AMERICAN RED CROSS BASIC LIFE SUPPORT |100 QUESTIONS AND ANSWERS.

You use critical thinking when you: Perform a rapid assessment and determine a course of action. Anticipate roles and functions as part of a team based on the patient's presentation and condition. Re-evaluate the situation for changes, interpret these changes and modify care accordingly. Closed-loop communication A communication technique used to prevent misunderstandings; the receiver confirms that the message has been received and understood. Team Leader Responsibilities Assigns and understands team roles. Sets clear expectations. Prioritizes, directs and acts decisively. Encourages and allows team input and interaction. Focuses on the big picture. Monitors performance while providing support. Acts as a role model. Coaches the team. Re-evaluates and summarizes progress. Leads a debriefing session. Asses Perform visual survey, check for responsiveness, and simultaneously check for breathing and pulse. When checking pulse and breathing, you check for at least 5 seconds but no more than 10 seconds Shoot-tap-shoot Used to check for patient responsiveness. On an adult or child, you tap the shoulder. On infant, you tap bottom of the foot. Recognize Patient may be experiencing a life-threatening emergency. Injury, respiratory arrest, cardiac arrest, obstructed airway, or opioid overdose. Care Provide care and Reassess and document What do you do for a patient in respiratory arrest? Deliver ventilations, no compressions. (when has pulse as well) What do you do for a patient in cardiac arrest? Start 30 compressions within 10 seconds of identification. Get AED and activate response team. Open the airway To check for breathing and a pulse, you must first open the patient's airway using either the head-tilt/chin-lift technique or the modified jaw-thrust maneuver. Modified jaw-thrust maneuver When patient as an expected neck or head injury. You are about to start your morning rounds, when you hear a loud crash in Mrs. Bailey's room. When you enter her doorway, you see her lying on the floor with her walker tipped over next to her. You must first perform a visual survey. What actions should you take? Scan the patient's room for any obvious hazards, determine whether any additional help is needed, and observe for any signs of illness or injury, including life-threatening bleeding. The room is safe to enter. As you approach Mrs. Bailey you do not see any signs of life-threatening bleeding, but she appears unresponsive. Which action should you perform next? Use the shoot-tap-shoot sequence to determine responsiveness. Mrs. Bailey is unresponsive. You suspect she may have a head injury. Which technique should you use to open Mrs. Bailey's airway? Modified Jaw Thrust As you check Mrs. Bailey's breathing, you look to see whether her chest rises and falls, listen for escaping air and feel for breathing against the side of your cheek. Is this the correct course of action? Yes Rapid assessment of Mrs. Bailey's breathing reveals irregular, gasping breaths. You correctly identify this pattern of breathing as: Agonal Breaths Adult In-Hospital Cardiac Chain of Survival Surveillance and prevention Recognition of a cardiac emergency and activation of the emergency response system Early CPR to keep oxygen-rich blood flowing and to help delay brain damage and death Early defibrillation to help restore an effective heart rhythm and significantly increase the patient's chance for survival. Integrated post-cardiac arrest care to optimize ventilation and oxygenation and treat hypotension immediately after the return of spontaneous circulation. ROSC (return of spontaneous circulation) After return of spontaneous circulation (ROSC), survival outcomes are improved when providers work to stabilize the patient, minimize complications and diagnose and treat the underlying cause. Myocardial Infarction (MI) a heart attack; a condition where the heart muscle does not receive enough blood and lacks oxygen, causing damage or death to that area of the heart Proper rate for compressions for adults 100 to 120 compressions 30:2 ratio 30 compressions 2 breaths What should you do to perform high quality CPR on adults? 