For staff with direct patient contact Assessment

1. The main assessment indicator of a sudden cardiac arrest in a non-responsive adult victim is: Inability of the rescuer to detect a carotid pulse Absence of normal breathing Unresponsive

Correct Answer is 2 - Absence of normal breathing There is evidence to suggest that relying on a check of the carotid pulse to diagnose a cardiac arrest is unreliable and wastes time. This is particularly so when carried out by non health care professionals.

2. What is the most likely physiological origin of a cardiac arrest in adults? Cardiac system Respiratory system Central nervous system

Correct Answer is 1 - Cardiac system Cardiac arrests in adults are predominately of a cardiac origin. Understanding this is important, as current guidelines on adult basic life support reflect the importance placed on providing good quality, cardiac compressions quickly

3. Which of the following is the recommended technique for opening an adult victim’s airway during basic life support? Jaw thrust Head tilt, chin lift

Correct Answer is 2 - Head tilt, chin lift The head-tilt chin-lift is the most reliable method of opening the airway and is the primary manoeuvre used in any person in whom cervical spine injury is not a concern. It is the simplest way of ensuring an open airway in an unconscious victim. The technique lifts the tongue from the back of the throat thus opening the airway. The jaw-thrust manoeuvre is an effective technique for opening the airway, particularly in a victim in whom cervical spine injury is a concern. The technique is not advocated for use by lay rescuers or inexperienced health care personnel.

4. How long should you take to check if a collapsed adult victim is breathing normally? As long as it takes 20 seconds No more than 10 seconds Don’t bother to check because it’s not important to check breathing in a collapsed adult victim

Correct Answer is 3 - No more than 10 seconds Studies have shown that checking for normal breathing is prone to error, particularly as agonal gasps are often misdiagnosed as normal breathing. Remember, cardiac arrests in adults are most commonly of cardiac origin. If you have any doubt as to whether the breathing is normal or not, act as if it’s not normal

5. The depth that an adults chest can be compressed to during cardiac compressions is approximately one third True False

Correct Answer is 1 - True There is evidence to suggest that when chest compressions are carried out on both adults and children, they are frequently too shallow. In adults, a depth of 5-6 cms should equate to approximately one third of the chest depth. Don’t be afraid to push too hard.

6. Which of the following are true statements? Interruptions to chest compressions are associated with a reduced chance of survival Agonal gasps are present in up to 40% of cardiac arrest victims compressions Both statements above are true

Correct Answer is 3 – both statements above are true Interruptions to chest compressions are common and have been shown to reduce the chances of the victim surviving. The best chances of survival for any victim are to deliver continuous cardiac compressions whilst delivering rescue breaths independently. In the first few minutes after a cardiac arrest a victim may be breathing in a very shallow manner or taking a few noisy breaths or gasps. It is important to distinguish these from normal breathing.

7. Which of the following is the method of choice for CPR by trained lay rescuers and professionals? Compression only CPR Chest compression combined with rescue breathing

Correct Answer is 2 - Chest compression combined with rescue breathing Compression only CPR may be as effective as combined ventilation and compression in the first few minutes after non- asphyxia arrest. However, it is effective for only a limited period (less than 5 minutes).Lay rescuers who are unwilling to do rescue breathing are encouraged to do cardiac compression only resuscitation.

8. What is the recommended ratio of chest compression to rescue breaths in an adult victim? 15 compressions + 2 breaths 20 compressions + 5 breaths 30 compressions + 2 breaths

Correct Answer is 3 - 30 compressions + 2 breaths 30 compressions at a repeat rate 100 -120 times per minute followed by 2 rescue breaths. Compression and release time should be equal Depth 5- 6cms Periodically recheck correct hand positioning if resuming chest compressions Interruptions in chest compressions are common and are associated with reduced chance of survival.

9. Which option is the recovery position most suitable to maintain a patent airway in an unconscious breathing adult victim? Lying down, face up Lying down, face down Lying on side, mouth down, chin up

Correct Answer is 3 - Lying on side, mouth down, chin up The recovery position refers to one of a series of variations on a lateral, recumbent or three-quarter prone position of the body, in to which an unconscious breathing victim should be placed to maintain a patent airway. There are several variations of the recovery position but all share basic principles. The mouth is downward so that fluid can drain from the victim’s mouth and airway; the chin should be up to keep the airway. Arms and legs are used to stabilise the victim’s position. An unconscious victim left on their back may not be able to maintain a patent airway. This can lead to an obstruction of the airway by the tongue.

10. A collapsed victim is not breathing normally 10. A collapsed victim is not breathing normally. Which of the following should be considered when calling for help? Ask someone else to call Use your mobile if you’re on your own Only leave the victim if there is no other option All of the above

Correct Answer is 4 – all of the above Appropriate action at this could save the victim’s life and delay will increase the risk of mortality. If possible, the victim should not be left alone at any stage. Ask someone else to call for help or use your mobile

THANK YOU End of the assessment

Delegate Scores 21 Clare Martin 14 Linda Waldron 13 Maria Costello 12 Paula Hatch