Basic Cardiac Life Support (Bcls)

Front 1

In Singapore, heart disease is the _____ commonest cause of death; _____% of total mortality.

Back 1

Second commonest cause

24% of total mortality

Hint 1

Not the first but?

Close to one quarter.

Front 2

Total survival rate (pre-hospital collapses) is _____%

Back 2

2.6%

Hint 2

One, ______, button my shoe + 0.6%

Front 3

Best Treatment Approach for Cardiac Arrest Victims (Chain of Survival).

What are the 4 links?

Back 3

Early Recognition & Access

Early CPR

Early Defibrillation

Early Advanced Care

Hint 3

Early...

R_____

C_____

D_____

A_____

Front 4

Examples of early warning signs of heart attack are...

Back 4

Sweatiness

Shortness of Breath

Nausea or vomiting

Chest pain

Hint 4

Head

Nose

Mouth

Chest

Front 5

Chain of Survival: First Link

Early Recognition & Access

How is this facilitated?

Back 5

Rapid call for first response team

Allow road priority for ambulances

Allow fast access by paramedics e.g. lifts

Hint 5

Phone

Road

Lift

Front 6

Chain of Survival: Second Link

Early CPR

CPR can always restart the heart. True or False?

Back 6

False.

CPR cannot always restart the heart.

Hint 6

Buy time to keep vital organs alive till help arrives

Front 7

Chain of Survival: Third Link

Early Defibrillation

After collapse, survival rate deceases _____% to _____% for every 1 minute delay in delivering defibrillation.

Back 7

7%-10%

Hint 7

Its a name of a 24 hours convenient store but minus one.

Front 8

Chain of Survival: Fourth Link

Early Advanced Care

What does this link consist of?

Back 8

Advanced Airway Management

Administration of Medication

Hint 8

A.M.

Front 9

Which arteries are blood vessels that send oxygen-rich blood to the muscles of the heart?

Back 9

Coronary

Hint 9

Sounds like the person who checks on cause of death.

Front 10

Coronary artery disease is the end result of the gradual buildup of fatty deposits aka _____ and blood cells in the inner lining of the coronary arterial wall, a process that is called _____.

Back 10

Fatty deposits aka cholesterol plaques

Atherosclerosis

Hint 10

Sounds like the bad thing that accumulates on tooth.

At hero + ....

Front 11

In a heart attack, chest discomfort or pain usually lasts longer than 20 minutes. True or false?

Back 11

True

Hint 11

It can't be less than 20 minutes right?

Front 12

If someone has symptoms of heart attack, to call the ambulance at 9 9 9. True or false?

Back 12

False

9 9 5

Hint 12

999 is police.

Front 13

List 3 major risk factor for heart attack that cannot be changed.

Back 13

Heredity

Male gender

Increasing Age

Hint 13

What do we not have control on?

Front 14

List 4 major risk factors of heart attack that can be changed.

Back 14

Cigarette smoking

High BP

High blood cholesterol levels

Diabetes mellitus

Hint 14

Too much smoke

Too much stress

Too much fatty food

Too much sugar

Front 15

List 3 other risk factors of heart attack that can be changed.

Back 15

Physical inactivity

Obesity

Stress

Hint 15

O + P + S

Front 16

The most sensitive organ is _____ and if circulation to here is not restarted within _____ to _____ minutes, there may permanent and irreversible damage. Hence CPR is crucial.

Back 16

Brain

4-6 minutes.

Hint 16

Pinky and the _____

_____ + _____ = 10

Front 17

There is 21% oxygen in the air at sea level. When breathed in, only 16% of oxygen is utilised with 5% exhaled. True or false?

Back 17

False.

Only 5% is utilised and 16% exhaled.

Hint 17

Exhaled > Used

Front 18

Chest compression squeezes the heart between breastbone and spine and helps circulate blood and oxygen to vital organs especially _____, _____ and _____.

Back 18

Brain, heart and kidney

Hint 18

Must bring our mind to HK. (BHK)

Front 19

What are the steps for adult one man CPR?

Back 19

D - Check for Danger

R - Check for Responsiveness

S - Shout for help

A - Open Airway

B - Check for Normal Breathing

C - Perform 30 Chest Compressions

Hint 19

Here comes "Doctors ABC"

Front 20

For chest compression (adult one man CPR), we need to compress to depth of at least 5cm and at rate of at least 100/minute. True or false?

Back 20

True

Front 21

For adult one man CPR, we need to give 2 breaths; _____ second/breath with tidal Vol of _____ to _____ml.

Back 21

1 second/breath

400-600ml tidal vol

Front 22

Adult One Man CPR

Why does the casualty not respond?

Back 22

Obstructed airway e.g. by food, secretion of tongue that fallen backwards.

Breathing stopped.

Heart stopped beating.

Front 23

When calling 9 9 5, what information should we provide?

