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BLS 2015 General Concepts (Part 1)

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echoecho's version from 2016-06-16 19:23

Section

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INTRODUCTION:
Question Answer
What remains the leading cause death in the USA despite important advances in prevention?sudden cardiac arrest
What % of out-of-hospital cardiac arrests occur in the home?70
What % of out-of-hospital cardiac arrests are unwitnessed?50
How is the outcome of out-of-hospital cardiac arrests?poor
What % of adult patients with nontraumatic cardiac arrest who are treated by EMS survive to hospital discharge?10
memorize
AGE DEFINITIONS:
Question Answer
Age definitions of an adult?adolescents (after the onset of puberty) and older
Age definition of child?1 year of age to puberty
Age definition of infant?less than 1 year (excluding the newly born infants in the delivery room)
List the signs of puberty?chest or underarm hair in males and any breast development in females
memorize
HIGH QUALITY CPR:
Question Answer
Start compressions within ____ seconds of recognition of cardiac arrest?10
Push hard, push fast. Compress at a rate of ____ to ____/min?100-120
Compress with a depth of _____ inches (____ cm) in adults?2; 5
Compress at least _____ depth of the chest, about _____ inches (____ cm) for children?1/3; 2 ; 5
Compress at least _____ depth of the chest, about _____ inches (____ cm) for infants?1/3; 1 1/2; 4
Allow complete chest _________ after each compression?recoil
Minimize interruptions in compressions, try to limit interruptions to < than ____ seconds?10
Give effective breaths that make the ______ rise?chest
What should be avoided in ventilation?excessive ventilation
memorize
CHEST COMPRESSION DEPTH:
Question Answer
Compression depth greater than _______ inches (____ cm) in adults may cause injuries?2.4; 6
If you have a CPR quality feedback device, it is optimal to target your compression depth from ____ to ____ inches or _____ to _____ cm?2; 2.4; 5; 6
memorize
YOUR APPROACH TO A RESUSCITATION ATTEMPT:
Question Answer
Your approach to a resuscitation attempt will depend on what 4 things?1) available emergency equipment 2) availability of trained rescuers 3) level of training expertise 4) local protocols
memorize
PERSONAL PROTECTIVE EQUIPMENT:
Question Answer
What is Personal protective equipment?equipment worn to help protect the rescuer from health or safety risks
List examples of PPE?1) medical gloves 2) eye protection 3) full body coverage 4) high-visibility clothing 5) safety footwear 6) safety helmets
memorize
THE CHAIN OF SURVIVAL
ADULT CHAIN OF SURVIVAL:
Question Answer
List the 2 distinct adult Chains of Survival?1) IHCA (in-hospital cardiac arrest) 2) OHCA (out-of-hospital cardiac arrest)
memorize
CHAIN OF SURVIVAL FOR AN IN-HOSPITAL CARDIAC ARREST:
Question Answer
List the 5 links in IHCA?1) surveillance, prevention, and treatment of prearrest conditions 2) immediate recognition of cardiac arrest and activation of the emergency response system 3) early CPR with an emphasis on chest compressions 4) rapid defibrillation 5) multidisciplinary post cardiac arrest care
memorize
CHAIN OF SURVIVAL FOR OUT-OF-HOSPITAL CARDIAC ARREST:
Question Answer
List the 5 links in the OHCA?1) immediate recognition of cardiac arrest and activation of the emergency response system 2) early CPR with an emphasis on chest compressions 3) rapid defibrillation with an AED 4) effective advanced life support (including rapid stabilization and transport to post-cardiac arrest care) 5) multidisciplinary post-cardiac arrest care
memorize
KEY DIFFERENCE BETWEEN IHCA AND OHCA CHAINS OF SURVIVAL:
Question Answer
What is the difference between the initial support of IHCA and OHCA?1) IHCA = depends on an in-hospital system of appropriate surveillance monitoring, and prevention with responsive primary provider teams 2) OHCA = depends on community and EMS providers for support
What is the difference between the resuscitation teams of IHCA And OHCA?1) IHCA = resuscitation efforts depend on the smooth interaction of the institution's various departments and services (such as the patient ward, ED, cardiac catheriazation lab and ICU) and on a multidisciplinary team of professional providers, which include physicians, nurses, respiratory therapists, pharmacists, counselors and others 2) OHCA = lay rescuers are expected to recognize the patient's unresponsiveness, call for help, and activate the emergency response system. They initiate CPR and use an AED (if available) until a team of EMS providers takes over resuscitation and then transports the patient to an ED and/or cardiac catheterization lab, before the patient is transferred to an ICU for continued care
