BLS for healthcare providers

BLS for healthcare providers
Let’s review and test your knowledge!

DVD Menu & Student handbook
Part 1 Overview (2010 Key Changes): start-11:39 Part 2 Adult BLS (Adult BLS, Giving Breaths, 1-Rescuer, Using Bag-Mask, 2- Rescuer): 11:39-36:05 Part 3 Defibrillation: 36:08-46:25 Part 4 Child BLS: 46:25-50:53 Part 5 Infant BLS (2-Rescuer): 50:53-1:07:02 Part 6 AED Infant/Child: 1:07:02-1:08:23 (& Part 7 Advanced Airway: 1:08:23-1:08:35) Part 9 Rescue Breathing: 1:08:37-1:09:24 (& Part 8 Mouth-to-Mouth Breaths: 1:09:24-1:10:25) Part 10 Choking (& Infant Choking): 1:10:27-1:17:10

Part 1 – general concepts
7 slides

Name the 6 critical concepts of high-quality CPR needed to improve a victim’s chances of survival: Start compressions within 10 seconds Push hard, push fast Allow complete chest recoil Minimize interruptions in compressions Give effective breaths Avoid excessive ventilation

What is cardiac arrest in adults often caused by? A sudden cardiac event What is cardiac arrest in pediatrics often caused by? A result of respiratory failure and shock

What are the steps in the adult chain of survival? Immediate recognition of cardiac arrest & activation of EMS Early CPR with good chest compressions Rapid defibrillation Effective advanced life support Integrated post-cardiac arrest care

What are the steps in the pediatric chain of survival? Prevention of arrest Early high-quality CPR Rapid activation of EMS Effective advanced life support Integrated post-cardiac arrest care

Which of the following is not a step in the adult chain of survival? Early CPR with good compressions Effective advanced life support Rapid defibrillation Prevention of arrest D

Which of the following is the correct BLS sequence: Airway, breathing, chest compressions Circulation, breathing, airway Chest compressions, airway, breathing Breathing, chest compressions, airway C (CAB)

Part 2 – BLS for adults 16 slides

Part 2 – BLS/CPR for Adults
How do you decide if a child should be considered an adolescent and use the adult CPR protocol? After the onset of puberty as evidenced by chest or underarm hair in males & any breast development in females

Put these 6 initial steps in order: Carotid pulse check for 5-10 seconds Tap the victim’s shoulder & shout, “Are you all right?” Make sure scene is safe If no pulse, start compressions If no breathing or agonal gasps, shout for help. If no one responds, active EMS & get AED Check for breathing 3, 2, 6, 5, 1, 4

Agonal gasps can be defined as: Normal breathing for an unconscious cardiac patient Breathing too fast after a cardiac arrest Absence of breaths in a conscious patient A snort or snore that can occur after a cardiac arrest D

What is the compression:ventilation ratio for adults? 30:2 How many compressions per minute should be delivered in an adult? 100 What does it mean to allow complete chest recoil? To allow the chest to re-expand completely so blood flows into the heart

True or False?? For adult compressions press straight down at least 2” on the upper half of the sternum False-lower half Victims should be on a firm surface for effective compressions True-provides better blood flow

Why is it recommended that you don’t move the victim while CPR is in progress unless the victim is in a dangerous environment? Minimizing interruptions provides better CPR

Name 2 ways to open the airway: Head tilt-chin lift & Jaw thrust If you suspect a head or neck injury, which technique should you use? Jaw thrust

You are walking down the street and witness a man fall off the second story of his house. After going through all of the initial steps, you begin chest compressions and use the jaw thrust technique to open his airway. However, you are unable to get his airway open. What should you do? Continue to use jaw thrust due to risk of neck injury Use head-tilt chin lift Reposition his mouth None of the above B

Complete these statements about head-tilt chin-lift: Do not press deeply into the soft tissue under the chin because this might block the ________________. airway Do not use the ____________ to lift the chin. thumb Do not close the victim’s _____________ completely. mouth

In order to comply with OSHA regulations about standard precautions, which of the following should the HCW use during CPR? Gloves Bag-mask devices Mask barrier device All of the above D

Why do you think bag-mask ventilation is not recommended for lone rescuer CPR? It takes too long to position correctly When using a bag-mask what is the technique used to hold the mask in place called? E-C Clamp

Part 2 – BLS/CPR Adults You should squeeze the bag over ____ second(s) while watching for chest rise. 1 second 2 seconds 3 seconds 4 seconds A

Answer the following questions about 2-rescuer CPR: What should the 2nd rescuer do while the 1st rescuer starts CPR? Activate EMS & get AED After how many cycles should rescuers switch roles? How many minutes is that? 5 cycles – about 2 mins

It is important to count compressions out loud because: Effective teams communicate continuously The rescuer providing breaths can anticipate when breaths are due It helps to minimize interruptions It helps both rescuers know when the time for a switch is approaching All are correct!

