1
Q
What does CPR stand for? Define it.
A
- Cardiopulmonary Resuscitation.
- CPR is used to establish arificial ventilation and circulation in a patient who is not breathing and has no pulse.
2
Q
As a Health Care Provider, what are the three main populations you will be learning CPR for?
A
- Adults
- Children
- Infants
3
Q
What does BLS stand for? Define it. What is the difference between BLS and BCLS?
A
- BLS stands for Basic Life Support
- BLS is a noninvasive emergency lifesaving care that is used to treat medical conditions including airway obstruction, respiratory arrest, and cardiac arrest.
- No difference, the two are used interchangably, BCLS stands for Basic Cardiac Life Support.
4
Q
What does ALS stand for? Define it. How about ACLS?
A
- ALS stands for Advanced Life Support
- ALS involves advanced lifesaving procedures such as cardiac monitoring, administration of intravenous (IV) fluids and medications, and use of advanced airway adjuncts.
- ACLS stands for Advanced Cardiac Life Support, used interchangably with ALS.
5
Q
Define arrest (medical definition). What is respiratory arrest? What is cardiac arrest?
A
- Arrest is cessation or stoppage in terms of function or disease process
- Respiratory arrest is the cessation (temporary or complete stopping) of normal breathing due to failure of the lungs to function effectively.
- Cardiac arrest is the cessation (temporary or complete stopping) of functional circulation of blood due to failure of the heart to contract effectively.
6
Q
What are Ventilations?
A
- The exchange of air between the lungs and the atmosphere so that oxygen can be exchange for carbon dioxide in the alveoli.
7
Q
What does code mean? Define code blue.
A
- Code “insert color here” is typically used to signify that an emergency is occuring.
- Code blue means someone is dying (especially in cardiac arrest) and needs saving.
8
Q
What are the functions of the American Heart Association (AHA) perform?
A
- Research
- Training
- Public Education
9
Q
What is the Chain of Survival? What are the segments of the Adult Chain of Survival?
A
The chain of survival refers to a series of actions that, when put into motion reduce the mortality associated with cardiac arrest.
- Early access: someone must recognize (or witness) an impending cardiac arrest and activate EMS.
- Early CPR: bystander CPR (emphasis on chest compressions)should be provided immediately after collapse of a patient; provide oxygen to the brain to prevent biological death.
- Early Defibrillation: shock the heart to stop its ventricular fibrillation or pulseless ventricular tachycardia.
- Early ACLS: effective advanced cardiac life support is another critical link the chain of survival usually done by paramedics and AEMTS.
- (Handbook extra) Integrated post-cardiac arrest care; typically intregrated with “early ACLS” step in the typical definition of chain of survival.
10
Q
Describe each step in the Pediatric Chain of Survival.
A
- Early prevention of arrest (such as keeping small objects away from infants since they will choke on it. Often cardiac arrest is second to respiratory arrest for children.)
- Early CPR
- Early Access: activation of EMS
- Early ACLS
- (Handbook extra) Integrated post-cardiac arrest care.
11
Q
What does ECC stand for?
A
- Emergency Cardiovascular Care
12
Q
Define Clinical Death. Define Biological death.
A
- Clinical death: no pulse, not breathing
- Biological death: permanent, irreversible brain death (begins 4-6 minutes after arrest)
13
Q
What are the CABD’s of CPR?
A
- C: Chest Compressions; circulation
- A: Airway
- B: Breathing
- D: Defibrillation
14
Q
According to the American Heart Association (AHA) what counts as an adult in which we perform adult CPR?
A
- Adults include adolescents, populations after the onset of puberty such as chest or underarm hair in males and any breast development in females and onward.
- However! If the patient is as big as an adult anyhow, treat them like so.
15
Q
What causes cardiac arrest?
A
- Heart attacks (cardiovascular disease) poor circulation so heart muscle starts to die.
- Trauma (Getting hit hard in the chest, car accident, etc…)
- Drowning
- Drugs
- Electrocution
16
Q
What can cardiovascular diseases lead to?
A
- Heart attack (myocardial infarction; MI) death of heart muscle tissue from vessel blockage.
- Stroke: cerebral vascular accident; CVA; brain attack; clogged blood vessels blocking blood to the brain
- Aneurysm: genetic defect in which vascular walls are weakened and enough force to the walls will cause it to bubble, then burst, blood leaks, thus oxygen depreviation.
