For staff with direct patient contact who work with children and infants Assessment

1. What is the most likely physiological origin of a cardiac arrest in infants and children? 1.Cardiac system 2.Respiratory system 3.Central nervous system

Correct answer 3 - Respiratory system Cardiac arrests in adults are predominately of a cardiac origin, whereas asphyxial (respiratory) arrest is a more likely occurrence in children. Untreated, this may lead to a cardiac arrest. Understanding this is important, as a slightly different approach for paediatric basic life support has been developed with a focus on providing initial breaths before starting chest compressions.

2. What is the definition of an infant for paediatric resuscitation purposes? 1.Post birth to 5 years 2.1 year to 5 years 3.Post birth to 1 year

Correct answer 3 - Post birth to 1 year. Infant – post birth to 1 year Child – 1 year to post puberty If a lay rescuer with no specific knowledge of paediatric resuscitation, they should use the adult sequence. Just slight modifications will make the technique more suitable and hopefully effective for use in children.

3. Which of the following is the recommended technique for opening a child victim’s airway during basic life support? 1.Jaw thrust 2.Head tilt, chin lift

Correct answer 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 infant or child in whom cervical spine injury is not a concern.  It is the simplest way of ensuring an open airway in an unconscious child. 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. Which is not a reason why it’s important to only very gently stimulate infants and children who have collapsed to check their response? 1.You might frighten them 2.They may have a cervical spine injury 3.Shaking infants and small children can cause brain injury

Correct answer 1 - You might frighten them Infants and children should not be shaken. The anatomy of their brains are very delicate and this puts them at particular risk of neurological injury if shaken to vigorously. In addition, the child may have a cervical spine injury, particularly if they have collapsed because of an accident or trauma.

5. How long should you take to check if a collapsed infant or child is breathing normally? 1.As long as it takes 2.20 seconds 3.No more than 10 seconds 4.Don’t bother to check because it’s not important to check breathing in a collapsed child victim

Correct answer 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. If you have any doubt as to whether the breathing is normal or not, act as if it’s not normal.

6. If you assess an infant or child and find they are not breathing, should you give them 5 rescue breaths before assessing their circulation? 1.Yes 2.No

Correct answer 1 - Yes When an infant or child suddenly collapses it is often respiratory related. Therefore it is important to give up to 5 rescue breaths before checking their circulation. You should look for any gag reflex or coughing response to giving rescue breaths.

7. What depth should an infant or child’s chest be compressed to during cardiac compressions? 1.1/2 of the depth of the chest 2.2 cm 3.At least 1/3 of the depth of the chest

Correct answer 3 - At least 1/3 of the depth of the chest There is evidence to suggest that when chest compressions are carried out on both adults and children, they are frequently too shallow. In both infant and child victims the chest should be compressed to at least 1/3 of the depth of the chest. Infants approximately 4 cms Child approximately 5 cms. Don’t be afraid to push too hard.

8. What is the recommended ratio of chest compression to rescue breaths in an infant or child victim? 1.15 compressions + 2 breaths 2.20 compressions + 5 breaths 3.30 compressions + 2 breaths

Correct answer compressions + 2 breaths 15 compressions at a repeat rate times per minute followed by 2 rescue breaths. Compression and release time should be equal Depth – at least 1/3 of the depth of the chest Periodically recheck correct hand positioning if resuming chest compressions Interruptions in chest compressions are common and are associated with reduced chance of survival.

9. A collapsed child victim is not breathing normally. Which of the following should NOT be considered when calling for help? 1.Ask someone else to call 2.Use your mobile if you’re on your own 3.Only leave the victim if there is no other option 4.Take the child to hospital yourself

Correct answer 4- Take the child to hospital yourself Appropriate action at this could save the child’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. Use your mobile

10. If an infant victim shows signs of severe airway obstruction and is conscious you should firstly give: 1.5 chest thrusts 2.5 abdominal thrusts 3.Up to 5 back blows

Correct answer back blows You should firstly give up to 5 back blows to an infant victim who shows signs of severe airway obstruction. The aim is to relieve the obstruction with each blow rather than necessarily giving all 5. If back blows fail to relieve the obstruction, give up to 5 chest thrusts.

THANK YOU End of the assessment

Delegate Scores 10Rachael BYRNE10Samantha Elise KEANE 10Kirsty Anne FORREST10Emily Jane GARNETT 10Hannah Claire STOKES10Vicki-lea BELL 10Anne-Marie BOOTH9Emma SADLER 10Rachel ASTLES 10Amy GREGORY 10Ashley-marie SMITH 10Stacey Barbara HEATH 10Thomas Luke KELLETT 10Rachael Victoria JONES