There are 3 rescuers present, what would be the best arrangement of rescuers to provide the most effective CPR? 1 rescuer opens airway and holds mask 1 rescuer squeezes the bag 1 rescuer does chest compressions

Part 3 – aed for adults 8 slides

Part 3 – AED for Adults & Children 8 years of age & older
What does AED stand for? Automated External Defibrillator What is an AED? Computerized device that can identify cardiac rhythms that need a shock & deliver the shock

Which of the following statements about the heart is correct? The first step of operating an AED is to clear the patient A defibrillator delivers a shock to stop the abnormal rhythm & allow the heart to restart An AED can not help a person suffering from ventricular fibrillation The AED will only deliver 1 shock B

Put the following steps in the correct order: If shock is advised, clear the victim & press shock Power on the AED Analyze the rhythm-be sure no one is touching the victim Resume CPR after shock or if no shock was advised, start with chest compressions After 5 cycles or about 2 min, the AED will prompt you again to analyze the rhythm Attach AED pads-use adult pads for victims 8 yrs & older 2, 6, 3, 1, 4, 5

Draw AED pads on the victim’s chest in the correct position:

Fill in the blanks on the following statements: The shock is much more likely to be effective if you minimize interruptions between compressions and AED shock delivery to ____________ seconds or less. 10 Never move a patient while the AED is analyzing the rhythm because movement can cause a ___________________________. misreading

Which of the following statements about special situations while using the AED is correct? It is ok to place the AED pads over transdermal medication patches. Water will not interfere with the AED shock. Place AED pads over implanted defibrillators or pacemakers in order to help deliver the shock It is ok to use a razor to shave a victim’s chest if the pads will not stick. D

True or False?? It is ok to use the AED if the victim is lying on snow or in a small puddle? True

Part 4 – BLS for children 11 slides

Part 4 – BLS/CPR for children from 1 year of age to puberty
Nancy is performing CPR on Susie, a 4 year old who is not breathing and does not have a pulse. What should the compression:ventilation ratio be? 15:2 30:1 30:2 100 per minute C

How deep should Nancy be compressing into Susie’s chest? Select all of the correct answers. Approximately 2 inches 1/2 the depth of the chest At least 2 inches 1/3 the depth of the chest A and D

Which of the following statements is NOT correct based on the scenario with Nancy and Susie? Nancy can use 1- or 2- handed chest compressions Since Nancy did not witness the arrest and is alone, she should call activate EMS & get the AED first When Sam arrives and states he knows CPR, they can do 15 compressions:2 breaths The compression rate should be 100 per minute B

Most infants and children are thought to develop _________ arrest and bradycardia? Respiratory Cardiac Both answers are correct Neither answers are correct A

True or False?? Since most infants & children are thought to develop respiratory arrest & bradycardia before they develop cardiac arrest, they have a lower survival rate if they receive prompt CPR before developing cardiac arrest. False-they have a higher survival rate

True or False?? If the rescuer leaves a child with respiratory arrest or bradycardia to activate EMS, the victim may progress to cardiac arrest, and the chance of survival will be much lower. True

Which of the following statements is correct about CPR in children? For pulse check, auscultate the carotid or femoral pulse If the P<40 with signs of poor perfusion, begin CPR Palpate for a pulse for at least 5 seconds but no more than 10 seconds The bag mask barrier device should cover the eyes and overlap the chin C

Match the statement with the correct response for lone rescuer situations: Adult found unresponsive Child found unresponsive Witnessed adult arrest Witnessed child arrest Provide 2 minutes of CPR before leaving the victim to activate EMS & get AED Activate EMS & get AED 1-B A B B

True or False?? When sudden cardiac arrest occurs in adults, the O2 content in the blood is usually normal, so compressions alone may maintain O2 delivery to the heart & brain for the first few minutes after arrest. True but is this true for children too?

Do you know why it’s important to give both compressions & breaths for infants & children during CPR? They usually have respiratory failure or shock that reduces the O2 content in the blood before the onset of arrest. For that reason chest compressions alone aren’t as effective for delivering O2 to the heart & brain as the combination of compressions & breaths.