Back 23

Location (Where)

Telephone Number (What)

What happened? (Why)

Number of casualties (How many)

Tell - Immediate ambulance needed

Listen - Instructions and instructions to hang up

Hint 23

3Ws & 1H.

Tell and listen

Front 24

For CPR to be effective, the casualty must lie sideways. True or False?

Back 24

False.

For CPR to be effective, the casualty must lie on firm and flat surface.

Hint 24

2Fs

Front 25

Adult One Man CPR

To open the airway, do the _____ manoeuvre. By moving the lower jaw forward, the tongue which has fallen back will be lifted away from the back of the throat.

Back 25

Head tilt-chin tilt manoeuvre.

To perform the manoeuvre:

1. Place one hand on casualty's forehead and fingers of other hand under bony part of lower jaw to lift the jaw forward.

2. Apply firm backwards pressure on forehead while lifting jaw.

Do not perform blind finger sweep as it may push foreign bodies back into airway.

Perform jaw thrust or gentle chin lift of head or neck injury is suspected.

Hint 25

Front 26

Adult One Man CPR: Check for Normal breathing

Do these for 10 seconds. What do you need to do?

Back 26

Look for chest rise and fall

Listen for air escaping during exhalation

Feel for flow of air from mouth/nose moving past your cheeks

CPR immediately if gasping

Front 27

Adult One Man CPR: Assess Pulse

1. With index and middle finger locate _____

2. Slide finger down into groove at side of neck near you; _____ pulse

3. Apply gentle pressure and feel for pulse as you check breathing.

4. Check not more than 10 seconds.

5. If no pulse, commence chest compression. If unsure, assume cardiac arrest and commence chest compressions.

Back 27

Adam's Apple / centre of throat

Carotid Pulse

Front 28

Chest Compression = serial, rhythmic pressure over _____ half of sternum to create blood flow to vital organs by increasing _____ pressure.

Back 28

Lower

Intrathoracic

Front 29

Hand position for chest compression: run middle finger from lower margin of rib cage till you reach the _____ _____.

And then place index finger next to middle finger, followed by heel of other hand next to index finger on lower half of sternum.

Back 29

Xiphoid process

Front 30

Adult One Man CPR: Chest Compressions.

1. Interlace fingers of both hands and lift fingers off chest wall.

2. Straighten both elbows and lock them in position.

3. Position shoulder directly over casualty's chest.

4. Use body weight to compress at least 5cm, counting loudly:

1 and 2 and 3 and 4 and 5 and

1 and 2 and 3 and 4 and 10 and

1 and 2 and 3 and 4 and 15

1 and 2 and 3 and 4 and 20

1 and 2 and 3 and 4 and 25

1 and 2 and 3 and 4 and 30

The ratios:

_____ compressions: 2 breaths

_____ cycles of 30 compressions and 2 breaths for approximately _____ minutes

Back 30

30 compressions: 2 breaths

5 cycles of 30 compressions and 2 breaths for approximately 2 minutes

Front 31

Adult One Man CPR: Mouth to Mouth Breathing

1. Maintain head tilt-chin tilt.

2. Pinch nose with thumb and index finger.

3. Seal lips around casualty's mouth and give 2 breaths

4. Release nostril after each breath

Duration of each breath = _____ second

Back 31

1

Front 32

Adult One Man CPR: Mouth to Mouth Breathing

To much air can cause air to enter stomach and result in _____ ______

Back 32

Gastric Distension

Hint 32

Dissatisfied and with tension.

Front 33

Adult One Man CPR: Reassess

1. Assess for pulse and breathing after every _____ cycles of CPR _____:_____

2. If pulse absent or unsure, continue CPR 30:2

3. If both pulse and breathing present, position casualty in _____ _____

4. Continue to monitor at least once in _____ minutes.

Back 33

1. Assess for pulse and breathing after every 5 cycles of CPR 30:2

.....

3. If both pulse and breathing present, position casualty in recovery position.

4. Continue to monitor at least once in 5 minutes.

Front 34

FBAO stands for?

Back 34

Foreign Body Airway Obstruction (FBAO)

Front 35

FBAO can be cause by:

Intrinsic (tongue and epiglottis) causes such as: Name 3

or

Extrinsic (Foreign Body) causes such as: Name 2

Contributing factors include:

1. Large, poorly chewed food pieces

2. Elevated blood alcohol levels

3. Dentures

4. Playing, crying, laughing and talking with food in mouth.

Back 35

Intrinsic (Tongue and Epiglottis)

1. Tongue fall backwards into pharynx in an unconscious casualty

2. Blood from head or facial injuries flow into airway

3. Regurgitated stomach contents enter airway

Extrinsic (Foreign Body)

1. Food

2. Dentures

Front 36

FBAO Symptoms

Partial Airway Obstruction:

Name 2 symptoms

Complete Airway Obstruction:

Name 5 symptoms

Back 36

Partial:

1. Coughing

2. Wheezing

Complete:

1. Can't speak

2. Can't breathe

3. Can't cough

4. Become Cyanotic

5. Clutch neck with thumb and fingers.

Front 37

Heimlich Manoeuvre (or sub diaphragmatic abdominal thrusts), which elevates diaphragm and increase airway pressure is used on:

Children (1-8yo) and responsive adults (>8yo)

Or

Pregnant and obese casualties?

