CH 15-17 Numbers

Brain cells begin to die how long after cardiac arrest?

4–6 minutes (p. 523)

Defibrillation success drops by how much for each minute in VF?

10% per minute (p. 523)

Sudden death = patient dies within how long of symptom onset?

1 hour (p. 523)

Electrical phase of cardiac arrest (time)

0–5 minutes; heart is ready for immediate defibrillation (p. 523)

Circulatory phase of cardiac arrest (time)

5–10 minutes; high-quality CPR first improves shock success (p. 524)

Metabolic phase of cardiac arrest (time)

After 10 minutes; resuscitation rarely works (p. 524)

Chest compression rate (all ages)

100–120 per minute (p. 526)

Adult compression depth

At least 2 in (5 cm), not more than 2.4 in (6 cm) (p. 531)

Child compression depth

1/3 of chest depth, about 2 in (5 cm) (p. 530)

Infant compression depth

1/3 of chest depth, about 1.5 in (4 cm) (p. 530)

Adult compression:ventilation ratio

30:2 with one OR two rescuers (p. 531)

Infant/child compression:ventilation ratio

30:2 with one rescuer; 15:2 with two rescuers (p. 530)

Adult ventilation rate with an advanced airway

1 breath every 6 seconds (10/min), no pause in compressions (p. 526)

Pediatric ventilation rate during CPR or after ROSC (Ch 15)

1 every 2–3 seconds (20–30/min) (p. 526, 535)

Pediatric ventilation rate for respiratory failure (Ch 16)

20–25 per minute (p. 589)

Infant/child with a pulse: start compressions when HR is below ___

60 bpm with signs of poor perfusion (p. 530)

How long to check pulse and breathing at the same time

At least 5 seconds, no more than 10 seconds (p. 530)

CPR between AED rhythm analyses

5 cycles, about 2 minutes (p. 531)

First shock converts VF how often?

More than 85% of the time (p. 526)

EtCO2 goal during CPR

At least 10 mmHg, ideally 20 mmHg (p. 526)

EtCO2 reading that signals ROSC

Sudden spike, usually above 50 mmHg (p. 535)

Monophasic AED energy levels

200, 300, 360 joules (p. 527)

Biphasic AED energy

About 150–200 joules or less; biphasic is preferred (p. 527)

AED shocks V-Tach when the rate is above ___

180 bpm (p. 527)

Percentage of cardiac arrests in VF in the first 8 minutes

50–60% (p. 527)

AED for patients under 1 year

Manual defibrillation preferred; dose-attenuating or adult AED if not available (p. 529)

AED for ages 1–8

Dose-attenuating (pediatric) pads; adult pads if none (p. 529)

AED for ages over 8

Adult pads, no dose attenuator (p. 529)

First AED shock can be delivered within ___ of application

1 minute (p. 527)

After ROSC, verify the pulse for ___

1 minute (p. 534)

Oxygen target after ROSC

SpO2 90–94% (p. 534)

Reassess a post-ROSC patient every ___

5 minutes; check pulse every 2 min if unresponsive (p. 534)

Targeted temperature management (TTM) temperature and length

32–36 °C for at least 24 hours (p. 535)

AED operators should practice skills every ___

90 days (p. 536)

Number of shocks an ICD usually gives

4–5 shocks (p. 541)

How far to place an AED pad from an implanted ICD

1 inch to the side (p. 541)

If an ICD is shocking, wait ___ before attaching the AED

30–60 seconds (p. 541)

SIDS age range

Under 1 year; leading cause of death from 1 month to 1 year (p. 539)

SIDS peak age

2–4 months (p. 539)

CISD (critical incident stress debriefing) is available within ___

24–48 hours (p. 540)

Pregnant cardiac arrest: C-section must happen within ___

5–6 minutes (p. 533)

Fundus at or above the belly button = gestation of at least ___

20 weeks (p. 533)

Transport cardiac arrest patient (no ALS) after ___ (p. 534)

3 shocks or 3 'no shock' messages (algorithm on p. 538 says 3 no-shocks or 2 shocks)

Ambulance patient compartment temperature for shock

85 degrees (p. 520)

Preheat isolette or ambulance for a newborn to ___

At least 98 °F (36.5 °C) (p. 521)

Oxygen for shock patient

Non-rebreather at 15 lpm (p. 519)

Pediatric shock oxygen target

SpO2 95% or higher (NRB 15 lpm) (p. 521)

Cardiogenic shock is likely when the left ventricle loses more than ___

40% (p. 509)

Septic shock systolic BP

Below 90 mmHg (p. 512)

