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45 Cards in this Set

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  • Back
List the first 3 links in the adult "Chain of Survival" for lay persons:
-immediate recognition of sudden cardiac arrest and activation of the emergency response system
-early CPR
-rapid defibrillation
List the first 5 links in the adult "Chain of Survival" for HCPs:
-immediate recognition of sudden cardiac arrest and activation of the emergency response system
-early CPR
-rapid defibrillation
-effective ACLS
-integrated post-cardiac arrest care
When implemented effectively, survival rates can approach ____ % following witnessed out-of-hospital VF arrest:
50%
What neuro problem is sometimes the first manifestation of cardiac arrest?
brief generalized seizures
First and second steps after a lone rescuer finds an unresponsive adult:
1. ensure the scene is safe
2. check for response by tapping the victim on the shoulder and shouting at the victim
When should you assume an unresponsive adult has had a cardiac arrest? Pulse check needed?
-if the victim has absent or abnormal breathing (gasping or agonal breathing only)
-no pulse check needed for lay rescuer
-HCP should take no more than 10 seconds to check for a pulse
Which two main organs does CPR produce blood flow for?
heart and brain
Adult chest compression rate and depth:
at least 100 bpm and at least 2 inches with full recoil (allows heart to fill)
What is the recommended ratio of chest compressions to ventillations for HCPs rescuing an adult?
30:2
Recommendations for rescue breaths:
-deliver breath over 1 second
-sufficient air for visible chest rise
Should a lone rescuer perform the first round of chest compressions or get the AED?
-activate emergency response and get AED
-unless it is a witnessed adult victim of drowning or foreign body obstruction (5 cycles of compressions then activate emergency response)
Once an advanced airway is placed, what is the correct ventilation rate?
1 breath every 6-8 seconds (8-10 per minute); avoid excess ventilation
How do you treat an unresponsive adult with no breathing but with a pulse?
-give one breath every 5-6 seconds
-recheck pulse in 2 minutes
What do you do if you have an AED but the rhythm is not shockable?
resume CPR immediately, recheck rhythm every 2 minutes and repeat cycle
What do you do if you have an AED and the rhythm is shockable?
give 1 shock and resume CPR immediately for 2 minutes
A victim with occasional gasps should be treated as breathing or not breathing?
not breathing
List some tips for maximizing effectiveness of chest compressions:
-place the victim on a firm surface (backboard, deflate air mattresses) when possible in a supine position
Describe proper hand positioning for chest compressions:
-place the heel of one hand on the center of the victim's chest and the heel of the other on top of the first
Outcomes improve when ##-## chest compressions are delivered per minute.
68-120
How often should lay rescuers interrupt chest compressions to check for a pulse or ROSC?
never
In what situations is CPR with rescue breaths recommended over hands-only CPR?
-pediatric arrests (other than sudden, witnessed collapse of adolescents)
-asphyxial cardiac arrests in adults and children (drowning, drug overdose)
-prolonged cardiac arrests
Should a hands-only rescuer position the neck in a certain way?
No evidence to recommend any specific passive airway (e.g. hyperextension)
When should HCPs use the head tilt-chin lift maneuver?
always, unless head or neck trauma
When should spinal injury be suspected?
-blunt trauma (0.12-3.7% of victims)
-craniofacial injury
-Glasgow Coma Scale score of <8
How should HCPs open a victim's airway if cervical spine injury is suspected?
jaw thrust without head extension
-keep in mind that head tilt-chin lift may be necessary (even with ? spine injury) if patient needs it for an open airway
What are the consequences of excessive ventilation?
-regurgitation
-aspiration
-increases intrathoracic pressure
-decreases venous return to the heart
-diminishes cardiac output and survival
Steps for mouth-to-mouth breathing:
-open the airway
-pinch the victim's nose
-create an airtight seal
-give 1 breath over 1 second
-take a regular breath (to prevent dizziness and overinflation)
-give a second rescue breath over 1 second
List two other ventilation options (not advanced airways) besides the mouth:
-nose
-tracheal stoma
When should cricoid pressure be applied?
-no evidence to support use
-can be used to help visulaize vocal cords during intubation
Describe the recovery position for unresponsive but breathing and circulating adults:
lay victim on their side with the lower arm in front of the body
Describe the classic symptoms associated with ACS:
-chest discomfort
-discomfort in other areas of the body
-shortness of breath
-sweating
-nausea
-lightheadedness

-sx typically last more than 15 minutes
In whom are atypical sx of cardiac arrest most common?
-women
-elderly
-diabetics
In which ACS patients is aspirin not recommended?
-aspirin allergy
-recent GI bleeding
When should oxygen be given to an ACS patient?
-dyspneic
-hypoxemic
-obvious signs of heart failure
-O2sat <94%

-give lowest amount needed to get O2 above 94%
When are nitrates contraindicated in an ACS patient?
-SBP < 90 or >30 below baseline in patients with right bentricular infarction
-known ingestion of PDE-5 in last 24 hours (48 hours for Cialis)
-use extreme caution in patients with inferior STEMI and suspected RV involvement b/c they are dependent on preload
List the s/sx of stroke:
-sudden numbness or weakness of the face, arm, or leg especially on one side of the body
-sudden confusion, trouble speaking, or understanding
-sudden trouble seeing in one or both eyes
-sudden trouble walking, dizziness, loss of balance or coordination
-sudden severe headache with no known cause
Spinal cord injury is: rare or common among drowning victims?
rare, remove patient from water immediately (less concern about immobilization)
When should spinal cord injury be suspected in a drowning victim?
-obvious signs of injury
-alcohol intoxication
-h/o diving into shallow water
T/F: hypothermia victims should be re-warmed before starting CPR
false
T/F: you should interrupt a patient with foreign-body airway obstruction who is coughing to provide rescue efforts
F, true only if signs of severe obstruction develop (silent cough, stridor, unresponsive)
Rank chest thrusts, abdominal thrusts, and back slaps in order of effectiveness for victims > 1 yo:
abd thrusts
chest thrusts
back slaps
When should abdominal thrusts not be used?
-pregnant women (chest thrusts instead)
-infants < 1 yo (back slaps)
-fat people (chest thrusts instead)
What is the new recommended sequence for airways, breathing, and circulation?
CAB
What do you do if you are giving someone chest compressions and a pulse is then detected?
Stop chest compressions and start rescue breaths 1 every 5-6 seconds. Check a pulse every 2 minutes.
In an unconscious patient, which algorithm do you start with: CPR or ACLS? Conscious patient?
A. CPR then ACLS
B. ACLS