AHA flashcards

10

start compressions within __ seconds after recognizing cardiac arrest

automated external defibrillator

AED

American Heart Association

AHA

Advanced Life Support

ALS

anteroposterior

AP

Basic Life Support

BLS

chest compression fraction

CCF

cardiopulmonary resuscitation

CPR

electrocardiogram

ECG

emergency department

ED

Emergency Medical Services

EMS

foreign-body airway obstruction

FBAO

lateral uterine displacement

LUD

public access defibrillation

PAD

pediatric advanced life support

PALS

personal protective equipment

PPE

pulseless ventricular tachycardia

pVT

return of spontaneous circulation

ROSC

telecommunicator-assisted cardiopulmonary resuscitation

T-CPR

transient ischemic attack

TIA

100 to 120/min

rate of compressions

2 inches, no more than 2.4 inches

depth of compressions for adults

approximately 2 inches

depth of compressions for children

1.5 inches

depth of compressions for infants

chest recoil

need to allow this completely after each compression to ensure adequate blood flow during CPR.

interruptions

need to be limited to less than 10 seconds during compressions

breaths

need to be effective and delivered over 1 second, using only enough volume to make the persons chest rise.

infants

younger than 1 (excluding newly born infants in the delivery room)

children

1 year of age to puberty (signs of puberty are chest or underarm hair in male individuals; any breast development in female individuals)

adults

adolescents (ie, after the onset of puberty) and older

the chain of survival

shows the actions that must take place to give the person in cardiac arrest the best chance of survival. Each link is independent, yet connected, to the links before and after. If any link is broken, the chance for a good outcome decreases.

Recognition and Emergency Activation

the first step in the chain of survival, which involves assessing the surroundings for safety, checking for responsiveness, and calling for help nearby and calling 911. Then check for breathing by scanning the persons chest for rise and fall (at least 5, no more than 10 seconds). If they aren’t breathing normally, start CPR

high-qualitity CPR

step in the chain of survival, most closely associated with minimal interruptions and early defibrillation

defibrillation

step in the chain of survival, should be provided as soon as the device is available

Advanced Resuscitation

step in the chain of survival, time when a multirescuer team takes over the resuscitation attempt. This high-performance team will continue high-quality CPR and defibrillation and may perform advanced interventions (vascular access, giving medications, advanced airway, and obtaining an ECG)

Post–Cardiac Arrest Care

step in the chain of survival that occurs after return of spontaneous circulation (ROSC) where health care professionals focus on preventing the return of cardiac arrest

Recovery and Survivorship

step in the chain of survival that encompasses the ongoing care and support for individuals after cardiac arrest, focusing on rehabilitation and quality of life.

example of Hands-Only CPR

A single rescuer with little training and no equipment who witnesses a teen or an adult in cardiac arrest might provide only chest compressions until help arrives.

example of 30:2 CPR

A police officer trained in BLS who finds an adolescent in cardiac arrest will provide both chest compressions and breaths by using a ratio of 30 compressions to 2 breaths.

example of High-performance team

Three emergency responders who are called to assist a woman in cardiac arrest will perform multirescuer coordinated CPR. Rescuer 1 performs chest compressions, rescuer 2 gives breaths with a bag-mask device, and rescuer 3 uses the AED. Rescuer 3 also assumes the role of CPR Coach. A CPR Coach helps team members perform high-quality CPR and minimize pauses in chest compressions.

chest compressions, airway, and breathing

main components of CPR

verify scene safety

step 1 in adult BLS algorithm

step 1 in adult BLS algorithm

Make sure that the scene is safe for you and the person.

Check for responsiveness, shout for nearby help, activate the emergency response system, and send someone to get an AED/defibrillator.

step 2 in adult BLS algorithm

step 2 in adult BLS algorithm

• Tap the person’s shoulders and shout, “Hey! Are you OK? Are you OK?”

• If the person is not responsive, activate the emergency response system. Get the AED/defibrillator or send someone to do so.

step 3 in adult BLS algorithm

Look for no breathing or only gasping, and check pulse (simultaneously). Should take at least 5 but no more than 10 seconds

step 4 in adult BLS algorithm

If the person is breathing normally and a pulse is felt: monitor until advanced care arrives

step 5 in adult BLS algorithm

If the person has abnormal breathing and a pulse is felt:

• Provide breaths, with 1 breath every 6 seconds or 10 breaths per minute.

• Check pulse every 2 minutes; if there’s no pulse, start CPR.

