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63 Cards in this Set

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In an emergency...
1. Size up scene (is safe)
2. Initial Assessment
3. Summon advanced medical personnel
When do you call first? When do you care fisrt?
-call first if suspect cardiac emergency
-care first situations are likely to be breathing emergencies
-provide care for 2 minutes and then summon advanced medical personnel if...
unconscious infant/child; victim of drowining; cardiac arrest assoc w/ trauma; OD
Signs of Stroke
-stroke is third leading cause of death in U.S.
-signs and symptoms: FAST
Face: weakness on one side of face
Arm: weakness/numbness in one arm
Speech: slurred speech
Time: note time signs/symptoms were first observed
Adult, Child, and Infant: Ages
-adult: 12 yrs or older
-child: 1 to about 12 years
-infant: under 1
Adult and Child Ages w/ AED
-adult: 9 years or older
-child: 1 to 8 years old or less than 55 lbs
Breathing Emergences
-respiratory distress: difficulty breathing
-respiratory arrest/failure: stop breathing
Rescue breathing
-each breath should last about 1 sec and make chest clearly rise
-adult: 1 breath every 5 sec
-child/infant: 1 breath every 3 sec
Airway Obstruction
-most common cause of respiratory emergencies
-anatomical obstruction or mechanical obstruction
Conscious choking victim
-get consent first
-adult/child: 5 black blows followed by 5 abdominal thrusts
-infant: 5 black blows/ 5 abdominal thrusts
Special considerations for choking victims
-if victim is pregnant, position hands slightly higher on victim's chest
Unconscious Choking Vicitm
-consent implied
-adult/child/infant: 5 thrusts, look for object, see object swipe it out, try 2 rescue breaths, repeat cycle if necessary
Chest compression depths
-adult: 1.5 to 2 in.
-child: 1 to 1.5 in.
-infant: .5 to 1 in.
Initial Assessment
1. check for consciousness and obtain consent if conscious
2. if no response, summon advanced medical personnel
3. check for signs of life (movement/breathing) for no more than 10 sec
4. give 2 rescue breaths if no movement or breathing
5. if chest clearly rises, check for pulse no more than 10 sec
6. check for severe bleeding
Opening airway
-tilt adult head back
-tilt child head slightly past neutral
-tilt infant head to neutral
-if head, neck, or back injury use jaw-thrust maneuver
Checking pulse
-adult/child: carotid artery on neck
-infant: brachial on inside of upper arm
What to do: movement, breathing, pulse
-place in recovery position and monitor ABC's
What to do: first 2 rescue breaths don't make chest clearly rise
-unconscious choking victim
What to do: pulse but no movement or breathing
-rescue breathing
What to do: no movement, no breathing, and no pulse
-CPR
Rescue Breathing: Adult
-pulse but no movement or breathing
-1 breath every 5 seconds
-continue for 2 minutes
-remove mask and look for movement and recheck for breathing and a pulse for no more than 10 seconds
Rescue Breathing: Child and Infant
-1 breath every 3 seconds
-continue for 2 minutes
-recheck for breathing, pulse, and movement
Conscious Choking Adult and Child
1. size up scene
2. ask "are you choking?"
-identify self and ask if can help (obtain consent)
-encourage continued coughing if coughing
3. if victim can't cough, speak, or breath have some one summon medical help
4. lean victim forward and give 5 back blows w/ heel of hand
5. give 5 abdominal thrusts
Back Blows
-place one arm diagonally across chest and lean victim forward
-strike victim bwt shoulder blades
Abdominal Thrusts
-adult: stand behind victim
-child: stand or kneel behind child
-place thumb side of fist above the navel
-give quick, upward thrusts
Continue giving back blow and abdominal thrusts until
-object is forced out
-victim begins to breathe or coupgh
-victim becomes unconscious
Conscious Choking Infant
-position infant face down on forearm
-lower infant onto thigh keeping infant's head lower than chest
-give 5 back blows
-position infant face-up along forearm
-give 5 chest thrust w/ 2 or 3 fingers just below nipple line
what if first 2 rescue breaths don't make chest clearly rise
-reposistion the airway by tilting head further back and try 2 breaths again
-if breaths still don't go in go to unconscious choking victim
Unconscious choking adult/child
-give 5 chest thrusts
-compress at rate of 100 compression per minute
-look inside victim's mouth
-if see object take it out
-give 2 breath again
Unconscious choking infant
-remove mask and give 5 chest compressions (2/3 fingers below nipple line)
-look for object in mouth
-see object take out
-give 2 breaths again
Cardia Chain of Survival
1. early recognition of emergency and early access to EMS
2. Early CPR
3. Early Difibrillation
4. Early advance medical care
Common causes of heart attack
-usu result from cardiovascular disease
-respiratory distress
-electrocution
-traumatic injury
Atherosclerosis
-depositis of cholestrol and other materials buildup on inner walls of arteries causing vessels to narrow
-when coronary arteries narrow, a heart attack may occur
Signs of Heart Attack
-discomfort, pressure, or pain (in chest)
-pain that comes and goes (angina pectoris)
-trouble breathing (faster than normal)
-ashen or pale skin
-sweat heavily or dizzy
-pain in left arm
-naseau/vomitting
Myocardial Infarction
-heart attack
-muscles of heart suffer a loss of oxygenated blood
Care for a heart attack
-call 911
-have victim rest
-loosen tight/uncomfortable clothing
-monitor victim
-comfort victim
-give aspirin if able
-assist w/ prescribed meds
-be prepared to give CPR or use AED
Cardiac Arrest
-caused by heart attack, electrocution, respiratory arrest, or drowining
-hearth stops beating or is beating to irregulary or weakly to circulate blood effectively
Signs of cardiac arrest
-unconsciouness
-no movement or breathing
-no pulse
CPR
-chest compressions circulate blood to victim's brain and other vital organs
-let chest fully recoil to normal position after each compression before starting next compression
What may happen when giving CPR
-break victim's ribs or seperate cartilage
-victim may vomit
-scene may become chaotic
-not all victim's survive
Adult CPR
-30 chest compressions and 2 rescue breaths
-two hands on the center of the chest
-compress 1.5 to 2 in.