Part 5 – BLS for infants 13 slides

Part 5 – BLS/CPR for Infants
Which of the following statements is correct for BLS in infants? Infant mean babies up to 12 months of age The carotid artery should be used for pulse checks The compression rate is 30 compressions per minute Compression depth is approximately least ½” A

Match the correct picture to the following statements: A. 2 finger compression technique for singe rescuer 2 thumb-encircling hands technique Technique used for 2 rescuers Technique used for single rescuer B. 1-B 2-A 3-A 4-B

Fill in the blanks about infant CPR: Compressions should be at least ____________ the anterior-posterior chest depth. Compressions should be approximately ________ inches deep. Compression:ventilation rate is ____________ for one rescuer. Compression:ventilation rate is ____________ for two rescuers. Use the ____________________ artery for pulse checks. 1/3, 1 ½, 30:1, 15:2, brachial

1-B 2-A 3-A 4-A Part 5 – BLS/CPR for
Match the statement with the correct response for lone rescuer situations: Infant found unresponsive Witnessed infant arrest Adult found unresponsive Witnessed adult arrest Activate EMS & get AED Provide 2 minutes of CPR before leaving the victim to activate EMS & get AED 1-B 2-A A A

Fill in the blanks on the algorithm on the next slide and then check your answers on the following slide.

Which of the following statements about infant CPR is correct? Place the infant on a soft surface Place 2 fingers in the center of the infant’s chest just below the nipple line Press on the bottom of the breastbone Push hard and fast, make sure you don’t allow the chest to recoil completely B

How would you open the airway of an infant who has no suspected neck injury? Head tilt-chin lift What does it mean to keep the infant’s head in a neutral position? Why is this important? Keep external ear canal level with the top of their shoulders- Don’t extend the head beyond the sniffing position. This position is best to maximize airway patency

The 2 thumb-encircling hand technique is the preferred 2-rescuer chest compression technique because: It produces better blood flow It more consistently results in appropriate depth or force of compression It may generate higher blood pressures than the 2-finger technique All answers are correct

True or False?? When using the 2 thumb-encircling hands technique it is ok for the thumbs to overlap in very small infants. True

When giving breaths, watch for _________ __________ with each breath. It is important to switch roles every ______ minutes to avoid rescuer fatigue. Chest rise; 2 minutes

Part 6 – aed for infants & children
5 slides

Part 6 – aed for infants & children from 1 - 8 years of age
To deliver a shock to a pediatric victim, the rescuer should: Make sure to overlap the pads when applying them to the victim’s chest Use a manual defibrillator only for children over 8 years old Never use an AED on an infant Use adult pad for victims 8 years of age and older D

Draw a line to match the following situations to all of the correct responses. (See next slide for answers): Use the AED as soon as possible Use child pads if available Use only adult pads Use a child key or child switch Do not use child pads Do not use child key or child switch Ok to use adult pads Victims 8 years of age and older Victims Younger than 8 years of age

Victims 8 years of age and older: Use the AED as soon as possible Use only adult pads Do not use child pads Do not use child key or child switch Victims Younger than 8 years of age: Use the AED as soon as possible Use child pads if available Use a child key or child switch Ok to use adult pads

True or False?? Some AEDs have been modified to deliver different shock doses: one shock for adults and one for children. True For infants, a manual defibrillator is preferred to an AED for defibrillation. If a manual defibrillator is not available, you should not use an AED on an infant. False

Part 7 – CPR with an advanced airway
5 slides

Part 7 – cpr with an advanced airway
The compression rate for 2-rescuer CPR is: 30:2 15:2 At least 100/minute Different in adults and children C

Choose all of the following that are examples of an advanced airway: Endotracheal tube Mouth-to-mouth Bag-mask Laryngeal mask airway A & D

Fill in the blanks: Until an advanced airway is placed, rescuers must __________ compressions to provide breaths. Pause Once an advanced airway is placed, do not ____________ compressions to give breaths. Stop

When delivering breaths with an advanced airway, which of the following is correct? Give 1 breath every 6-8 seconds Give 8-10 breaths per second Give 100 breaths per minute Give 1 breath every seconds A

Part 8 – mouth-to-mouth breaths
9 slides

True or False?? Mouth-to-mouth breathing is the preferred technique to deliver breaths to victims. False using a pocket mask or bag-mask reduces the rescuers risk of infection

