Cardiac Arrest and Chain of Survival Overview
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Cardiac Arrest and Chain of Survival Overview

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Questions and Answers

What is the pathophysiology of emphysema?

Destruction of the alveoli leading to reduced gas exchange.

What are the signs and symptoms of chronic bronchitis?

Productive cough, shortness of breath, wheezing.

What is the treatment for asthma/status asthmaticus?

Bronchodilators, corticosteroids, oxygen therapy.

What are the common indications for the use of nitroglycerin?

<p>Angina, heart failure.</p> Signup and view all the answers

Define the Good Samaritan law.

<p>Legal protection for individuals who voluntarily provide assistance in emergencies.</p> Signup and view all the answers

What is the compression to ventilation ratio for adult 1-rescuer CPR?

<p>30:2</p> Signup and view all the answers

List the stages of labor.

<p>First stage: dilation; Second stage: delivery; Third stage: delivery of placenta.</p> Signup and view all the answers

What are the signs and symptoms of hyperglycemia?

<p>Frequent urination, increased thirst, fatigue.</p> Signup and view all the answers

What does APGAR stand for?

<p>Appearance, Pulse, Grimace, Activity, Respiration.</p> Signup and view all the answers

What is an indication for using an EpiPen?

<p>Severe allergic reaction</p> Signup and view all the answers

What is classified as a hollow organ in the abdomen?

<p>Stomach</p> Signup and view all the answers

Child or elder abuse must be reported to CPS/APS within 48 hours.

<p>False</p> Signup and view all the answers

How is insulin made?

<p>Insulin is produced in the pancreas.</p> Signup and view all the answers

What is normal blood sugar?

<p>$70-100 mg/dL$</p> Signup and view all the answers

Which factor is NOT typically a sign of acute coronary syndrome?

<p>Euphoria</p> Signup and view all the answers

What is a characteristic symptom of pneumonia?

<p>Productive cough with purulent sputum</p> Signup and view all the answers

Which of the following medications is indicated for the treatment of narcotic overdose?

<p>Naloxone</p> Signup and view all the answers

Which assessment tool is specifically used to evaluate stroke patients?

<p>Cincinnati Stroke Scale</p> Signup and view all the answers

What is a common treatment for hyperventilation syndrome?

<p>Rebreathing into a paper bag</p> Signup and view all the answers

Which condition is typically associated with sudden onset chest pain and difficulty breathing due to the presence of air in the pleural space?

<p>Spontaneous pneumothorax</p> Signup and view all the answers

What should be closely monitored in a patient experiencing a generalized seizure?

<p>All of the above</p> Signup and view all the answers

Which of the following is NOT typically a side effect of nitroglycerin?

<p>Bradycardia</p> Signup and view all the answers

What is the compression to ventilation ratio for an adult during 2-person CPR?

<p>30:2</p> Signup and view all the answers

What should be provided to a patient with an Apgar score of less than 7?

<p>Immediate resuscitation</p> Signup and view all the answers

Which airway maneuver is indicated for a patient with complete airway obstruction?

<p>Abdominal thrusts</p> Signup and view all the answers

What is the maximum flow rate in liters per minute for a non-rebreather mask?

<p>15 L/min</p> Signup and view all the answers

Which of the following defines the concept of 'informed consent'?

<p>Consent given by a conscious and aware patient</p> Signup and view all the answers

What is the first step in the primary assessment of a patient?

<p>Determine responsiveness</p> Signup and view all the answers

What is the maximum time allowed for a written report to be submitted after notifying CPS/APS about child or elder abuse?

<p>48 hours</p> Signup and view all the answers

Which of the following is NOT an indication for the use of rigid/tonsil tip suction?

<p>Patient with a gag reflex</p> Signup and view all the answers

What is the primary purpose of using the SAMPLE history in patient assessment?

<p>To gather a comprehensive patient history</p> Signup and view all the answers

Which airway adjunct is appropriate for an unresponsive patient who lacks a gag reflex?

<p>Oropharyngeal airway</p> Signup and view all the answers

What components are assessed in the Glasgow Coma Scale?

<p>Motor response, verbal response, eye opening</p> Signup and view all the answers

Which respiratory disease is characterized by wheezing and pursed-lipped breathing, often associated with a barrel-chested appearance?

<p>Emphysema</p> Signup and view all the answers

What is the flow rate of oxygen delivered by a nasal cannula?

<p>1-6 liters per minute</p> Signup and view all the answers

What is the appropriate duration for suctioning an adult patient?

<p>10 seconds</p> Signup and view all the answers

What are the primary signs of congestive heart failure on the right side?

<p>JVD and pedal edema</p> Signup and view all the answers

What is the maximum number of doses for administering nitroglycerin?

