Basics of CPR and First Aids

S. C. Jiménez
Flashcards by S. C. Jiménez, updated more than 1 year ago
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Basics of CPR and First Aids
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Early recognition and Call for help (*to prevent cardiac arrest) 1st step
Early CPR (*to buy time) 2nd step
Early Defibrillation (to restart the heart) 3rd step
Post resuscitation care (*to restore quality of life) 4th step
1. approach safely 2. check response 3. shout for help 4. open airway 5. check breathing 6. call 112 7. 30 chest compressions 8. 2 rescue breaths initial steps
occurs shortly after the heart stops in up to 40% of cardiac arrests; described as barely, heavy, noisy, or gasping breathing recognized as a sign of cardiac arrest Abnormal Breathing
Place the heel of one hand in the center of the chest; Place other hand on top; interlock fingers or avoid putting pressure on the side of the chest; compress the chest (*100-100/min + 5-6cm + equal compression and relaxation) change CPR operator every 2 minutes Chest Compressions
pinch the nose; take a normal breath; place lips over mouth; blow until the chest rises; take about 1 second; allow chest to fall; repeat Rescue Breaths
switch on AED; attach pads to patient's bare chest; analyzing cardiac rhythm (NO TOUCH); Stay Clear to Deliver Shock; 30 chest compressions; 2 rescue breaths AED steps
if patient starts to breathe, place in recovery position (*turning to right side) recovery position
adult CPR techniques compressions of 1/3 in depth CPR in children
use only 8+ years old (with Adult AED) 1-8 years old with pediatric pads if available AED in children
the emphasis on "high-quality chest compression" Guidelines 2010
carotid pulse check; pocket mask; bag-mask ventilation; general points of using face mask; use of oxygen; choking; drowning; two-rescuer CPR Resuscitation Skills
not recommended for lay rescuers; use index and middle fingers in the groove on one side of the neck only; check for breathing and carotid pulse at the same time (*extend neck; no more than 10 seconds) Carotid Pulse Check
1) start chest compressions 2) continue 30 chest compression 3) 2 rescue breaths 4) do NOT re-check for carotid pulse Carotid Pulse Check ABSENT / UNSURE
1. Give rescue breaths on their own (*10 per minute) 2. Re-check for carotid pulse / signs of life after 1 minute CAROTID PULSE CHECK DEFINITE / PRESENT
extend neck fully; create a good seal between mask and mouth/nose; deliver each breath over 1 second blow just enough to make chest rise and fall as in normal breathing (*NO Over Ventilation) Combine 30 + 2 General Points on Using Face-Masks
Supplemental Oxygen can be used in cardiac arrest if available; given via a bag-vale mask or pocket-mask; give as MUCH as possible as SOON as possible (*flow rate of 10-15L/min) USE of OXYGEN
Removal of Oxygen from Patient during defibrillation at least 1m away USE of OXYGEN (*with AED)
encourage victim to cough; closely monitor for deterioration Choking (mild obstruction)
conscious patient: 5 back blows + 5 abdominal thrusts unconscious patient: activate EMS + start CPR Choking (severe obstruction)
early rescue breaths; safety of rescuer is very important; patient should be removed from water; only when trained, rescue breaths can be given in water; AED must be on dry land/rescue boat + dried chest of patient Drowning
30 chest compressions + 2 rescue breaths; 1 rescuer performs rescue breaths + 1 rescuer performs chest compressions; operating AED + performing CPR 2-rescuer CPR
Basic Life Support - Defibrillation BLSD
Terminal event (*natural death) or Sudden event (*unpredicted death) Cardiac Arrests
appx. 700,000 cardiac arrests annually in Europe; survival to hospital discharge rate of 5-10% early resuscitation and prompt defibrillation (1-2 mins) 60+ % Background info
80% of cardiac arrests occur known or unknown underlying heart diseases; in western countries, 80%+ of cardiac arrest due to coronary diseases; 20% of congenital heart diseases, myocarditis, valvular disease, and electrophysiological anomalies such as prolonged QT and pre-excitation syndrome background (continued)
few cardiac arrest due to acute failure of pulmonary gas exchange or type I/II acute respiratory failure, or hypothermia/electrocution; most frequently by drowning, smoke inhalation, sedation, narcotic overdose, pulmonary embolism, cerebrovascular accident background (*continued)
sudden cardiac arrest --> loss of consciousness --> no breath or gasping --> loss of central pulses --> pale cyanosis --> mydriasis (*fixed) --> biological death clinical and biological deaths
abnormal pattern of breathing; occurs shortly after cardiac arrest (up to 40%) barely, heavy, noisy, gasping; a sign of cardiac arrest Agonal Breathing (gasping)
loss of cerebral blood flow --> (15 sec) loss of consciousness --> (1 min) loss of brainstem functions (*gasping, mydriasis) --> (4-5 min) ATP depletion and anaerobic metabolism --> irreversible damage Brain and Cardiac Arrest
Shockable (80%) --> VF (*ventricular fibrillation) Non-shockable (20%) --> pulseless ventricular tachycardia, "asystole (: no electrical activity" / only P waves, large QRS complexes (6/min) Types of Cardiac Rhythms
Airway Breathing Circulation ABC approach
head tilt (*not for suspected trauma) + chin lift + jaw thrust (*professional) + finger sweep (*NO, unless object seen) Airway
30 chest compression (*15-20 sec) + 2 rescue breaths (*500-600 ml); look, listen, and feel for normal breathing; AGONAL breathing (*gasping) Breathing
qualified help arrives and takes over; return of spontaneous circulation (*patient has NO longer signs of clinical death); rescuer becomes exhausted CPR continues until
lateral safety position (*right) Breathing Unconscious Patient
Foreign Body Airway Obstruction mild or severe FBAO
answer of "Yes" + can speak, cough, and breathe MILD FBAO
unable to speak (*may nod) + no breathing or wheezy breathing, silent attempts to cough + unconsciousness SEVERE FBAO
1) severe / ineffective cough --> unconscious (: CPR start) or conscious (: 5 back blows + 5 abdominal thrusts or Heimlich maneuver) 2) mild / effective cough --> encourage to cough (*continue to check for deterioration to ineffective cough or until obstruction removed) Adult FBAO treatment
heart beat + respiratory rate + temperature + blood pressure + O2 saturation Vital Signs
normal vital signs change with AGE, SEX, WEIGHT, EXERCISE TOLERANCE, and CONDITION Vital Signs (normal changes)
Patient at seated posture; 5 mins prior rest; observation before measuring patient (*anxious, painful, upset); Vital Signs (measurement)
control by hypothalamus; age/infection/medication affect; core temperature different from anatomical sites Temperature
reflects circulating volume and strength of contractility; intravascular volume/contractility/oxygen demand affect; at least for 30 sec, regularity, strength, and equality should be checked Pulse
regulated by vasomotor center in the medulla; intravascular volume/vascular tone/contractility affect; automated monitors less reliable Blood Pressure
controlled by respiratory centers in the medulla and pons; hypercapnia/hypoxemia/acidosis affect; establish baseline, critical illness, change in oxygenation, and evaluate response to treatment Respiratory Rate
above 37 orally or 37.5 rectally Fever
below 35 hypothermia
bradycardia < 60-100 /min < tachycardia 40 - 60 for athletes female has higher babies up to 1 (*100-160) / 1-10 (*60-140) Pulse Rate
rate; rhythm; volume; synchronous with other pulse (*radio-femoral delay); state of the vessel wall Pulse Quality
altered mental status; fast respiratory rate; low blood pressure qSOFA scores
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