SOLUTIONS
Principles of high quality CPR - ANSWER
Ways to ensure the delivery of high quality CPR - ANSWER - Allow the chest to recoil fully
- Compress to a depth of at least 2 in but not more than 2.4 in
- Minimize interruptions to chest compressions
- Provide compressions at the proper rate (100 to 120/minute)
How to insert an oropharyngeal airway. - ANSWER
how to insert nasopharyngeal airway - ANSWER
Considerations when an advanced airway is in place - ANSWER
Proper placement of electrodes for monitoring of HR, rhythm, and obtaining 12 and 15-lead ECG -
ANSWER
Procedure for defibrillation - ANSWER
Procedure for synchronized cardioversion - ANSWER
Procedure for transcutaneous pacing - ANSWER
Procedure for obtaining intraosseous (IO) access - ANSWER
How to interpret EtCO2 during resuscitation ventilation? - ANSWER 30-45 what it is normally
, 15-20 during a resuscitation
Below 10 could be a problem with rate or quality of compressions
Spike is often the first sign of ROSC
Four components of communication - ANSWER Sender, message, receiver, feedback (closed loop
communication)
Debriefing - ANSWER Review, Analyze, Reflect, Summarize
Team leader responsibilities - ANSWER - Assigns team roles
- Sets expectations
- Prioritizes, directs, acts decisively
- Encourages and allows team input and interaction
- Focuses on big picture
- Monitors performance while providing support
- Acts as a role model
- Coaches the team
- Re-evaluates and summarizes progress
- Leads a debriefing session
Team member responsibilities - ANSWER - Have the knowledge and skills to perform their assigned role
- Communicate with the team leader if they feel they are lacking the above, identify something the team
leader may have overlooked, recognize a dangerous situation or need for urgent action
- Stay in their assigned role but assist others as needed, as long as they are able to maintain their own
responsibilities
Six-Person High-Performance Resuscitation Team - ANSWER Includes three CPR/defibrillator roles, and
three leadership/supportive roles
1) Airway manager and ventilator
, 2) Compressor
3) AED/Defibrillator operator (also relieves for compressions)
4) Establishing vascular access and administering medication
5) Team leader prioritizing/directing others' actions
6) Data Manager - communicates and records key data (i.e. med admin or interruptions to chest
compressions)
Example of a debrief review - ANSWER A 15-year-old patient who had been brought to the emergency
department for evaluation of an earlier episode of syncope went into witnessed ventricular fibrillation.
Compressions were started, defibrillator pads were applied and an initial shock of 120 J was delivered.
An OPA was inserted and high-flow oxygen was initiated. After 2 minutes of CPR and a rhythm check, the
patient was observed to still be in ventricular fibrillation; a second shock of 150 J was delivered, CPR was
resumed, 1 mg of epinephrine was administered and capnography monitoring was established. After
approximately 1 more minute of CPR, the patient achieved ROSC.
What should be prioritized during ventricular fibrillation - defibrillation or ventilations? - ANSWER
Defibrillation is the most effective therapy for the treatment of vfib
A systematic approach to assessment includes a ____, ____, and ____ assessment. - ANSWER Rapid,
primary, secondary
- Initial impression
- Responsiveness
- Breathing
- Pulse
Are components of a _____ assessmetn - ANSWER Rapid
- Airway
- Breathing
- Circulation
- Disability