What is the difference between the available resources of IHCA and OHCA?1) IHCA = depending on the facility, in-hospital multidisciplinary teams may have immediate access to additional personnel as well as resources of the ED, cardiac catheterization lab, and ICU 2) OHCA = in out-of-hospital settings, lay rescuers may have access to an AED, such as through their local public-access defibrillation system, emergency or first aid equipment and dispatch-assisted guidance. EMS crews / paramedics may find themselves alone, with no resources except those they brought with them. Additional back up resources and equipemtn may take some time to arrive
What is the difference between the resuscitation constraints of IHCA and OHCA?Both IHCA and OHCA may be affected by factors such as crowd control, family presence, space constraints, resources, training, transportation, and device failures
What is the difference between the level of complexity of IHCA and OHCA?Both IHCA and OHCA cases are typically complex, requiring teamwork and coordination among responders and care providers
memorize
IMPORTANCE OF EACH LINK IN THE CHAIN OF SURVIVAL
IN-HOSPITAL CARDIAC ARREST IMPORTANCE OF EACH LINK:
Question Answer
Describe the surveillance prevention and treatment of prearrest condition link in IHCA?1) for adult patients who are in the hospital, cardiac arrest usually happens as a result of serious respiratory or circulatory conditions that get worse. 2) many arrests can be predicted and prevented by careful observation, prevention, and early treatment of prearrest conditions
Describe the immediate recognition of cardiac arrest and activation of the emergency response system in IHCA?1) you must first recognize that the victim is in cardiac arrest based on unresponsiveness, no breathing (or no normal breathing or only gasping), and no pulse 2) Once you have recognized that the victim is in cardiac arrest, activate the emergency response system or ask someone else to do it. 3) the sooner you activate the emergency response system, the sooner the next level of care will arrive
Describe the early CPR with an emphasis on chest compressions in IHCA?1) if the victim is in cardiac arrest, begin high-quality CPR without delay 2) high-quality CPR started immediately after cardiac arrest can greatly improve a victim's chance of survival 3) bystanders who are not trained in CPR are encouraged to at least provide chest compressions. Chest compressions can be performed by those with no training and can be guided by dispatchers over the telephone
Describe the rapid defibrillation in IHCA?1) rapid defibrillation in combination with high-quality CPR can double or triple the chances of survival. Provide defibrillation with a manual defibrillator or AED as soon as the device is available. 2) the AED is a lightweight, portable device that can identify lethal heart rhythms and deliver a shock to terminate the abnormal rhythm and allow the heart's normal rhythm to resume 3) AEDs are simple to operate, allowing lay rescuers and healthcare providers to attempt defibrillation safely
Describe the multi-disciplinary post-cardiac arrest care in IHCA?1) once ROSC (return to spontaneous circulation) is achieved, the next link is for the patient to receive post-cardiac arrest care) 2) this advanced level of care is provided by a multidisciplinary team of healthcare providers. They focus on preventing the return of cardiac arrest and tailor specific therapies to improve long-term survival 3) post-cardiac arrest care may be provided in the cardiac catheterization suite and/or ICU
memorize
OUT-OF-HOSPITAL CARDIAC ARREST IMPORTANCE OF EACH LINK:
Question Answer
Describe the immediate recognition of cardiac arrest and activation of the emergency response system in OHCA?1) you must first recognize that the victim is in cardiac arrest based on unresponsiveness, no breathing (or no normal breathing or only gasping), and no pulse 2) once you have recognized that the victim is in cardiac arrest, activate the emergency response system or ask someone else to do it 3) the sooner you activate the emergency response system, the sooner the next level of care will arrive
Describe the early CPR with an emphasis on chest compression in OHCA?1) if the victim is in cardiac arrest, begin high-quality CPR without delay 2) high-quality CPR started immediately after cardiac arrest can greatly improve a victim's chance of survival 3) bystanders who are not trained in CPR are encouraged to at least provide chest compressions. Chest compressions can be performed by those with no training and can be guided by dispatchers over the telephone