100-120 compressions let chest fully recoil after each compression Depth of at least 2 inches no more than 2.4 inches Minimize interruptions to less than 10 seconds Depth of compressions for adults at least 2 inches no more than 2.4 inches Tidal volume for adults 400 mL to 700 mL Location for hands during CPR on adults Center of chest on the lower half of the sternum Hand position for adult CPR Other hand on top of the first one and fingers interlaced or hold them up. Shoulders directly over your hands with elbows locked Ventilations for adults in respiratory arrest Deliver 1 ventilation every 5 to 6 seconds; each ventilation should last about 1 second and make the chest begin to rise. Continue ventilations. Check the pulse and breathing about every 2 minutes. If you find no pulse, begin CPR. Ventilations for adult in cardiac arrest deliver 2 ventilations that last about 1 second each and make the chest begin to rise. Pocket mask ventilations Use of a pocket mask is recommended during single-provider CPR to limit interruptions in chest compressions. This allows you to remain at the side of the patient and limit unnecessary movement, which could delay your return to chest compressions. Bag-Valve-Mask Resuscitator Ventilations A BVM resuscitator is a handheld device used to ventilate patients during respiratory arrest or multiple-provider CPR. During single-provider CPR, use of a BVM resuscitator is not recommended because it will increase the time between sets of chest compressions resulting in poor outcomes. Unlike a pocket mask, a BVM resuscitator delivers ambient air rather than the provider's exhaled air. So, the patient receives a higher concentration of oxygen (approximately 20% to 21%) with BVM ventilations than with pocket mask or mouth-to-mouth (approximately 16% to 17%). Mouth-to-Mouth Ventilations Open the airway to a past-neutral position (for an adult). Pinch the patient's nose shut. Take a normal breath, make a complete seal over the patient's mouth with your mouth and blow into the patient's mouth to deliver 1 ventilation over 1 second until you see the chest begin to rise. After each ventilation, break the seal and take a breath before resealing your mouth over the patient's mouth. Then deliver the next ventilation. Mouth-to-Nose Ventilations If you are unable to make a complete seal over the patient's mouth, you may need to use mouth-to-nose ventilations instead. With the patient's head tilted back, close the mouth by pushing up on the chin. Seal your mouth around the patient's nose and breathe into the nose. If possible, open the patient's mouth between ventilations to allow air to escape. With a BVM when there is two providers, what happens? Cardiac arrest 1 ventilations every 6 seconds, compressions do not stop With BVM, what happens for respiratory arrest? 1 ventilation every 6 seconds When do providers switch positions during CPR? (no AED) Every 2 minutes High Quality CPR Conduct rapid assessment Place the patient on a firm, flat surface Position hands correctly Position your body effectively Provide 30 chest compressions Seal the mask and open the airway Provide 2 ventilations Switch positions every 2 minutes Continue providing CPR cycles How long should you wait to check pulse and breathing? every 2 minutes If using a feedback device, make sure the compressions are no more than _____________ deep. 2.4 inches Providers are preparing to deliver ventilations to a patient in cardiac arrest. One provider seals the mask with both hands in the E-C hand position and simultaneously opens the airway to a past-neutral position. The other provider depresses the bag. How much volume should be administered? The provider should supply 400-700 mL, depressing the bag halfway. When is using an AED safe? Pregnancy, Trauma, Pacemakers or ICDs, Transdermal Medication Patches, Chest Hair, Jewelry and Body piercings, Metal surfaces, and Inclement weather. When is AED not safe? Water or combustible materials What should you do with the AED when there is chest hair, jewelry, transdermal patch, or pacemaker present? Chest hair: quickly shave the areas. Jewelry: avoid placing AED patches on the jewelry or piercings. Transdermal Patch: remove the patch and wipe away remaining medication on skin. Pacemaker: Avoid placing patches near them. Single provider AED use If you do not have an AED with you, call for help and begin CPR. If you have no way of calling for help, place the patient in the recovery position and get the AED. Turn on the AED and follow the prompts, then expose the patient's chest. Attach the AED pads using an anterior/lateral or anterior/posterior position according to the manufacturer's recommendation. If necessary, plug in the connector and push the analyze button. Tell everyone to "clear" while the AED analyzes. No one, including you, should be touching the patient. If the AED advises a shock, again tell everyone to "clear." Press the shock button to deliver the shock, then immediately begin CPR. You do not need to wait for the AED prompt. Continue for about 2 minutes until: The AED prompts that it is reanalyzing.The patient shows signs of return of spontaneous circulation. Other trained providers arrive and relieve you.