True or False?? Mouth-to-mouth breathing is a quick, effective way to provide oxygen to the victim. True

When providing mouth-to-mouth: Take a deep breath to deliver more oxygen to the victim Make sure the victim’s nose is not blocked by the rescuers hand If the chest doesn’t rise after 2 attempts, attempt to reposition the victim’s head and give another breath Give 1 breath over 1 second and watch for chest rise D

Fill in the blanks: If you are unable to ventilate the victim after 2 attempts, promptly return to _________ _________________. chest compressions Pinch the victim’s _________ closed with your thumb and index finger. nose

What is gastric inflation? When air enters the stomach instead of the lungs List 2 ways gastric inflation happens. Giving breaths too quickly Giving breaths with too much force

Which of the following statements about gastric inflation is correct? Gastric inflation never occurs when mouth-to-mouth is delivered properly To reduce gastric inflation deliver air until you make the victim’s chest rise Gastric inflation doesn’t lead to any serious complications Gastric inflation only occurs when using a bag-mask B

What is the preferred method for delivering breaths to an infant when a pocket mask or a bag-mask is not available? Mouth-to-mouth-and- nose

True or False?? If you are unable to cover the infant’s nose and mouth, pinch the victim’s nose tightly with your thumb and finger and use mouth-to-mouth breathing True How many breaths should you deliver to the victim? 2

Part 9 – rescue breathing
6 slides

When an adult, child, or infant has a pulse but is not breathing effectively, rescuers should __________. Give breaths without compressions Perform CPR starting with compressions Wait for agonal breathing before starting rescue breathing Monitor the patient for apnea A

Fill in the blanks regarding rescue breathing for adults: Give 1 breath every ___ to ___ seconds (about ___ to ___ breaths per minute) 1 breath every 5 to 6 seconds About 10 to 12 breaths/min

Fill in the blanks regarding rescue breathing for infants & children: Give 1 breath every ___ to ___ seconds (about ___ to ___ breaths per minute) 1 breath every 3 to 5 seconds About 12 to 20 breaths/min

Which of the following statement is correct about rescue breathing? Give each breath in 2 seconds Each breath should result in visible chest rise Check the pulse after every breath Children are not at risk for hypoxic injury B

Fill in the blanks: In infants & children, if, despite adequate oxygenation & ventilation, the pulse is <____ with signs of poor perfusion, start CPR. 60 Respiratory arrest is the absence of respirations which is known as ____________. apnea

Part 10 – relief of choking
9 slides

Which of the following statements is correct about relieving choking? Signs of severe airway obstruction include coughing forcefully Signs of mild airway obstruction include clutching the neck with the thumb and fingers If the victim cannot talk you should attempt to relieve the airway obstruction If the victim is wheezing between coughs that is a sign that you should attempt to relieve the airway obstruction C

Draw lines to match the victims to the correct technique to relieve choking & then check your answers on the next slide: Adult victim Obese victim Child victim Infant victim Pregnant victim Abdominal thrusts Chest thrusts Back slaps

If a choking victim becomes unresponsive: (choose all of the correct responses) Start CPR beginning with respirations Every time you open the airway to give breaths, check for the object After 5 cycles or 2 minutes of activate EMS if someone hasn’t already If you see an object, remove it with your fingers B, C, D are correct

List 2 ways you can tell if you have successfully removed an airway obstruction in an unresponsive victim. Feel air movement & see chest rise when you give breaths See & remove a foreign body from the victim’s mouth

Place the steps to relieve choking in a responsive infant in the correct sequence: Place your free hand on the infant’s back and while cradling the infant between your 2 forearms, turn the infant as a unit Deliver 5 back slaps Deliver 5 quick downward chest thrusts Repeat the sequence until object is removed or infant becomes unresponsive Hold the infant facedown with head slightly lower than the chest, resting on your forearm 5, 2, 1, 3, 4

True or False?? Always perform blind finger sweeps in infants & children so you can clear their airway. False-blind finger sweeps can push the foreign body back into the airway causing further obstruction If the infant becomes unresponsive, continue doing back slaps and chest thrusts False-stop giving back slaps & start CPR

Place the steps to relieve choking in an unresponsive infant in the correct sequence: Open airway Leave the victim and call 911 Give breaths Give compressions Look for obstruction object Give 2 cycles of CPR Remove object only if you can see it and it can easily be removed 4, 1, 5, 7, 3, 6, 2

appendix 4 slides

appendix Fill in the blanks on the summary on the next slide and then check your answers on the following slide.

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