BLS

Question 1

What are the changes with BLS for cardiac arrest since covid

Answer 1

• Wear non-AGP PPE for assessment and chest compressions
• AGP PPE needs to be worn for airway interventions and ventilations
• The A (airway) in DRS ABC has now been removed - do not open the airway and do not do head tilt chin lift
• Humidity moisture exchange filter added to bag valve mask

Question 2

What is the sequence for dealing cardiac arrest

Answer 2

1. check for danger
2. check for response
3. shout for help
4. check breathing and circulation
5. start chest compressions
6. AED
7. Airway intervention/ventilation
8. Post-resus care

Question 3

What is the process for checking for response

Answer 3

• Make sure patients mouth and nose covered
• Gently shake
• Speak loudly

Question 4

When shouting for help, what should you ask the person to do

Answer 4

Get the emergency kit

Call 999

Question 5

What should the person calling 999 say to emergency services

Answer 5

• Cardiac arrest
• Not breathing
• Location
• Contact number
• Covid status

Question 6

What is the process of checking breathing and circulation

Answer 6

• Palpate carotid pulse
• Hand on chest
• Check at same time for 10 seconds
• Agonal breathing may be seen - ignore it

Question 7

What PPE must be worn for chest compressions

Answer 7

non AGP PPE at least

Question 8

What is the technique for chest compressions

Answer 8

• Interlock fingers & straight elbows
• Compress 5-6cm
• 100-120 compressions per minnute

Question 9

How do we prepare the patient for AED

Answer 9

• Cut through clothing
• Dry up any sweat
• Shave chest if required

Question 10

What should you ensure when delivering shock

Answer 10

ensure you are far from the patient, do not touch any equipment and move oxygen 1m away

Question 11

What levels of the dental school will you find an AED

Answer 11

• 1
• 3
• 4
• 6
• 7

Question 12

What must be worn for airway intervention / ventilation

Answer 12

full AGP PPE

Question 13

What has been added to the bag valve mask since covid

Answer 13

HME

Question 14

What should oxygen be set at

Answer 14

15L of 100% oxygen per minute

Question 15

If patients chest doesn’t rise and fill in first 2 ventilations what should you do

Answer 15

use oropharyngeal airway adjuncts

Question 16

How do we size oropharyngeal airway adjuncts

Answer 16

• Rule of thumb is green for female and orange for male
• To size, one finger on mandible and size from here to the incisors

Question 17

How do we insert oropharyngeal airway adjuncts

Answer 17

• To insert, put in upside down and twist 180
• Once inserted keep going with 30:2
• If patient chest still doesnt rise, just continue

Question 18

What is the post resus care

Answer 18

• Reassess B + C
  
  • Reassure casualty even if unconscious
  • Maintain airway
  • Deliver oxygen via bag valve masque
• Do not remove AED pads
• Can cover up to maintain dignity and keep warm
• Be prepared for re-arrest

Question 19

What is the sequence for choking

Answer 19

1. ask can the cough
2. if unable to cough, 5 back blows
3. if doesn’t work, 5 abdominal thrusts
4. keep going between the 2 until relieved or unresponsive
5. CPR if becomes unresponsive

Question 20

How do you do back blows

Answer 20

• Lean person forward, supporting them at the front
• Apply blows between shoulder blades using heel of one hand

Question 21

How do you do abdominal thrusts

Answer 21

• Stand behind the person and put both your arms around upper part of abdomen
• Lean person forward
• Clench your fist and place it between the navel and ribcage
• Grab fist with other hand and pull sharply inwards and upwards

Question 22

How many rhythms are there in a cardiac arrest and how many are shockable?

Answer 22

4 - 2 are shockable

Question 23

What are the shockable rhythms?

Answer 23

Ventricular fibrilation (Vfib)

Pulseless ventricular tachycardia (V-tach)

(asystole and pulseless electrical activity are the non-shockable ones)

Question 24

What do you do if you pt does not have a shockable rhythm?

Answer 24

Continue CPR till ambulance arrives (remember everyone is an organ donar now)