17
Q
What are the signs of a Heart Attack? What should you do if you have chest pain?
A
A heart attack usually has crushing chest pain; agina pectoris
- Typical symptom: pressure, “tightness”, dread; feeling like they are going to die, denial.
- Atypical symptoms: indigestion, jaw pain down to left arm
If you have chest pain or any of these symptoms for that matter, activate EMS.
18
Q
What is ventricular fibrillation? What is the most effective step in the chain of survival against this heart condition?
A
- Arhythmic heart activity, heart is not beating correctly, quiviering.
- Early defibrillation
19
Q
How many types of defibrillators are there? What is the AHA goal regarding this?
A
- Manual: paramedics typically use this one. It is equipped with an ECG reader and the voltage and shock settings are manual
- Semiautomatic: the one we typically use such as the AED, it is equipped with interchangable adult, child, and infant pads in which the machine adjusts its voltage accordingly. It instructs you on what you need to do.
- Automatic: implanted in a person as a device (AID) automatic internal defibrillator. It monitors the heart and it shocks automatically at the sign of heart problems.
Public access is AHA goal.
20
Q
What is PAD?
A
- PAD stands for public access defibrillation. AEDs can be found at…
- Casinos
- Airports
- City Buildings
- Senior centers
- Gated communities
- Gyms
- etc…
21
Q
What are the typical signs and symptoms of a stroke or “brain attack”? What is the number one risk factor for strokes?
A
1 risk factor is hypertension (high blood pressure) for it causes the body to degrade from overworking itself.
Signs and symptoms of stroke…
- Hemiparesis & hemiparalysis: paralysis of half of the body; restricted movement
- Massive headache and blurred vision
- Aphasia: speaking problems as if they were drunk
- One sided face droop
22
Q
Define CVD risk factors. What are CVD risk factors that cannot be changed? How about those can be changed? What are some common conditions (e.g. diseases) people have that also serve as a factor for CVD? What can multiple risk factors do?
A
CVD risk factors are factors that influence the probability of cardiovascular disease.
CVD risk factors that cannot be changed are..
- Heredity: person’s genome could case it (does it run in familiy?)
- Gender: typically males
- Age: the more older you are, the more likely a heart attack will happen
- Race
CVD risk Factors that can be changed are…
- Smoking
- High blood pressure
- High cholesterol (found in eggs, red meats, diary products)
- Lack of exercise
Other factors…
- Diabetes
- Obesity (excess pressure; poor digestion; poor circulation)
- Excessive stress
Having multiple risk factors poses a greater risk than having 1 risk factor.
23
Q
Why is prevention emphasized in the chain of survival for pediatrics?
A
When it comes to pediatric safety, injury due to “accidient” is the number one cause of death and most are preventable. Cardiac arrest in younger individuals is caused by preventable causes.
- Seat belts
- fire safety
- pools
- firearms
- etc…
24
Q
What is the common cause of death in pediatrics?
A
- Airway problems are common cause of death in infants and children
- Respiratory arrest from preventable causes lead to cardiac arrest
25
When is a patient obviously dead? What must you check when a patient is obviously dead? What are special situations in which a patient is considered under this category?
* Decapitation
* Incineration
* Decomposition (stench accompanied)
* Evisceration of heart, lung, or brain
* Post mortem lividity (all blood settles with gravity to bottom part of body)
* Rigor mortis
Check the apical pulse.
Special situations...
* MVI with limited resources
* Entrapment (\>15 minutes extrication time; trapped for more than 15 minutes)
* ?
26
What are reasons to stop CPR?
* Patient revives
* Patient is turned over to rescuers of equal or greater training
* Doctor tells you to stop
* You are so exhausted you cannot continue
* If your life is in danger
* During patient assessment or reassessment after five cycles of CPR
* Patient has a DNR (Do not Resusitate)
27
What do you do when you enter a scene with an individual (state for both adults and pediatric populations) that is possibly unconscious? (State steps up to EMS activation)
* Check if the scene is safe
* Shake the individual's shoulder and shoulder and shout to establish whether they are responsive, if not...
* Adults
- Initate EMS (911) immediately and get AED (if another person isn't there)
* Children and infants
- Witnessed: initate EMS (911) immediate and get AED.
- Unwitnessed: 5 cycles of CPR first, then initate EMS (911) and get AED
28
How do you position the patient for CPR?