Back 37

Children (1-8yo) and responsive adults (>8yo)

Hint 37

Baby is in womb...

Front 38

Chest thrust is used on:

Children (1-8yo) and responsive adults (>8yo)

Or

Pregnant and obese casualties?

Back 38

Pregnant and obese casualties

Hint 38

Baby is in womb.

Front 39

Heimlich Manoeuvre may damage internal organs resulting in rupture or laceration of abdominal or thoracic viscera. True or false?

Back 39

True

Front 40

How many abdominal/chest thrust do we administer on conscious casualties?

Back 40

5

Front 41

Does the FBAO casualty need to be standing when attempting to relief them?

Back 41

No.

If casualty is standing, have casualty stand with feet apart and rescuer's foot in between.

If casualty is sitting, kneel down behind casualty.

Hint 41

We need to cater to casualty...

Front 42

To locate landmark to relief FBAO Adult:

1. Place arms around casualty's abdomen.

2. Locate navel

3. Place _____ fingers breath above navel and well below tip of xiphoid process.

4. Make a fist with one hand, grabbing thumb with 4 fingers.

5. Place thumb side of fist against casualty's abdomen in midline and just above 2 fingers spacing.

5. Lean casualty forward

6. Grasp fist with other hand.

7. Give quick successive inward and upward abdominal thrust.

8. Check if foreign body is expelled after _____ thrusts.

9 Repeat until foreign body is expelled or casualty becomes unconscious.

Back 42

3. Place 2 fingers breath above navel and well below tip of xiphoid process.

8. Check if foreign body is expelled after 5 thrusts.

Front 43

Chest Thrust for FBAO Conscious Adult

To do this place arms under/above casualty's armpit, encircling chest?

Back 43

Under

Front 44

Chest Thrust for FBAO Conscious Adult

Place thumb side of fist on _____ of the casualty's breastbone.

Back 44

Middle

Front 45

Steps for relief of Unconscious FBAO Adult

The manoeuvre to use a hooked index finger to dislodge foreign body and manoeuvre it out the mouth is called...

Back 45

Finger Sweep

Hint 45

Let the fingers do the *clearing dust from ground*

Front 46

Infant CPR

Cardiac arrest is usually the primary cause for infant collapse. True or false?

Back 46

False.

Infants rarely collapse due to primary heart problem. Cardiac arrest is usually secondary to other events e.g. major trauma or respiratory illness.

Front 47

Infant CPR

If breathing is present when assessing for spontaneous breathing, turn infant onto _____ _____.

Back 47

Lateral (side) position.

Front 48

Infant CPR: Assess for Pulse

1. Maintain head tilt, locate _____ _____ (inner aspect of upper arm, between infant's elbow and shoulder) with index and middle finger.

2. Apply gentle pressure to feel for up to _____ seconds.

Back 48

Brachial Pulse

10 seconds.

Front 49

Infant CPR: Chest Compressions

1. Maintain head tilt with one hand and draw imaginery line between nipples with index finger of other hand.

2. At sternum, place ____ and ____ fingers next to index finger

3. Move all 3 fingers to centre of sternum.

4. Position finger upright.

5. Lift up only index finger and maintain other fingers.

6. Compress lower sternum by 4cm depth, loudly as with adult CPR.

7. _____ cycles of _____ compressions at rate of _____ per minute. _____ breaths for approximately _____ minutes.

8. _____ short breaths in quick succession (____ ml of air at 1 second per breath)

Back 49

2. At sternum, place middle (3rd) and ring (4th) fingers next to index finger

...

7. 5 cycles of 30 compressions at rate of 100 per minute. 2 breaths for approximately 2 minutes.8. 2 short breaths in quick succession (30ml of air at 1 second per breath)

Front 50

FBAO Consious Infant

What 2 techniques to use?

Back 50

Back Blows

Chest Thrusts

Hint 50

Back and front...

Front 51

FBAO Conscious Infant

Name the symptoms.

Back 51

Coughing

Gagging

Stridor (high pitched, noisy sound or wheezing)

Loss of voice

Increased breathing difficulty

Infant's face cyanosed

Hint 51

2 to do with mouth

2 to do with voice

1 on breathing

1 related to Avatar/Smurfs

Front 52

FBAO Conscious Infant

How many back blows does rescuer deliver before the same number of chest thrusts?

Back 52

5

Front 53

Infants should never be given abdominal thrusts. True or false?

Back 53

True.