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BLS 2015 Automated External Defibrillator for Adults and Children 8 Years of Age and Older (Part 3)

rename
echoecho's version from 2016-06-16 14:36

Section

GENERAL CONCEPTS
OVERVIEW:
Question Answer
Define a AED?1) an automated external defibillator (AED) 2) lightweight, portable, computerized device that can identify an abnormal heart rhythm that needs a shock 3)AED can deliver a shock that can stop the abnormal rhythm (ventricular fibrillation or pulseless ventricular tachycardia) and allow the heart's normal rhythm to return 4) AEDs are simple to operate, allowing laypersons and healthcare providers to attempt defibrillation safely
memorize
EARLY DEFIBRILLATION:
Question Answer
The time between _______ and ________ is an important factor in survival from sudden cardiac arrest caused by ventricular fibrillation or pulseless ventricular tachycardia?collapse; defibrillation
memorize
PUBLIC-ACCESS DEFIBRILLATION:
Question Answer
Define public-access defibrillation?means having trained rescuers and AEDs available in pulbic places wehre large number of people gather or where there is reasonable likelihood of witnessed cardiac arrests
List examples of public places where public-access defibrillation is available?airports; convention centers; sports facilities; inducstrial buildings; offices; fitness facilities; shopping malls; apartments; and healthcare facilities
Communities, businesses or public facilities where AEDs are available are encouraged to participate in local _____ programs?PAD (public-access defibrillation)
List the 3 steps that a community, business or public facility were AEDs are available can participate in the local PAD?1) notify or register their AED with the local EMS agency 2) establish medical authority (appointing a local physician) to provide medical oversight for quality control 3) ensure that all expected rescuers are trained in high-quality CPR and AED use
memorize
MAINTAINING THE AED AND SUPPLIES:
Question Answer
AEDs should be properly maintained according to the manufacturer's instructions. List what maintenance includes?1) battery replacement 2) calibration and testing of energy dose 3) ordering a replacing supplies (which may be kept in a separate emergency or first aid kit) like AED pad replacement including pediatric pads; additional emergency equipment (scissors, razor for shaving a hairy chest, wipes, gloves, barrier device like a pocket mask)
Once the AED arrives, why is it placed at the victim's side next to the rescurer who will operate it?1) provides ready access to AED controls and easy placement of AED pads 2) it allows a second rescuer to perform high-quality CPR from the opposite side of the victim WITHOUT interfering with AED operation
memorize
IMPORTANCE OF MINIMIZING THE TIME BETWEEN LAST COMPRESSION AND SHOCK DELIVERY:
Question Answer
If rescuers minimize the interval between the last compression and shock delivery, what is more likely to happen?the shock is much more likely to be effective (like eliminating ventricular fibrillation and increasing the changes of return of spontaneous circulation)
Minimizing this interval will require what?practice and excellent team coordination, particularly between the compressor and the rescuer operating the AED
memorize
LIFE-THREATENING ARRHYTHMIAS:
Question Answer
Define an arrhythmia?it is an irregular or abnormal heart beat
When do arrhythmias occur?when the electrical impulses that cause the heart to beat happen too quickly, too slowly or erratically
Can arrhythmias be life threatening?yes
List 2 life-threatening arrhythmias that cause cardiac arrest?1) pulseless ventricular tachycardia (pVT) 2) ventricular fibrillation (VF)
Define pVT (pulseless ventricular tachycardia)?when the lower chambers of the heart (ventricles) begin contracting at a very fast pace, a rapid heart rate develops
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What is the consequence of pVT in extremely severe cases? in extremely severe cases, the ventricles pump so quickly and inefficiently that no pulse can be detected)
Question Answer
What is the consequence of pulseless ventricular tachycardia?body tissues and organs (especially the heart and brain) no longer receive oxygen
Define ventricular fibrillation?it is an arrest rhythm where the heart's electrical activity becomes disordered so that the heart muscles QUIVER in a fast, unsynchronized way so the heart does NOT pump blood
List the 3 modabilities that are needed to improve the chances of survival from pulseless pVT and VF?1) rapid defibrillation 2) high-quality CPR 3) all components of the Chain of Survival
memorize
DEFIBRILLATION:
Question Answer
An AED analyzes the heart rhythm to do what?identify the presence of a rhythm that responds to shock therapy (a so-called shockable rhythm)
If VF or pVT is identified, what does the device do?it prompts the delivery of an electrical shock to the heart
What does the shock do?it temporarily "stuns" the heart muscle and this stops the VF or pVT and "resets" the electrical system of the heart so a normal (organized) heart rhythm can return
What happens when an organized heart rhythm returns and high-quality CPR continues?the heart muscle can begin to contract and pump blood effectively
If circulation returns, what is palpable?a pulse
What is this return in circulation called?ROSC (return of spontaneous circulation)
memorize
USING THE AED
BE FAMILIAR WITH THE AED EQUIPMENT IN YOUR SETTING:
Question Answer
Give an example of differences of one AED model from another model?some AEDs must be powered on while others power on automatically when the lid is opened. Be familiar with your model.
memorize
UNIVERSAL STEPS FOR OPERATING AN AED?
Question Answer
One should always do what when using an AED?turn on the device (if it is one that requires that as some power on automatically) and follow the AED prompts
To reduce the time to shock delivery, you should ideally perform the first 2 steps listed within ____ seconds after the AED arrives at the victim's side?30
