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EMERGENCY CARE 1
EMERGENCY CARE 1 Review
| Question | Answer |
|---|---|
| Identify the basic steps for performing one-rescuer resuscitation for an unwitnessed cardiopulmonary arrest in an adult or child 8 years of age and older | Determine unresponsiveness, Call for help Check for pulse, If pulseless begin chest compressions,if definite pulse is present give one breath every 5-6 sec recheck pulse in 2 min,Use AED or defibrillator,Continue CPR until other emergency comes |
| Identify the indications,rationale (why the method works), complications and contraindications for Head-tilt/Chin-lift | Preferred method of establishing the airway during CPR. + Easy to perform,Permits control of loose dentures,Successful with all age groups. - Fractured neck,or suspicion of neck fracture |
| Identify the indications,rationale (why the method works), complications and contraindications for JAW THRUST/MODIFIED JAW THRUST | + Aloows for establishing patent airway in PT with suspected neck fracture. - Difficult to perform, Difficult to obtain a good seal during mouth to mouth ventilation, Tiring for operators wrists,PT loose dentures not controlled |
| Identify three complications of external cardiac compressions | Rib fractures, Fractured sternum/clavicle,Contusions to heart and/or lung |
| Identify three complication of ventilation | Gastric distention most common, Pneumothorax,Gastric rupture |
| Which pulse should be used to assess the effectiveness of CPR? | Carotid pulse should be present during copressions- Best Method |
| Identify and briefly desribe four methods of emergency ventilation. | Mouth to mouth (FIO2 16% -17%), Mouth to nose Mouth to tube or Mask, Mouth to Valve/Mask, |
| List the signs of a MILD airway obstruction | Good air exchange Responsive and can cough forcefully May wheeze between coughs |
| List the treatment for a MILD airway obstruction | Encourage the vitim to continue spontaneous coughing and breathing efforts,Do not interfere with victims attempts to expel foreign body, Stay with victim, Call 911 if mild airway obstruction continues |
| List the signs of a SEVERE Airway Obstruction | Poor or no airway exchange,Weak-Ineffective Cough,High pitched noise while inhaling, |
| List the treatment for a SEVERE Airway Obstruction for an infant if the infant is responsive | infant is straddled over the resuer arm face down (prone), Deliver 5 back blows with the heel of Hand, turn infant over and apply 5 chest thrust, repeat until obstruction is relieved or the infant becomes unresponsive |
| List the treatment for a SEVERE Airway Obstruction for an infant if the infant is unresponsive | Activate emergency response system, lower victim to floor begin CPR, Before attempting to ventilate look for a foreign object in mouth and remove it, Continue CPR for 5 cycles or about 2 min |
| List the treatment for a SEVERE Airway Obstruction for a PT 1 year an older if the PT becomes UNRESPONSIVE | Activate emergency response system, lower victim to floor begin CPR, Before attempting to ventilate look for a foreign object in mouth and remove it, Continue CPR for 5 cycles or about 2 min |
| Hypotension is Characterized by; | By low blood presuure Poor Capilary Refill Weak Thready Pulse |
| Hypotension Should be treated with | Fluid Challenge (1-2 Lnormal saline or Lactated Ringers) Vasopressor Infusion (Dopmine,Dobutamine) |
| List the signs of a MILD airway obstruction | Good air exchange Responsive and can cough forcefully May wheeze between coughs |
| List the treatment for a MILD airway obstruction | Encourage the vitim to continue spontaneous coughing and breathing efforts,Do not interfere with victims attempts to expel foreign body, Stay with victim, Call 911 if mild airway obstruction continues |
| List the signs of a SEVERE Airway Obstruction | Poor or no airway exchange,Weak-Ineffective Cough,High pitched noise while inhaling, |
| List the treatment for a SEVERE Airway Obstruction for an infant if the infant is responsive | infant is straddled over the resuer arm face down (prone), Deliver 5 back blows with the heel of Hand, turn infant over and apply 5 chest thrust, repeat until obstruction is relieved or the infant becomes unresponsive |
| List the treatment for a SEVERE Airway Obstruction for an infant if the infant is unresponsive | Activate emergency response system, lower victim to floor begin CPR, Before attempting to ventilate look for a foreign object in mouth and remove it, Continue CPR for 5 cycles or about 2 min |
| List the treatment for a SEVERE Airway Obstruction for a PT 1 year an older if the PT becomes UNRESPONSIVE | Activate emergency response system, lower victim to floor begin CPR, Before attempting to ventilate look for a foreign object in mouth and remove it, Continue CPR for 5 cycles or about 2 min |
| Hypotension is Characterized by; | By low blood presuure Poor Capilary Refill Weak Thready Pulse |