Describe the rapid defibrillation with an AED in OHCA?1) rapid defibrillation in combination with high-quality CPR can double or triple the chances of survival. Provide defibrillation with a manual defibrillator or AED as soon as the device is available. 2) the AED is a lightweight, portable device that can identify lethal heart rhythms and deliver a shock to terminate the abnormal rhythm and allow the heart's normal rhythm to resume 3) AEDs are simple to operate, allowing lay rescuers and healthcare providers to attempt defibrillation safely
Describe the effective advanced life support (including rapid stabilization and transport to post-cardiac arrest care) in OHCA?1) advanced life support (ALS) bridges the transition from BLS to more advanced care. ALS can occur in any setting (both out of hospital and in hospital). Effective ALS teams may provide the patient with additional care, if needed, such as the following = 12 lead EKG or advanced cardiac monitoring; electrical therapy interventions (cardioversion), obtaining vascular access; giving appropriate drugs; placing an advanced airway
Describe the multidisciplinary post-cardiac arrest care in OHCA?1) once ROSC (return to spontaneous circulation) is achieved, the next link is for the patient to receive post-cardiac arrest care) 2) this advanced level of care is provided by a multidisciplinary team of healthcare providers. They focus on preventing the return of cardiac arrest and tailor specific therapies to improve long-term survival 3) post-cardiac arrest care may be provided in the cardiac catheterization suite and/or ICU
memorize
PEDIATRIC CHAIN OF SURVIVAL:
Question Answer
In adults, cardiac arrest is often sudden and results from cardiac cause. In children, cardiac arrest is often secondary to what?respiratory failure and shock
Identifying children with these problems is essential to reducing what?the likelihood of pediatric cardiac arrest and maximizing survival and recovery
List the 5 links to the Pediatric Chain of Survival?1) prevention of arrest 2) early high-quality bystander CPR 3) rapid activation of the emergency response system 4) effective advanced life support (including rapid stablization and transport to post-cardiac arrest care) 5) integrated post-cardiac arrest care
memorize
CARDIAC ARREST OR HEART ATTACK?
Question Answer
What is sudden cardiac arrest?1) occurs when the heart develops an abnormal rhythm and can't pump blood 2) the abnormal rhythm causes the heart to quiver so it can no longer pump blood to the brain, lungs and other organs 3) sudden cardiac arrest is often a "rhythm" problem 4) within seconds, the person becomes unresponsive and is not breathing or is only gasping. 5) death occurs within minutes if the victim does not receive immediate lifesaving treatment
What is a heart attack?1) occurs when blood flow to part of the heart muscle is blocked 2) it occurs when a clot forms in a blood vessel carrying oxygenated blood to the heart muscle. If the blocked vessel is not reopened quickly, the muscle normally nourished by that vessel begins to die 3) a heart attack is a "clot" problem 4) signs of a heart attack may appear immediately or last weeks or longer and may include severe discomfort in the chest or other areas of the upper body; shortness of breath; cold sweats; nausea/vomiting 4) typically during a heart attack, the heart continues to pump blood. The longer the person with a heart attack goes without treatment, the greater the possible damage to the heart muscle 5) occasionally the damaged heart muscle triggers an abnormal rhythm that can lead to sudden cardiac arrest 6) heart attack symptoms in women can be different from those in men, and women may be more likely to experience pain in the jaw, arms, back or neck; light-headedness; nausea / vomiting
Most heart attacks do not lead to sudden cardiac arrest, though a small percentage of people with a heart attack will develop sudden cardiac arrest. But when sudden cardiac arrest occurs, heart attack is a common cause. Other conditions may also change the heart's rhythm and lead to cardiac arrest, true or false?true
memorize
REVIEW QUESTIONS:
1) In which locations do most out-of-hospital cardiac arrests occur?
a) healthcare clinics
b) homes
c) recreational facilities
d) shopping centers
Answer = b
2) Which is the most common cause of cardiac arrest in children?
a) cardiac problem
b) congenital or acquired heart defect
c) respiratory failure or shock
d) infection and sepsis
Answer = c
3) What is the third link in the adult out-of-hospital Chain of Survival?
a) advanced life support
b) high-quality CPR
c) prevention
d) rapid defibrillation
Answer = d
4) Which statement best describes sudden cardiac arrest?
a) when respiratory distress in adults occurs and the heart rate does not change
b) when the heart rate is 40-60 / min and respirations increase
c) when blood flow to the heart is blocked and the heart rate increases
d) when an abnormal rhythm develops and the heart stops beating unexpectedly
Answer = d