1. Assess, Recog- nize and Care Concept 2. Rapid Assess- ment a systematic, continuous approach for responding to emergency situations Perform a visual
... [Show More] survey, checking responsiveness, open- ing the airway while simultaneously checking for breathing and pulse 3. visual survey assess for safety, formulate initial impression of the pa- tient, determine need for additional resources 4. Scene size up safety, number of patients, and the NOI or MOI 5. When a patient is unresponsive re- member to activate EMS and get AED 6. Open Airway Make sure patient is in supine position use head/tilt - chin/lift or modified jaw thrust maneuver 7. Checking Patient's Pulse/Breathing 8. Emergencies Re- quiring BLS 9. Injury or Illness (responsive) 10. Injury or Illness (unresponsive) check for at least 5 seconds, no more than 10 sec Agonal breaths or isolated or infrequent gasps are not normal breathing Do not reach across when checking carotid pulse (could obstruct airway) Injury/Illness, respiratory arrest, cardiac arrest, obstructed airway, and opiod overdoes If Responsive, obtain consent to provide care, reassure them, and take steps to find out what occurred activate EMS, call for AED, if no suspected head/neck/spine or pelvic injury place in side laying re- cover position - if injury is suspected, refrain from moving unless necessary - Monitor patient until help arrives 11. ROSC Return of spontaneous circulation 12. Respiratory Ar- rest 13. How should you deliver ventila- tion during respi- ratory arrest patient is unresponsive, is not breathing normally (or only gasping) but has a pulse. deliver 1 ventilation every 5 to 6 seconds, each ventilation should last 1 second and make chest begin to rise 14. Cardiac Arrest Patient is unresponsive, not breathing normally and does not have a pulse *start CPR within 10 seconds of recog- nizing cardiac arrest and use AED when it's available 15. In-Hospital Car- Surveillance and prevention diac Arrest Chain Recognition of a cardiac emergency and activation of of Survival 16. Out-of-hospital Cardiac arrest 17. myocardinal in- farction (MI) 18. Signs and Symp- toms of MI Emergency response system Early CPR Early Defib Integrated post-cardiac arrest care Recognition of Cardiac Emergency and Activation of emergency response system early cpr early defib advanced life support integrated post-cardiac arrest care Refers to the necrosis (death) of heart tissue as a result of insufficient delivery of oxygenated blood for the heart chest discomfort/pain that is severe that lasts longer than 3-5 minutes, goes away and comes back or persists even during rest Discomfort pressure or pain that can be uncomfortable to unbearable, Crushing sensation in the chest that could spread to the arm, shoulder, neck, jaw, stomach and back and is usually not relieved by switching position, rest or medication, difficulty breathing, pale or ashen skin (face), diaphoresis, nausea, vomiting, dizziness, light- headedness, possible altered mental status 19. Atypical Warning Signs of MI 20. Immediate Care for MI (depending on facility's pro- tocol) 21. High Quality CPR for Adults Occurs most often in women, diabetics, and older patients symptoms: shortness of breath, stomach back or jaw pain, unexplained fatigue or malaise May occur with or without chest pain - may be atypical chest pain - sudden, sharp, but shortlived outside the breastbone administer (2-4) low dose (81-mg) or (1) [325mg] adult aspirin additional care may include: administering oxygen, other medications, and diagnostic tests 30 chest compression followed by 2 ventilations (30:2) 22. Key Components Compress the chest at a rate of 100-120 compressions of High-Quality CPR 23. Ventilations for Cardiac Arrest 24. ventilations dur- ing respiratory arrest per minute compress the chest to a depth of at least 2 in, but no more than 2.4 in allow for full chest recoil Minimize interruptions to chest compressions to 10 sec Avoid excessive ventilations - each ventilation should last about 1 second and deliver enough volume to make the chest begin to rise deliver 2 ventilations that last 1 second and make chest begin to rise deliver 1 ventilation every 5-6 seconds, each ventilation should last 1 second and make chest begin to rise check the pulse and breathing every 2 minutes if patient does not have pulse begin CPR 25. BVM Bag-Valve-Mask Resuscitator hand held device attached to a resuscitation mask that is used to ventilate a victim in respiratory arrest or when performing CPR. 26. 