus 8 (0-11yo)
- 10 - 11 is age x 3.3 ie 33 x 4 = 132 so round up to 150
- 12 - 15 yo 200 joules (as per table) likely over 150 so round up

Question 9

KJ for adult patient

Answer 9

200 kj

Question 10

Adult Pad placement

Answer 10

• The ‘Apex’ pad is placed on the left, at the mid-axillary line, 6th intercostal space
• The ‘Sternal’ pad is rolled on laterally from right sternal margin on the patient’s right chest, under the right clavicle
  and above the right nipple

Question 11

Paediatric Pad placement

Answer 11

• The ‘anterior’ pad is placed on the left side, mid- axillary line (same as adult placement)
• The ‘posterior’ pad is placed on the right upper chest/clavicle (same as adult placement)

Question 12

Considerations for pad placement

Answer 12

Do not place defibrillation pads over GTN patches, GTN paste, implanted pacemakers or ECG electrodes and/or
cables.
* Avoid skin pigmentations and nipples to prevent burns.
* Avoid skin folds to prevent electrical arcing.
* Do not allow contact between the defibrillation pads and/or ECG electrodes or cables.
* Do not perform chest compressions over the defibrillation pads or wires (note: this does not include the CPR feedback device).
* Do not defibrillate if the defibrillation pads are not properly adhering to the patient

Question 13

ECG recognition requirements for AV

Answer 13

• Ventricular rate
• Ventricular rhythm
• P waves
• PR interval
• QRS duration

Question 14

Normal sinus rhythm criteria

Answer 14

-Ventricular rate: 60 – 100
- Ventricular rhythm: Regular
- P waves: Present and associated with each QRS
- PR interval: 0.12 - 0.2 seconds
- QRS duration: < 0.12 seconds

Question 15

VF criteria

Answer 15

-Ventricular rate: Nil discernible
- QRS duration: Nil discernible
- Ventricular rhythm: Bizarre, chaotic, amplitude > 0.1mV
- P waves: Nil discernible
- PR interval: Nil discernible

Question 16

VT criteria

Answer 16

-Ventricular rate: Greater than 100
- Ventricular rhythm: Regular
- P waves: Not associated or nil discernible
- PR interval: Nil discernible
- QRS duration: > 0.12 seconds

Question 17

Asystole criteria

Answer 17

• Ventricular rate: Nil discernible
• Ventricular rhythm: No electrical activity, flat isoelectric line, amplitude ≤ 0.1mV
• P waves: Nil discernible
• PR interval: Nil discernible
• QRS duration: Nil discernible

Question 18

ECG small square value

Answer 18

-1 small square = 0.04 seconds
- 2 small squares = 0.08 seconds
- 3 small squares = 0.12 seconds
- 4 small squares = 0.16 seconds
- 5 small squares = 0.2 seconds (= 1 large square)

Question 19

ECG large square values

Answer 19

-1 large square = 0.2 seconds
- 2 large squares = 0.4 seconds
- 3 large squares = 0.6 seconds
- 4 large squares = 0.8 seconds
- 5 large squares = 1 second

Question 20

CPR ratios

Answer 20

ADULT
30:2 if no ETT or SGA
15:1 if ETT or SGA present
PAEDIATRIC
15:2 if 2 responders 30:2 single responder
NEONATE
HR <60 3:1 with O2
HR 60-100 ventilate 40-60/min