• If an opioid overdose is suspected, administer an opioid antagonist (eg, naloxone), if available.

step 6 in adult BLS algorithm

If the person is not breathing or is only gasping and a pulse is not felt:

• Start CPR.

  • –Perform cycles of 30 compressions and 2 breaths.

  • –Use AED/defibrillator as soon as it is available.

  • –If an opioid overdose is suspected, administer an opioid antagonist (eg, naloxone), if available.

step 7 in adult BLS algorithm

The AED arrives.

• Turn on the AED and follow the prompts.

step 8 in adults BLS algorithm

Check rhythm. Is it shockable?

• Follow the AED prompts.

step 9 in adult BLS algorithm

Yes, the AED identifies a shockable rhythm.

• Give one shock. Immediately resume CPR for 2 minutes (until prompted by the AED/defibrillator to allow for a rhythm check).

• Continue until ALS professionals take over or the person starts to move.

step 10 in adult BLS algorithm

No, the AED identifies a nonshockable rhythm.

• Immediately resume CPR for 2 minutes (until prompted by the AED/defibrillator to allow for a rhythm check).

• Continue until ALS professionals take over or the person starts to move.

agonal gasps

not normal breathing, may sound like a gasp, snort, snore, or groan that can occur in a person who is in cardiac arrest.

seizure-like activity

During cardiac arrest, a person will become unresponsive and collapse. They can look like they are having a seizure for the first few minutes. They might stop breathing or may only gasp, which can sound like a snort, snore, or groan.

compression to ventilation ratio for single rescuers

30 compressions to 2 breaths for people of any age

compression rate

100 to 120/min. same for all cardiac arrests

compression depth for adults

At least 2 inches (5 cm), no more that 2.4 inches

chest recoil

The complete return of the chest to its normal position after each compression during CPR, allowing for maximum blood flow.

head tilt-chin lift and jaw thrust

Two methods for opening the airway

head tilt-chin lift

A technique used to open the airway by tilting the patient's head back and lifting the chin, without closing the persons mouth completely

jaw thrust

A method for opening the airway by pushing the jaw forward without tilting the head, particularly effective in suspected spinal injuries.

pocket masks

Devices used to create a seal over a patient's mouth and nose to deliver rescue breaths during CPR.

adult breaths

Rescue breaths given to adults during CPR, consisting of2 breaths. deliver each breath over 1 second, noting visible chest rise with each breath and resuming chest compressions in less than 10 seconds

bag-mask devices

Equipment used to provide positive pressure ventilation to patients, typically involving a self-expanding bag, a unidirectional valve, and a mask to form a seal over the patient's face.

Bag-Mask Device Technique for a Single Rescuer

the process of using a head tilt, using the bridge of the nose as a guide for correct positioning and the thumb and the index finger of one hand to make a “C” and the remaining fingers to lift the angles of the jaw (3 fingers to form an “E”), open the airway and press the face to the mask. Squeezing the bag with the other hand to give ventilations while watching for chest rise. Deliver each ventilation over 1 second, with or without the use of supplemental oxygen.

Bag-Mask Device Technique for 2 or More Rescuers

a method where one rescuer maintains an airtight seal on the mask while the other rescuer squeezes the bag to deliver ventilations, ensuring effective positive pressure ventilation and monitor for chest rise.

Two Rescuers for Jaw Thrust and Bag-Mask Ventilation

more efficiently performed when 2 or more rescuers are providing ventilation. One rescuer must be positioned above the person’s head and use both hands to open the airway, lift the jaw, and hold the mask to the face while the second rescuer squeezes the bag. The second rescuer is positioned at the person’s side.

rescuer 1

responsible for delivering compressions and maintaining an open airway during CPR. Can switch compressors about every 5 cycles or every 2 minutes, taking less than 5 seconds to switch

rescuer 2

responsible for maintaining an open airway by using either head tilt-chin lift or jaw thrust, giving breaths, and encouraging the first rescuer to give effective compressions

High-Performance Teams

• When giving compressions, rescuers should switch compressors after every 5 cycles of 30:2 CPR (about every 2 minutes) or sooner if fatigued.

• As additional rescuers arrive, they can help with bag-mask ventilation, compressions, and using the AED and other emergency equipment.

defibrillation

what shockable rythms are treated with

Defibrillation

the medical term for interrupting or stopping an abnormal heart rhythm by using controlled electrical shocks. The shock stops the abnormal rhythm. This resets the heart’s electrical system so a normal (organized) heart rhythm can return.