26. CPP (coronary perfusion pres- sure) 27. Ventilations us- ing BVM Re- suscitator deliv- ers how much oxygen concen- tration to patient 28. Ventilations for Patient in Car- diac Arrest 29. When an ad- vanced airway is in place dur- ing respiratory arrest 30. Automated Exter- nal Difibrillator (AED) 31. AED's Deliver de- fibrillation(s) to patients with two specific arrhyth- mias 32. When a patient experiences car- diac arrest an should be applied as soon as possible to in- the difference between the pressure in the aorta and the pressure in the right atrium during diastole 20%-21% *Attaching supplemental oxygen can increase concentra- tion up to 90%-100% and is recommended as soon as possible 2 or more providers must be present, 1 delivers ventilation every 6 seconds while other delivers continuous chest compressions. *Since providers do not pause for ventilations, ratio 30:2 does not apply deliver 1 ventilation every 6 seconds portable electronic device that automatically analyzes the patient's heart rhythm and provides DEFIBRILLATION (electric shock that may help the heart re-establish a per- fusing rhythm Ventrical fibrillation (VF) and Ventrical tachycardia (VT) AED crease patient's chances of sur- vival 33. For every 7% to 10% 1-minute delay in CPR and defibril- lation, a patient's chance of sur- vival is reduced by to 34. AED Safety (Pa- Pregnancy - it is safe to use AED tient Considera- Trauma - use AED tions) Pacemakers or ICDs - you should use AED, however adjust placement of pads to ensure it's not placed over device Transdermal Medication Patches - before applying AED, remove with gloved hands, and wipe away additional med- ication Chest Hair - Quickly shave prior to placing pads Jewelry and piercings - AED can still be used, just adjust pad placement if necessary (don't place directly over met- al) 35. AED Operator this team member manages AED and relieves the com- Role pressor 36. Compressor This team member is responsible for chest compressions Role 37. Team Leader The team leader assigns roles, sets clear expectations, Role prioritizes, directs, encourages team input and interaction, monitors the delivery of CPR/AED, makes adjustments in real time and focuses on the big picture 38. Airway Manager This team member maintains an open airway and seals Role the mask 39. This team member provides ventilations Ventilator Team Member 40. Recorder Team Member 41. For single and multi provider CPR, you should continue CPR/AED use un- til 42. True or False BVM should be completely de- flated 43. What could in- creasing difficul- ty when provid- ing ventilations using BVM Re- suscitation indi- cate 44. How does one provider operate BVM 45. If you are unable to make a com- plete seal over a patient's mouth, what might you do to continue ventilation? This team member records and communicates key data during the resuscitation effort, - for example, data related to interruptions to chest compressions other trained providers arrive and relieve you you see signs of ROSC, such as spontaneous movement or breathing You are presented with valid DNR (do not resuscitate) You are too exhausted to continue The situation becomes unsafe false: BVM resuscitators can hold more than 1000 mL of volume, and should never be completely deflated when providing ventilations. Doing so could lead to overventila- tion may indicate an increase in intrathoracic pressure, inade- quate airway opening or other complications. Communicate this info to your team so corrective actions can take place When one provider operates BVM, they maintain the mask seal and open airway with one hand in the E-C hand po- sition. With the other hand, they depress the bag halfway to deliver ventilations mouth to nose ventilations 46. How do two providers oper- ate BVM When two providers operate the BVM, one provider main- tains the mask seal and open airway with two hands in the EC position, while the other provider depresses the bag halfway to deliver ventilations 47. What is the oxy- 20% gen concentra- tion of ambient air 48. How much 16% to 17%, *breaking the seal after each ventilation oxygen helps maintain the oxygen concentration. concentration does a patient If you do not break the seal, the second ventilation can receive during contain 0% oxygen concentration and high concentration mouth-to-mouth of carbon dioxide ventilations 49. How do you de- make a seal over patient's mouth with your mouth, pinch liver mouth to the nose shut and deliver ventilations as you would using mouth ventila- a pocket mask tions 50. Chest Compres- represents the amount of time spend performing compres- sion Fraction sions, and is another way to gain objective feedback about (CCF) the quality of CPR. It is calculated by dividing the time that providers are in contact with the patient's chest by the total duration of the resuscitation event, beginning with arrival of team to achievement of ROSC or end of CPR 51. CCF of at least 60%, 80% should be the goal is needed to pro- mote optimal out- comes 52. capnography measures the end-tidal carbon dioxide level, is a noninva- sive way of obtaining an objective measure of compres- sion quality with every ventilation. 