-about 100 compressions per min
Child CPR
-30 compressions and 2 rescue breaths
-two hands or one on center of chest
-compress 1 to 1.5 in.
-100 compressions per min
Infant CPR
-30 compressions and 2 rescue breaths
-two or three fingers on center of chest
-compress .5 to 1 in.
-100 compressions per min
Two-Rescuer CPR
-adult: 30 compressions/2 breaths
-child: 15 compressions/2 breaths
-infant: 15 compressions/2 breaths
-15:2 ratio provides more frequent respiration for children and infants
CPR-Special Situations
-in stairwell, move victim to flat area (don't interrupt CPR for longer than 30 sec)
-do not interrupt CPR while a victim is being transferred to ambulance or ER
Administering emergency oxygen
-higher concentration of O2 being deliverd to a victim can help counter the effects of a life-threatening injury or illness to the body
Continue CPR until...
-another trained person arrives to take over
-AED is available to use
-too exhausted
-scene becomes unsafe
-notice an obvious sign of life
two-rescuer CPR
-rescuer 2 gives chest compression
-rescuer 1 gives 2 breaths after compressions
-do about 2 minutes of compression/breath cycles
-change positions
AED
-automated external defibrillation
-provides electric shock to heart
-disrupts electrical activity of V-fib and V-tach long enough so hearth can spontaneously develop effective rhythm on own
Hearts electricl system
-electrical impulses from conduction system travel through atria (upper chambers) to ventricles (lower chambers)
-under normal conditions impulse reaches muscular walls of ventricles and causes ventricles to contract forcing blood out of heart to circulate through body
Sinoatrial Node (SA)
-normal point of origin on electrical impulses above atria
Atrioventricular Node (AV)
-midway point bwt atria and ventricles
-electical impulse travels to here where pathway divides into 2 branches (right and left ventricle)
Pulse
-contraction of left ventricle
ECG
-electrocardiogram
-evaulate electrical activity of heart
-rhythms appear as series of peaks and valleys
Ventricular Fibrillation (V-fib)
-totally disorganzied electricl activity in the heart
-fibrillations or quiverings of ventricles
-ventricles can't pump blood and there is no movement, breathing, or pulse
Two most common rhythms initially present in cardiac arrest
-ventricular fibrillation
-ventricular tachycardia
Ventricular Tachycardia (V-tach)
-rapid contraction of the ventricles
-rate is often so fast that the heart is unable to pump blood properly
-no movement, breathing, or pulse
Asystole
-all electrical activity ceases b/c v-fib and v-tach were not interrupted
-asytole cannot be corrected by defibrillation
Using an AED: adult
-provide 1 shock followed by 5 cycles (2 min) of CPR
Possible causes of cardiac arrest in children
-respiratory distress (ie choking)
-traumatic injuries or accidents
-hard blow to chest
-congenital heart disease
AED precautions
-don't touch victim while defibrillating or analyzing
-don't use alcohol to wipe victim's chest (flammable)
-don't defibrillate around flammable materials
-don't use AED in moving vehicle
-don't use AED on victim in contact w/ water
-don't use pediatric pads on adults
-don't use AED on victim wearing nitroglycerin patch or other patches
-don't use phone or radio w/in 6 ft of AED
AED special situations
-around water: remove wet clothes
-implantable devices: do not place defibrillation pad directly over device
-nitrogylcerin patches: remove all patches
hypothermia: initial assessment takes longer (30-45 sec) and don't shake cause could result in v-fib
-traume
-chest hair
Using an AED: adult and child
-turn on AED
-wipe chest dry
-attack the pads (one on upper right chest other on lower left side)
*make sure pads aren't touching
-make sure no one is touchin victim ("stand clear")
-push analyze buttom
-push shock buttom if indicated
-after shock or if no shock is indicated give 5 cycles of CPR
6 steps in EMS system
1. survey scene
2. call 911
3. professional rescue care
4. pre-hospital care
5. hospital care
6. rehab