| Hypotension Should be treated with | Fluid Challenge (1-2 Lnormal saline or Lactated Ringers) Vasopressor Infusion (Dopmine,Dobutamine) |
| List two drugs that are indicated in the treatment of braycardia in the ADULT | Atropine,Dopamine and epinephrine for an ADULT |
| List two drugs that are indicated in the treatment of Ventricular Tachycardia or Ventricular Fibrillation that is Unresponsive to Defibrillation | If defibrillation in unsuccessful Administer; Epinephrine Amiodarone |
| Complete the following outline the treatment procedure for Ventricular Fibrillation/Pulseless Ventricular Tachycardia | Ventricular Fibrillation/Pulseless Ventricular Tachycardia----> Defibrillate/Shock |
| The treatment procedure for Ventricular Fibrillation/Pulseless Ventricular Tachycardia----> Defibrillate/Shock Then If Pulse Returns---> then | If Pulse Returns---> then Universal Algorithm |
| Fibrillation/Pulseless Ventricular Tachycardia----> Defibrillate/Shock If Rhythm Shockable?--->then | Persistent V Fib or V Tach then --> CPR,Intubate,IV, Epinepherine,Defibrillate Amiodarone Defibrillate--->Amiodarone Defibrillate |
| Fibrillation/Pulseless Ventricular Tachycardia----> Defibrillate/Shock If Rhythm Not Shockable?--->then | PEA/Asystole--->PEA/Asystole Algorithm |
| Asystole OR PEA (Pulseless Electrical Activity)---> | Confirm Asystole in 2 leads---> High Quality CPR,IV Access,Intubate,Pacing (for asystole) consider causes |
| Describe what the cardioversion procedure is used for? | Therapeutic prodcedure that involves administering a low voltage current to the heart tissue in an attempt to convert a cardiac dysrhythmia to normal sinus rhythm. The electric current is synchronizing with the PT own rhythm |
| The synchronizing switch must be ____ to perform CARDIOVERSION? | ON --> Electric shock is delivered on the R wave of ECG |
| Biphasic defibrillators are indicated to treat what arrhythmias? | Unstable ATRIAL FIBRILLATION: initial dose is 2120-200 joules Unstable SVT or Unstable ATRIAL FLUTTER; initial energy dose is 50-100 joules |
| What should be done if defrillation occurs during the producere? | Check pulse,then turn off sychronizing switch, increase energy setting, snd immediately defibrillate |
| What medications should be given pior to procedure? | Midazolam (Versed) is a strong, short acting sedative given prior to cardioversion |
| Defibrillation is recommended to treat what type of ARRHYTHMIAS? | It is used when Life-threatening cardiac dyrhythmias are persent |
| List the indications fo Defibrillation | Pulseless Ventricular Tachcyardia Ventricular Fibrillation |
| At what energy dose should the first defibrillation attempt be made? | Biphasic Defibrillator; 120--- 200 Joules Monophasic Defibrillator; 360 Joules |
| An AED will recommmend shock delivery only if the victims heart rhythm is ___? | Only if the Victims heart rhythm is one that a shock can treat |
| List three indications for using and AED | NO RESPONSE NO BREATHING NO PULSE USE AED ONLY WHEN A VICTIM HAS ALL OF THESE CLINICAL FINDINGS |
| A manual resuscitator bag used for an adult PT should ideally provide what tidal volume? | ADULT- 800 mL average (1000-1800 max) INFANT- 200 mL |
| List the three safety features the ideal resuscitation bag should have | A true non-rebreathing valve Universal connector with a 22mm OD and 15mm ID Patient valve that does not jam at 15 L per min |
| What purpose does the reservoir serve? | To provide 95-100% 0xygen (at 15 L/min) Quick attachment/non-bulky |
| Describe the features of the ideal resuscitation mask? | Well fitting- covers PT mouth and nose Shapeable,Transparent |
| Using excessively high flows during manual resuscitation may cause what problem? | may cause valves to jam. Use 15L/min or low range of flush |
| While manually ventilating a PT via endotracheal tube, the respiratory therapist noctices that it is getting harder to compress the resuscitation device. Why might this occcur? | PT valve may be stuck open or closed |
| List three advantages of mouth-to-valve mask ventilation versus mouth-to-mouth ventilation | Eliminates direct contact with the PT Supplemental oxygen can be administered; up to 50% oxygen with a flow rate at 10L/min A one-way valve between the mask and the practitioners mouth eliminates the exposure to exhaled air. |
| Complete the following describing the ideal critera for oxygen powered resuscitation devices: FLOWRATE | Immediate flowrate of 100 L/min |
| Complete the following describing the ideal critera for oxygen powered resuscitation devices:PRESSURE RELIEF | Set at 50 cmH20 (audible alarm) |
| Complete the following describing the ideal critera for oxygen powered resuscitation devices: %OXYGEN | 100% oxygen delivered from gas source |
| Complete the following describing the ideal critera for oxygen powered resuscitation devices:INSPIRATION IS INITIATED BY | Inspiration can be started by using a manual button or by the PT generating negative pressure |
Created by:
Cam1228
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