<p>3 doses</p> Signup and view all the answers

What are the signs and symptoms of hypoglycemia?

<p>Confusion, irritability, and shakiness</p> Signup and view all the answers

What is the definition of status epilepticus?

<p>Two or more seizures without full recovery in between</p> Signup and view all the answers

What are the general signs and symptoms of a stroke?

<p>Weakness on one side of the body, confusion, and difficulty speaking</p> Signup and view all the answers

What are the symptoms of a severe allergic reaction?

<p>Difficulty breathing, swelling of the throat, and hives</p> Signup and view all the answers

What characterizes first trimester bleeding with tissue discharge?

<p>Bleeding accompanied by severe abdominal pain</p> Signup and view all the answers

What is the most common cause of seizures in children?

<p>Fever (febrile seizures)</p> Signup and view all the answers

What are the signs and symptoms of someone on a stimulant?

<p>Elevated heart rate, anxiety, and restlessness</p> Signup and view all the answers

What is defined as anaphylactic shock?

<p>A life-threatening allergic reaction causing rapid onset of symptoms</p> Signup and view all the answers

What is the most common reason for cardiac arrest in adults?

<p>Cardiac problems</p> Signup and view all the answers

Which of the following is included in the definition of cardiac arrest?

<p>Not breathing</p> Signup and view all the answers

During CPR for an adult, what is the recommended compression to ventilation ratio for one rescuer?

<p>30:2</p> Signup and view all the answers

What is the depth of chest compressions recommended for an adult during CPR?

<p>2-2.4 inches</p> Signup and view all the answers

What is the correct maximum duration for checking breathing and pulse during cardiac arrest recognition?

<p>10 seconds</p> Signup and view all the answers

What does ROSC stand for in the context of cardiac arrest?

<p>Return of Spontaneous Circulation</p> Signup and view all the answers

When performing CPR on an infant, what is the recommended depth of compressions?

<p>1/3 diameter of chest</p> Signup and view all the answers

Which of the following is NOT a sign of imminent delivery?

<p>A prolonged labor stage</p> Signup and view all the answers

What is the compression to ventilation ratio for child CPR when two rescuers are present?

<p>15:2</p> Signup and view all the answers

What should be minimized during CPR to ensure effectiveness?

<p>Compression interruptions</p> Signup and view all the answers

Study Notes

Cardiac Arrest

  • Cardiac arrest means the patient is unresponsive, not breathing, and has no pulse
  • Most common reasons for cardiac arrest in adults are cardiac problems and in children respiratory problems
  • Downtime is the time from cardiac arrest until effective CPR is performed
  • Total downtime is the time from cardiac arrest until outcome, like ROSC, patient delivery to hospital, etc.
  • ROSC (Return of Spontaneous Circulation) is when the patient regains a pulse
  • Survival is a cardiac arrest patient who regains ROSC and is eventually discharged from the hospital neurologically intact
  • Witnessed cardiac arrest is when the EMT witnessed the patient go into cardiac arrest.
  • Unwitnessed cardiac arrest is when the EMT arrived to a patient already in cardiac arrest.

Chain of Survival

  • The Chain of Survival is a sequence of actions that can improve survival rates for a patient experiencing cardiac arrest

Age Groups

  • Infant: Birth to 1 year of age (Neonate: birth to one month)
  • Child: 1 year until puberty (Boys: underarm hair, Girls: breast tissue)
  • Adult: Puberty and above

Recognizing Cardiac Arrest

  • Determine unresponsiveness by shaking and shouting, or using painful stimuli
  • Check breathing and pulse for a maximum of 10 seconds, can be done simultaneously
  • Check for a carotid pulse on your side

Starting CPR

  • For adults, the compression to ventilation ratio is 30:2 (one or two rescuer CPR).

  • Perform CPR at a rate of 100-120 compressions/minute

  • Compression depth should be 2-2.4 inches.

  • Use two hands, center of chest, below sternal notch, above xyphoid process.

  • For children, the compression to ventilation ratio is 30:2 (one rescuer) or 15:2 (two rescuer).

  • CPR rate should be 100-120/minute.

  • Compression depth is about 1/3 diameter of chest, about 2 inches.

  • Place hands on the center of the chest with one or two hands.

  • For infants, the compression to ventilation ratio is 30:2 (one person) or 15:2 (two person).

  • CPR rate is 100-120/minute.

  • Compression depth is 1/3 diameter of chest, about 1.5 inches.

  • Use two hands in an encircling thumb technique (new for 2020).