List the 6 universal steps for operating an AED?1) open the carrying case and power on the AED (if needed as some power on automatically when you open the lid) and follow the AED prompts 2) attach the AED pads to the victim's bare chest. Choose adult pads (not child pads or a child system) for victims 8 years and older. Peel the backing away from the AED pads. Attach the adhesive AED pads to the victim's bare chest and follow the placement diagrams on the pad. ATtach the AED connecting cables to the AED device (some AED cables re already preconnected to the device) 3) "CLEAR" the victim and allow the AED to analyze the rhythm. When the AED prompts you, clear the victim during analysis being sure that on one is touching the victim, not even the rescuer in charge of giving breaths. Some AEDs will tell you to push a button to allow the AED to begin analyzing the heart rhythm; others will do that automatically and the AED may take a few seconds to analyze. The AED then tells you if a shock is needed 4) If the AED advises a shock, it will tell you to clear the victim and then deliver a shock. Clear the victim before delivering the shock and be sure that one one is touching the victim. Loudly state a "clear the victim" message, such as "Everybody clear" or simply "clear". Look to be sure that one one is in contact with the victim. Press the shock button. The shock will produce a sudden contraction of the victim's muscles 5) if no shock is needed, and after any shock delivery, immediately resume CPR, starting with chest compressions 6) after 5 cycles or 2 minutes of CPR, the AED will prompt you to repeat steps 3 and 4
memorize
DO NOT DELAY HIGH-QUALITY CPR AFTER AED USE:
Question Answer
Immediately resume what after a shock is delivery or the AED prompts "no shock advised"?high-quality CPR
The AED will prompt you to repeat steps 3 and 4. Continue CPR until what?advanced life support providers take over or the victim begins to breathe, move or otherwise react
memorize
AED PAD PLACEMENT OPTIONS:
Question Answer
AED pads should be placed by following what?the diagrams on the pads
List to 2 common placements?1) anterolateral 2) anteroposterior
Describe how anterolateral placement is done?1) place one AED pad directly below the right collarbone 2) place the other pad to the side of the left nipple, with the top edge of the pad a few inches BELOW the armpit
Describe how anteroposterior placement is done?1) place one AED pad on the left side of the chest, between the victim's left side of the breastbone and the left nipple 2) place the other pad on the left side of the victim's back next to the spine
memorize
CHILD AED PADS:
Question Answer
Why should the smaller pads that are designed for children < 8 years of age not be used in an adult?the shock dose is too small for an adult and likely not be successful
memorize
SPECIAL CIRCUMSTANCES
HAIRY CHEST:
Question Answer
Why would a hairy chest with AED pads not work?1) AED pads may stick to the hair and not to the skin of the chest 2) the AED will not be able to analyze the victim's heart rhythm 3) the AED will display a "check electrodes" or "check electrode pads" message
What 2 options can be done to remove the hair from the chest?1) shave the area with a razor 2) if a second set of pads are available, remove the hair with the first set of pads by quickly pulling the pad off and removing the hair off the chest, then applying the second set of pads to the chest
memorize
WATER:
Question Answer
Why should an AED not be used in water?water is a good conductor of electricity
What should be done if the victim is in water?pull the victim out of the water
What should be done if the chest is covered with water?quickly wipe the chest before attaching the AED pads
If the victim is lying on snow or in a small puddle, you may do what?use the AED after quickly wiping the chest
memorize
IMPLANTED DEFIBRILLATORS AND PACEMAKERS?
Question Answer
Some patients may have an implanted defibrillator or pacemaker, what do these do?they deliver shocks automatically to the heart
If you place an AED pad DIRECTLY over an implanted medical device, what can happen?the implanted device may BLOCK delivery of the shock to the heart
How can one identify these devices on a patient?they look like a hard lump beneath the skin of the upper chest or abdomen (1/2 the size of a deck of cards)
What should be done if you see an implanted defibrillator/pacemaker in a patient?1) if possible, avoid placing the AED pad directly over the implanted device 2) follow the normal steps for operating the AED
memorize
TRANSDERMAL MEDICAL PATCHES:
Question Answer
Why should one not place an AED pad directly on top of a medication patch?1) the medication patch may block the transfer of energy from the AED pad to the heart 2) may cause small burns to the skin
List examples of medication patches?1) NTG 2) nicotine 3) pain med 4) hormone replacement
If it does not delay delivery, do what prior to attaching the AED pad?remove the patch and wipe the area
To avoid delivery of the medication to the rescuer, use what to remove the medication patch and remember to avoid _____ as much as possible?1) protect gloves or another barrier 2) delays
memorize
REVIEW QUESTIONS:
1) What is the most appropriate first step to take as soon as the AED arrives at the victim's side?
a) power on the AED
b) apply the pads
c) press the analyze botton
d) press the shock button
Answer = a
2) Which step is one of the universal steps for operating an AED?
a) placing the pads on the victim's bare chest
b) shaving the victim's hairy chest
c) removing the victim from water
d) finding the victims implanted pacemaker
Answer = a
3) If a victim of cardiac arrest has an implanted pacemaker or defibrillator, what special steps should be taken?
a) avoid placing the AED pad directly over the implanted device
b) avoid using the AED to prevent damage to the implanted device
c) turn off the implanted device before apply the AED pads
d) consider using pediatric pads to decrease the shock dose delivered
Answer = a
4) What action should you take when the AED is analyzing the heart rhythm?
a) check the pulse
b) continue chest compressions
c) give rescue breaths only
d) stand clear of the victim
Answer = d