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45 Cards in this Set
- Front
- Back
List the first 3 links in the adult "Chain of Survival" for lay persons:
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-immediate recognition of sudden cardiac arrest and activation of the emergency response system
-early CPR -rapid defibrillation |
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List the first 5 links in the adult "Chain of Survival" for HCPs:
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-immediate recognition of sudden cardiac arrest and activation of the emergency response system
-early CPR -rapid defibrillation -effective ACLS -integrated post-cardiac arrest care |
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When implemented effectively, survival rates can approach ____ % following witnessed out-of-hospital VF arrest:
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50%
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What neuro problem is sometimes the first manifestation of cardiac arrest?
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brief generalized seizures
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First and second steps after a lone rescuer finds an unresponsive adult:
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1. ensure the scene is safe
2. check for response by tapping the victim on the shoulder and shouting at the victim |
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When should you assume an unresponsive adult has had a cardiac arrest? Pulse check needed?
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-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 |
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Which two main organs does CPR produce blood flow for?
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heart and brain
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Adult chest compression rate and depth:
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at least 100 bpm and at least 2 inches with full recoil (allows heart to fill)
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What is the recommended ratio of chest compressions to ventillations for HCPs rescuing an adult?
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30:2
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Recommendations for rescue breaths:
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-deliver breath over 1 second
-sufficient air for visible chest rise |
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Should a lone rescuer perform the first round of chest compressions or get the AED?
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-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) |
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Once an advanced airway is placed, what is the correct ventilation rate?
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1 breath every 6-8 seconds (8-10 per minute); avoid excess ventilation
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How do you treat an unresponsive adult with no breathing but with a pulse?
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-give one breath every 5-6 seconds
-recheck pulse in 2 minutes |
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What do you do if you have an AED but the rhythm is not shockable?
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resume CPR immediately, recheck rhythm every 2 minutes and repeat cycle
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What do you do if you have an AED and the rhythm is shockable?
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give 1 shock and resume CPR immediately for 2 minutes
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A victim with occasional gasps should be treated as breathing or not breathing?
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not breathing
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List some tips for maximizing effectiveness of chest compressions:
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-place the victim on a firm surface (backboard, deflate air mattresses) when possible in a supine position
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Describe proper hand positioning for chest compressions:
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-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
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Outcomes improve when ##-## chest compressions are delivered per minute.
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68-120
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How often should lay rescuers interrupt chest compressions to check for a pulse or ROSC?
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never
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In what situations is CPR with rescue breaths recommended over hands-only CPR?
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-pediatric arrests (other than sudden, witnessed collapse of adolescents)
-asphyxial cardiac arrests in adults and children (drowning, drug overdose) -prolonged cardiac arrests |
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Should a hands-only rescuer position the neck in a certain way?
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No evidence to recommend any specific passive airway (e.g. hyperextension)
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When should HCPs use the head tilt-chin lift maneuver?
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always, unless head or neck trauma
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When should spinal injury be suspected?
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-blunt trauma (0.12-3.7% of victims)
-craniofacial injury -Glasgow Coma Scale score of <8 |
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How should HCPs open a victim's airway if cervical spine injury is suspected?
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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 |
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What are the consequences of excessive ventilation?
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-regurgitation
-aspiration -increases intrathoracic pressure -decreases venous return to the heart -diminishes cardiac output and survival |
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Steps for mouth-to-mouth breathing:
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-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 |
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List two other ventilation options (not advanced airways) besides the mouth:
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-nose
-tracheal stoma |
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When should cricoid pressure be applied?
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-no evidence to support use
-can be used to help visulaize vocal cords during intubation |
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Describe the recovery position for unresponsive but breathing and circulating adults:
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lay victim on their side with the lower arm in front of the body
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Describe the classic symptoms associated with ACS:
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-chest discomfort
-discomfort in other areas of the body -shortness of breath -sweating -nausea -lightheadedness -sx typically last more than 15 minutes |
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In whom are atypical sx of cardiac arrest most common?
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-women
-elderly -diabetics |
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In which ACS patients is aspirin not recommended?
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-aspirin allergy
-recent GI bleeding |
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When should oxygen be given to an ACS patient?
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-dyspneic
-hypoxemic -obvious signs of heart failure -O2sat <94% -give lowest amount needed to get O2 above 94% |
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When are nitrates contraindicated in an ACS patient?
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-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 |
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List the s/sx of stroke:
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-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 |
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Spinal cord injury is: rare or common among drowning victims?
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rare, remove patient from water immediately (less concern about immobilization)
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When should spinal cord injury be suspected in a drowning victim?
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-obvious signs of injury
-alcohol intoxication -h/o diving into shallow water |
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T/F: hypothermia victims should be re-warmed before starting CPR
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false
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T/F: you should interrupt a patient with foreign-body airway obstruction who is coughing to provide rescue efforts
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F, true only if signs of severe obstruction develop (silent cough, stridor, unresponsive)
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Rank chest thrusts, abdominal thrusts, and back slaps in order of effectiveness for victims > 1 yo:
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abd thrusts
chest thrusts back slaps |
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When should abdominal thrusts not be used?
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-pregnant women (chest thrusts instead)
-infants < 1 yo (back slaps) -fat people (chest thrusts instead) |
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What is the new recommended sequence for airways, breathing, and circulation?
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CAB
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What do you do if you are giving someone chest compressions and a pulse is then detected?
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Stop chest compressions and start rescue breaths 1 every 5-6 seconds. Check a pulse every 2 minutes.
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In an unconscious patient, which algorithm do you start with: CPR or ACLS? Conscious patient?
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A. CPR then ACLS
B. ACLS |