53. When should a provider deliver 2 initial ven- tilations before starting CPR 54. How often should a team of mul- tiple providers switch positions when providing CPR 55. What should providers use to monitor oxygen saturation 56. When should you NOT use pedi- atric AED pads 57. Anterior/Lateral Pad Placement 58. anterior/posteri- or pad placement 59. How is an infant defined when it comes to emer- gency care To measure the ETCO2 level, attach an adapter to BVM, or attach an adapter to the nasal cannula and place it under the mask. When high-quality CPR is provided ETCO2 levels should be in teh range of 15-20 mmHg If drowning or another hypoxic event is the suspected cause of cardiac arrest about every 2 minutes, taking no more than 10 seconds to switch pulse oximeter when providing care for an adult or child over 8 years old or weighing more than 55 lbs place one pad on the upper right chest, below right clavicle to the right of the sternum Place the other pad on the left side of the chest along the midaxillary line a few inches below the armpit place one pad to the center of the patient's chest--on the sternum place one pad to the patient's back between the scapulae someone under the age of 1, follow infant guidelines and use appropriately sized equipment 60. How is a child defined when it comes to emer- gency care 61. how is an ado- lescent defined when it comes to emergency care 62. Pediatric Cardiac Chain of Survival 63. Where should you tap an infant when determin- ing responsive- ness 64. The most com- mon causes of cardiac arrest in children includes 65. The pediatric car- diac chain of sur- vival focuses on because cardiac arrests in children often oc- curs as the result of preventable in- jury 66. When should you "call first" a child is defined as someone from the age of 1 to the onset of puberty (breast development in females, armpit hair in males) usually around age 12 an adolescent is defined as someone from the onset of puberty through adulthood. Follow adult guidelines and use appropriate sized equipment prevention of arrest, early CPR, early emergency care, pediatric advanced life support, integrated post cardiac arrest care (pediatric advanced life support) foot respiratory emergencies, congenital heart disorders, and trauma prevention for a child or an infant whom you witnessed suddenly collapse, or for an unresponsive child or infant with a known cardiac condition 67. When should you "care first" 68. What should you do with an infant when you need to get additional re- sources to care for them 69. It is critical to make sure a child or infant's brain is before leaving them to get additional re- sources 70. While caring for an infant, where do you check for their pulse? 71. When using the head-tilt/chin-lift technique on a child 72. when using the head-tilt/chin-lift technique on an infant 73. If a child or infant is in respiratory arrest for an unresponsive child or infant you did not see col- lapse, provide 2 minutes of care based on the conditions found then call for help to activate EMS and call for AED bring them with you oxygenated Brachial pulse with two fingers only tilt the head slightly past neutral position only tilt the head to a neutral position deliver 1 ventilation every 3-5 seconds 74. begin CPR withing 10 seconds and initiate AED use as soon as one is available if a child or infant is in cardiac ar- rest 75. When should you place a child or infant in recovery position to main- tain a clear air- way and monitor them until EMS arrives 76. When should you use the one hand compres- sion technique if the child/infant is unresponsive or experiencing an al- tered level of consciousness, is breathing normally and has a pulse when treating smaller children 77. Two-Finger Tech- nique Single providers should use this technique Using your hand closest to the infants feet, place two fingers in the center of the exposed chest parallel to the sternum, below the nipple line 78. Encircling Multiple providers should use this technique Thumbs Position (compressor) at infants feet, Position (ventilator) Technique at infants head Place both thumbs side by side on the center of the infant's chest, just below the nipple line, using the other fingers to encircle the infant's chest toward the back providing support Using both thumbs at the same time, compress chest about 1.5 in at a rate of at least 100 but no more than 120 compressions per minute, letting the chest return to normal position between compressions 79. Compression compression rate of 100 - 120 compressions per minute, Rate and Depth like with an adult for Children Compress chest about 2 in 80. Compression Rate and Depth for Infants 81. Ventilation tech- nique for chil- dren and infants 82. Compres- sion-to-ventila- tion ratio for children 83. compres- sion-to-ventila- tion ratio for infants 100 - 120 compressions per minute, at a depth of about 1.5 inches Same for cardiac arrests, 1 second and make chest begin to rise during respiratory arrest, deliver 1 ventilation every 3-5 seconds 30:2, however, in multiprovider cpr, ratio changes to 15:2 only one provider, 30:2, more than one provider 15:2 [Show Less]