* In a supine position
* On a hard surface
29
What state of being do you need to note the patient is in before you treat them based on an obstruction in their airway? What are the types of obstructions the airway can have?
* Are they conscious or unconscious?
* Conscious = try to clear airway via heimlich maneuver (adults/children 1 year or older) and a combination of back slaps with chest thrusts for infants.
* Unconscious = switch to CPR with an additional step of checking for the obstruction.
Types of obstructions
* Anatomical obstruction (tongue, finger, etc...)
* Solid obstruction (Food, toys, etc...)
* Liquid obstruction (Water, drowning, acid reflex, etc...)
30
How do you open the airway for the patient for CPR?
* Using the head-tilt chin lift (preferred)
* If they have a suspected neck injury: use the modifed jaw thrust
31
What are the types of ways you could do breathing for the CPR victim?
* Mouth-to-mouth
* Mouth to nose and mouth (infants)
* Mouth to stoma
* Mouth to mask
32
When do you do rescue breathing? How often do you do rescue breathing?
Rescue breathing is done when the patient has a pulse but they are not breathing.
* Adult = 1 every 5-6 seconds
* Child = 1 every 3-5 seconds
* Infant = 1 every 3-5 seconds
33
When do you know that you are giving the patient adequate ventilation when administering breaths?
* No resistance
* No escape of air around mask
* Chest rise - stop when chest begins to rise
34
What complications could occur during rescue breathing?
* Gastric distention which is the entering of air into the stomach
* Over ventilating from no head tilt (don't push head back too far or too forward)
35
How do you perform circulation doing CPR? How fast should the compressions be? How much should the depth of compressions be? How should the positioning be?
* You do it through chest compressions at the proper speed, depth, and position.
* 100 times/min for adults, children, and infants
* The depth of compressions should be...
* Adults 1 1/2 - 2" (1/2 of patient's body depth)
* Children 1 - 1 1/2" (1/3 of patient's body depth)
* Infant 1/2-1" (1/3 of the patient's body depth)
* The hand position should be at the nipple line off the zyphoid process
* Adults: 2 hands
* Children: 1 hand
* Infant: 2 fingers
36
What are the ratios of compressions to ventilations for adults, children, and infants?
* Adults would be 30:2 even if there are multiple rescuers
* Children/infant would be...
* 30:2 (1 rescuer)
* 15:2 (2 rescuers)
37
What are complications that can occur with compressions? Why? What should you do if you break ribs?
* Fractured ribs
* Fractured sternum (pop!)
* Lacerated lungs
* Lacerated liver, blood vessels, etc...
It happens when you go past 1/2 or 1/3 of the body depth
If you break ribs, just check your hand position and keep going!
38
How often do you check for a pulse during CPR?
You pause to recheck the pulse after 5 cycles of CPR (~2 minutes)
39
When do you interrupt CPR?
* 5-10 seconds to check a pulse. etc...
* During AED rhythm analysis and delivery of shocks
40
What are special situations in which you would use CPR?
* Cold water drowing
* Hypothermia
41
What laws would protect you?
Good samaritan laws, they should reduce your fear of being sued.
42
With a partner, enact a conscious choking adult and unconscious choking adult scenario. Lead each other through it!
## Footnote
Include these components!
- Choking (conscious, unconscious)
- CPR
- When to activate EMS!
- Rescue breathing
- What if you had two rescuers?
-Varies with partner
43
With a partner, enact a conscious choking infant and unconscious choking infant scenario. Lead each other through it!
Include these components!
- Choking (conscious, unconscious)
- When to activate EMS!
- CPR (Note pulse rate!!)
- Rescue breathing
-Varies with partner
Emergency Medical Technology
flashcards
Decks in class (22)
# Cards
-
Introduction to EMS40
-
BLS: CPR/AED/Choking43
-
AED deck9
-
Basic Sciences15
-
Vital Signs21
-
Positioning a patient6
-
Patient Assessment52
-
Shock21
-
Respiratory system36
-
Ambulance Module17
-
Chest trauma22
-
Acute Abdomen and Abdominal Trauma41
-
Cardiovascular System29
-
new6
-
EMT - 1 Expanded Scope20
-
Nervous System47
-
Diabetes16
-
Behavioral Problems11
-
Musculoskeletal System & Emergencies40
-
Sensory Organ Injury and Emergency20
-
Environmental Emergencies22
-
Hazmat, ICS, WMD18
