CPR/Pulse
How long do you take a pulse check? Where do you check on each age range? Adult - Child - Infant
Pulse check (and breathing check) should not take more than 10 seconds.
Pulse:
Adult=carotid Child=carotid Infant=brachial
Name a medication that is given intranasally.
Narcan is given intranasally with a MAD device.
Can broken ribs or intercoastal muscles occur even if good CPR is performed?
Yes. Ribs, costal cartilage fractures and intercostal muscle injuries can happen even when CPR is done correctly.
What is essential for good compressions to be effective?
Patient should be flat on their back on a hard flat surface.
You have a victim trapped in a small space that needs CPR. What do you do?
Take the victim to the nearest large space to begin compressions. Think about the space that a crew might need to treat the patient.
Can an adult be physically fit with a pulse of 50 or less? What are examples of how you can tell if there are medical issues?
Look for signs of Dizziness or lightheadedness, Fainting (syncope), Chest pain, Shortness of breath, Confusion, Low blood pressure, New fatigue in a non-athlete
If a patient feels new unusual symptoms after taking a medication, what is this called?
A side effect.
How could you describe if a pulse is hard to find?
Weak, thready, or unable to palpate.
How do we do compressions for larger children?
Child CPR can be done with one or two hands depending on the size of the child and a rescuers strength.
What is the correct way to open an airway when you have an unresponsive trauma patient?
The trauma airway maneuver (jaw-thrust maneuver)
If you found a pulseless infant/child and you are alone, when should you start compressions?
If you are alone, give a set of
30 compressions-2 breaths-5 times in 2 minutes before you go to find a phone to call 911.
Why is aspirin given to any patient by an EMR?
An EMR may administer aspirin to a patient experiencing a suspected cardiac event. Aspirin helps prevent platelets from clumping together, which reduces clot formation. EMRs do not administer medications specifically for pain relief.
One important risk factor is an allergy to aspirin, so always ask the patient about allergies before giving the medication.
Correctly describe the difference between a sign and a symptom.
Symptom = what the patient feels and shares with you.
Sign = what you can see, hear, feel, or measure.
How many minutes after sudden cardiac arrest occurs does the brain start to die?
The brain can start to die without oxygen in approximately 4 to 6 minutes.
What is ventricular tachycardia? ventricular fibrillation?
Vtach is a very rapid, regular heartbeat with inefficient pumping.
Vfib is a disorganized quivering where no blood is being pumped.
While trying to relieve a foreign bod they collapse. What do you do?
Immediately start chest compressions. This will circulate oxygenated blood through the body and assist in clearing the foreign body.
What are major side effects of giving a patient EPI?
Some will experience temporarily a fast heart rate, higher blood pressure and rapid breathing.
What is the posterior tibial pulse and how do you find it?
We check the posterior tibial pulse to evaluate circulation to the foot.
To locate, find the the bony bump on the inside of the ankle. Slide your fingers just behind and slightly below that bone. Press gently — not too hard — with 2–3 fingertips.
What does the patients chief complaint tell you about your patient?
The chief complaint (CC) is the main problem or symptom that made the patient seek care. It guides everything that follows in your assessment.
Where to focus your assessment
How urgent the situation might be
What questions to ask next
Remember: the chief complaint might not be their most serious problem.
How do you ensure you have the right hand placement for chest compressions?
Measure to ensure you are in the center of the chest on the lower half of the sternum.
Use caution around the xiphoid process, as it can cause internal injury if broken.
What are the the techniques of treating a FBAO?
Adults and Children: Lean patient forward and give five back blows. Stand patient up and give five abdominal thrusts. Repeat until relieved.
Infants: Five back blows and Five chest thrust turning the baby for each rotation. Repeat until relieved.
Give the doses for the following medications,
Albuterol
EPI
Nitro
Narcan
Albuterol: 90mcg with an MDI
EPI: 0.3mg with a auto-injector
Nitro: 0.4 sublingually
Narcan: 2mg is normal dose intranasally
What techniques can you use to get an accurate breathing rate?
Try to avoid telling them exactly what you are doing and use a variety of distraction techniques.
How do you get information if you are unsure of what drug to use or permission to give a drug?
Call medical control to get information.
What are you doing when you compress the sternum for an unresponsive patient while performing CPR?
Compressing on the chest changes pressure in the chest to enable oxygenated blood to be sent through the body.