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EMERGENCY CARE 1

EMERGENCY CARE 1 Review

QuestionAnswer
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