Decompensated shock: blood volume lost

More than 30% (p. 518)

Compensated shock heart rate and respiratory rate

HR over 100; RR 20–30 (p. 518)

Decompensated shock heart rate and respiratory rate

HR over 120 (140+ is dire); RR over 30 (p. 518)

Hypotension: adult and child over 10

Systolic below 90 mmHg (p. 520)

Hypotension: child 1–10 years

Systolic below 70 + (2 × age in years) (p. 520)

Hypotension: infant 1–12 months

Systolic below 60 mmHg (p. 520)

Lowest normal systolic BP for a 6-year-old

82 mmHg (70 + 12) (p. 520)

Normal capillary refill

2 seconds or less (p. 521)

Capillary refill in compensated shock

Delayed, 2–4 seconds (p. 521)

Capillary refill in decompensated shock

Absent, over 4 seconds (p. 521)

NASEMSO delayed capillary refill

Over 3 seconds (p. 522)

NASEMSO flash capillary refill (early septic shock)

Under 1 second (p. 522)

NASEMSO shock oxygen target

94–98% (p. 522)

NASEMSO: EtCO2 that may mean poor perfusion

Below 25 mmHg (p. 522)

NASEMSO: correct blood sugar if below ___

60 mg/dL (p. 522)

Percent of oxygen dissolved in plasma

1.5–3% (the rest rides on hemoglobin) (p. 505)

Immediate CPR increases VF survival by how much?

Double or triple (p. 524)

Sepsis: Americans affected per year

About 1.7 million (p. 512)

Sepsis death rate

About 40% (p. 512)

Percent of sepsis patients 65 or older

60% (p. 512)

BAS 90-30-90 sepsis criteria (need 1 or more)

SBP below 90, RR 30 or more, SpO2 below 90% (p. 513)

qSOFA sepsis criteria (need 2 or more)

RR 22 or more, altered mental status (GCS below 13), SBP 100 or less (p. 513)

Robson sepsis criteria (need 2 or more)

Temp above 38.3 °C or below 36 °C, HR above 90, RR above 20, altered mental status, BGL below 120 (as printed) (p. 513)

Normal SpO2 for most patients

94% or higher (p. 549)

SpO2 that means severe hypoxemia

Below 90% (p. 579)

COPD SpO2 goal

88–92%, nasal cannula 2–6 lpm (p. 555)

COPD patient on home oxygen: nasal cannula setting

Same flow or 1 lpm higher than home setting (p. 555)

Nasal cannula starting flow (titrate up)

2 lpm; if goal not reached at 6 lpm, switch to NRB 10–15 lpm (p. 568)

Non-rebreather flow for epiglottitis or poisonous inhalation

15 lpm (p. 564, 567)

CPAP pressure for COPD

5–10 cm H2O (p. 556)

CPAP pressure for SCAPE

Start at 5, titrate up to 15–18 cm H2O (p. 562)

CPAP indicated in COPD if respiratory rate is above ___

25 per minute (p. 556)

CPAP in asthma or pulmonary edema requires GCS above ___

10 (p. 558, 561)

Pulsus paradoxus

Systolic BP drops more than 10 mmHg during inhalation (p. 557)

Severe asthma heart rate

Above 120 bpm (p. 557)

Severe asthma respiratory rate

Above 30/min (critically ill: often above 40) (p. 557)

Critically ill asthma SpO2

Below 90% while ON oxygen (p. 557)

Slow-onset asthma: % of cases and timing

80%; over 6+ hours to days; more in females; less likely to die (p. 557)

Sudden-onset asthma: % of cases and timing

20%; within 6 hours; more in males; more likely to die (p. 557)

BVM rate for adult in severe asthma

10–12 per minute, allow time to exhale (p. 558)

Adult normal respiratory rate

12–20 per minute (p. 574)

Elderly normal resting respiratory rate

About 20 per minute (p. 574)

Respiratory rate too fast to be adequate: adult

Above 40 per minute (p. 574)

Respiratory rate too fast to be adequate: infant

Above 60 per minute (p. 574)

Chronic bronchitis definition

Productive cough at least 3 months a year for 2 years in a row (p. 555)

Emphysema typical age

60–70 years (p. 554)

Genetic (alpha 1 antitrypsin) emphysema age

40–50 years (p. 554)

Emphysema resting respiratory rate

Usually above 20 per minute (p. 554)

Flail chest definition

2 or more adjacent ribs broken in 2 or more places (p. 551)

SCAPE onset time

Usually within 6 hours (p. 561)

SCAPE blood pressure

SBP above 160, often above 200 (p. 562)