During CPR

  • Allow full chest recoil
  • Minimize compression interruptions to 10 seconds or less
  • You should be able to feel a pulse WITH compressions, carotid or femoral

Return of Spontaneous Circulation (ROSC)

  • Recheck all ABCs after a change in patient status, positive or negative

CPR When The Patient Vomits

  • Roll the patient on their side, clear the airway/suction, then roll them back and resume CPR.

Automated External Defibrillator (AED)

  • Use on a patient who is:
    • Unresponsive
    • Not breathing
    • Pulseless
  • The AED will defibrillate the following rhythms:
    • Ventricular Fibrillation (Vfib)
    • Ventricular Tachycardia (Vtach)

AED Usage

  • Use an AED as soon as it arrives.
  • Never touch the patient during the analyzing phase.
  • Always clear the victim before pressing the SHOCK button.
  • When transporting in an ambulance pull over and stop every time you analyze.

AED Cautions

  • Remove medication patches
  • Never use in water, dry off the patient
  • Avoid pacemakers
  • Shave patient if necessary
  • Remove all clothing, including bra

Rescue Breathing

  • Use when a patient is not breathing but has a pulse
  • Adults: 1 breath every 5-6 seconds or 10-12/minute
  • Children/Infants: 1 breath every 2-3 seconds or 20-30/minute (new 2020)
  • Do not use rescue breathing rate during CPR!

Obstructed Airway/Choking

  • Conscious Patients:
    • Adults/Child: Abdominal thrusts/Heimlich maneuver
    • ** infant:** 5 back blows, 5 chest thrusts
  • Unconscious/Unresponsive:
    • Adult/Child: CPR, look in the mouth prior to giving breaths
    • Infant: 5 back blows, 5 chest thrusts, attempt ventilations, look in the mouth prior to giving breaths

Partially Obstructed Airway

  • Patient appears to be choking but can still cough or move air.
  • Encourage them to stay calm and continue working to relieve obstruction.
  • DO NOT perform abdominal thrusts
  • Leaving your patient with a person of lower medical authority than you is considered abandonment.
  • Touching a patient without consent is considered battery.
  • To prove negligence you must prove 4 things:
    • Duty to act
    • Breach of duty
    • Injury to the patient
    • Causation

Good Samaritan Law

  • Protects people who in good faith provide care to a person in an emergency.

Cardiac Arrest

  • Cardiac arrest is unresponsive, not breathing, no pulse - dead.
  • Most common reasons for cardiac arrest:
    • Adults - Cardiac problems
    • Children - Respiratory problems

Cardiac Arrest Terms

  • Downtime - From cardiac arrest until effective CPR is performed
  • Total downtime - From cardiac arrest until the outcome
    • Possible outcomes: ROSC, patient delivered to hospital
  • Return of Spontaneous Circulation (ROSC) - When a patient regains a pulse
  • Survival - A cardiac arrest patient who regains ROSC and is eventually discharged from the hospital neurologically intact
  • Witnessed vs. Unwitnessed Cardiac Arrest:
    • Witnessed - EMT witnessed the patient go into cardiac arrest
      • Does not refer to a layperson watching the patient collapse
    • Unwitnessed - EMT arrived to a patient already in cardiac arrest

Chain of Survival

  • Recognizing Cardiac Arrest:
    • Determine unresponsiveness - Shake and shout, use painful stimuli
    • Check breathing and pulse simultaneously
    • 10 seconds maximum
    • Check carotid pulse on YOUR SIDE
  • Send someone to call 911 and get an AED
  • Start CPR

CPR - Adult

  • Compression to ventilation ratio: 30:2
    • One or two rescuer CPR
  • 100-120 compressions per minute
  • Depth of compression: 2-2.4 inches
  • Two hands, center of chest
    • Below sternal notch, above xyphoid process

CPR - Child

  • Compression to Ventilation Ratio:
    • One rescuer - 30:2
    • Two rescuer - 15:2
  • Rate: 100-120 per minute
  • Depth: 1/3 diameter of chest, about 2 inches
  • Hand placement: One or two hands, center of chest

CPR - Infant

  • Compression to Ventilation Ratio:
    • One person - 30:2
    • Two person - 15:2
  • Rate: 100-120 per minute
  • Depth: 1/3 diameter of chest, about 1.5 inches
  • Hand placement:
    • One person and two person: 2 hand, encircling thumb technique

During CPR

  • Allow full chest recoil
  • Minimize all compression interruptions to 10 seconds or less
  • Should be able to feel a pulse WITH COMPRESSIONS
    • Carotid or femoral

Return of Spontaneous Circulation (ROSC)

  • Recheck ABC's.

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Description

This quiz covers essential concepts about cardiac arrest, including definitions, causes, and survival rates. It also explores the Chain of Survival and its importance in improving patient outcomes. Test your knowledge on how to respond effectively during a cardiac event.

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