Early Defibrillation

increases the chance of survival from cardiac arrest that is caused by an abnormal or irregular heart rhythm, or an arrhythmia.

Ventricular fibrillation

In this arrest rhythm, the heart’s electrical activity becomes chaotic. The heart muscles quiver in a fast, unsynchronized way so that the heart does not pump blood.

pVT

When the lower chambers of the heart (ventricles) begin contracting at a very fast pace, a rapid heart rate known as ventricular tachycardia develops. In extremely severe cases, the ventricles pump so quickly and inefficiently that there is no detectable pulse (ie, the “pulseless” in pVT). Body tissues and organs, especially the heart and brain, no longer receive oxygen.

PAD Programs

Public Access Defibrillator programs designed to increase the availability of automated external defibrillators (AEDs) in public places, improving the chances of survival from cardiac arrest.

Cardiac Emergency Response Plans

A set of procedures and protocols established to effectively manage and respond to cardiac emergencies, ensuring rapid treatment and use of AEDs to improve patient outcomes.

Maintaining the AED and Supplies

involves someone being designated to maintain the battery, order and replace supplies, including AED pads (adult and mediatric), replacing used equipment, including barrier devices, golves, razors, and scissors to ensure the AED is ready for use in an emergency.

immediately

time to resume high-quality CPR after the AED operator delivers a shock or the AED prompts, “No shock advised.”

AED Pad Placement Options

Anterolateral Placement and Anteroposterior (AP) Placement. Always place pads directly on the skin and avoid contact with clothing, medication patches, and implanted devices.

Anterolateral Placement

one pad is placed vertically on the person’s right upper chest. The top of the pad should be just under the clavicle. Place the second pad horizontally on the person’s left lateral ribs. The middle of the pad should be below the axilla at the midaxillary line.

Anteroposterior (AP) Placement

first option for this placement: one pad is placed in the center of the person’s bare chest (anterior) and the other pad is placed in the center of the person’s back (posterior)

Anteroposterior (AP) Placement

second option for this placement: Placing one AED pad on the left side of the chest, between the left side of the person’s sternum and left nipple, and the other pad on the left side of the person’s back, next to the spine

provide high-quality CPR

is it better to use child AED pads to deliver a shock to an adult or to provide high-quality CPR?

shaving or trimming the area or using the first set of AED pads to remove the hair

if the patient has a hairy chest, what are the options to remove the hair?

pull them out of the water and quickly wipe the chest

if the patient is in water or has water or sweat on their chest, what should you do before applying the AED pads?

avoid placing them directly over the implanted device and proceed as normal

if a patient has an implanted defibrillator or pacemaker, what should you do when placing the AED pads?

if time allows, remove the patch and wipe the area before attatching the AED pad. (wear gloves)

if the patient has a transdermal medication patch, what should you do before applying the AED pads?

normally and if revived, place them of their left side to hekp improve blood flow.

if the patient is pregnant, how should you use the AED?

leave it on, as long as it is not in contact with the AED pads

if the patient is wearing jewelry when you are trying to place AED pads, what should you do?

remove all clothing covering the chest

if the patient is wearing clothing when you are trying to place AED pads, what should you do?

no

can you use the AED on clothes?

yes

can you still provide compressions over clothing?

high-quality resuscitation skills, good communication, and effective team dynamics

what does a successful resuscitation attempt depend on when working with a team?

The Compressor

the role of a team member who assesses the person, performs compressions according to local protocols, and rotates every 2 minutes or earlier if fatigued.

The Airway person

the role of a team member who should be positioned by the person’s head. This person opens the airway, provides bag-mask ventilation, and inserts airway adjuncts as appropriate. This person should watch for chest rise and avoid excessive ventilation.

The Monitor/Defibrillator/CPR Coach

the role of a team member who brings and operates the AED or monitor/defibrillator and acts as the CPR Coach, if designated. This person should be positioned next to the device, follow the prompts, and ensure that all team members are clear of the patient before delivering a shock if one is needed.

The Timer/Recorder

the role of a team member who keeps a record of the events that occur, including frequency and duration of interruptions in chest compressions, time of shock delivery, and medications administered. Remember, medication administration is not a part of BLS and it should be done by an advanced professional during a resuscitation attempt. This person also announces when interventions are due.

CCF

he proportion of time during a resuscitation attempt when the person is receiving high-quality chest compressions which can only be achieved by elimating pauses in chest compressions and providing continuous CPR.