Egan’s Chapter 34 Practice Questions:

1. Abdominal thrust: External pressure forcefully exerted on the abdomen, under the diaphragm, to expel obstructing objects from the upper airway

2. ACLS: emergency medical procedures beyond basic life support; includes intravenous fluid life establishment, possible defibrillation, drug administration, control of cardiac arrhythmia, and use of ventilation equipment. This procedure usually needs direct or indirect supervision of a physician. advanced cardiac life support

3. Adult Chest Compression: to provide adequate circulation (rate of 100 compressions per minute)

4. Adult compressions: supine position, expose chest, ID landmarks, choose position close to patient, ID lower half of sternum, between nipples, place hands, lock elbows, perform compressions, compress sternum 2 inches rate of 100 compressions/min. If interruption, resume quickly, not more than 5 seconds.

5. Advanced cardiovascular life support: ACLS

6. AED: portable automatic device to preform defibilliation on patients outside the hospital. Automatic external defibrillation

7. AED are used for what rhythms: VF and VT

8. automated external defibrillators: AEDs

9. Basic Life Support: BLS

10. BLS: Cardiopulmonary resuscitation designed to re-institute either circulatory or respiratory function without equipment or drugs, basic life support

11. CABD’s of resuscitation: circulation, airway, breathing, and defibrillation

12. Cardiac output during external chest compressions is: is an arterial systolic blood pressure of 60-80mmHg

13. Cardiac output is about is about what of the normal output during compressions: one-forth

14. Cardiopulmonary Resuscitation: CPR

15. Cardioversion: used in atrial fibrillation, defibrillation is done on the R-wave

16. chest compressions: at lower half of sternum, (adult) rate of100 compressions/min, 1:1 downstroke to upstroke ratio

17. children compressions: one-year-old to puberty, supine, lower half of sternum, one hand for compressions, use other hand to maintain head position, compress about 2 in rate of 100/min

18. CPR: basic emergency procedure for life support, consisting of artificial respiration and manual external cardiac massage, cardiopulmonary resuscitation

19. defibrillation: termination of ventricular fibrillation by delivering a direct counter-shock to the patient’s precordium. It is not timed with a wave.

20. determining unresponsiveness: collapsed person: check for neck injuries, level if consciousness, call for help activate EMS

21. during resuscitation of a victim in cardiac arrest how many breaths should be given over what period of time: 2 breaths , 1 second

22. duty cycle for downstroke and upstroke: 600 msec, allowing for a 1:1 ratio

23. electrical shock can cause: cardiac or respiratory arrest, remove patient from electrical source, turn off electricity, maintain rescuer safety

24. Exhaled air provides what % of Oxygen? and provides what arterial blood tension: 16, 50-60mmHg

25. gastric inflation: introduction of air into the stomach and intestine

26. gastric inflation: prolonged mouth to mouth, occurs 17% of cases. For prevention: use mask.

27. health care providers should use a ratio of what for adult and children: 30:2, compression to ventilation

28. health care providers should use a ratio of what for infants: 3:1compression to ventilation (2 rescuers)

29. implanted pacemakers and defibrillators: compression should be done, generally do not interfere with compressions, pads should be placed at least 1 inch from the location of pacemaker or defibrillator

30. infant compressions: use lower half of sternum, place index finger at nipple line, then tall and ring finger are used for the compressions, use other hand to maintain head position, compress 1.5in at 100/min

31. lay rescuers shout be taught to give how many compression per minute, emphasis is to give compressions how: 100/min, hard and fast

32. most common airway obstruction is: loss of muscle tone and tongue falls back

33. most effective CPR: 100 compressions per minute, depth of 2inches, allow chest to recoil minimize interruptions

34. mouth to mouth ventilation: rescuer uses deeper breath than normal 700-1000ml, delivers breath over 1second, visible chest rise

35. Near drowning and chest compression: move victim out of water to firm surface

36. patient has pulse but is not breathing: start ventilation immediately, 8-10 breaths/min

37. providing artificial ventilation must take place how quickly to prevent biologic death: 4-6 minutes

38. pulse and rhythm checks after shock should be done when: 5 cycles of CPR have been completed

39. Pulseless ventricular rhythms: are the first manifestation of cardiac arrest in 25% of cases

40. rational for defibrillation: most common initial rhythm V-Fib, treatment for V-Fib is electrical defibrillation, success diminishes quickly, V-Fib converts to asystole

41. restoring circulation: check for pulselessness: 1yo to adult femoral or carotid, infants brachial, only take 5-10 seconds to check pulse

42. restoring the airway: inspect for neck/facial injury, move victim to supine position movement of lower jaw and extension of neck pulls the tongue out of the way, head-tilt chin-lift, jaw thrusts

43. restoring ventilation: asses for breathing, check for chest movement, takes no longer than 3-5 minutes

44. SCA: Leading cause of death in the US. Sudden Cardiac arrest

45. steps for administering BLS, single practitioner: 1. check for lack of movement, response and not normal breathing or only gasping. 2. no response, check for pulse within 10 seconds. 3. Activates emergency response system. 4. if no AED, start compression and rescue breathing (30:2) for adult cardiac arrest. 5. open airway and check breathing. 6. if not breathing, give 2 breaths that can produce a rise of chest and resume compressions. 7. AED arrives with response team

46. synchronized cardioversion: counter-shock synchronized with the heart’s electrical activity

47. systolic output during compressions is: 60-80mmHg

48. when do you stop ALS: spontaneous pulse and breathing, pronounced death by DR, patient has DNR status.

49. when is mouth to nose ventilation used?: trismus (involuntary contraction of the jaw muscles-lock jaw), traumatic jaw, mouth injury, or if mouth seal is difficult to maintain

50. when to use chest compressions on neonates: if heart rate decreases to less than 60 beat per minute despite adequate ventilation with 100% O2, lower 1/3 of sternum, depth of 1/3 the AP, diameter, can use wrap around , deliver a slightly shorter compression than relaxation phase to allow fro more blood flow

51. with 2 rescuers how often do yo switch?: every 5 cycles, about every 2 minutes

52. An advanced airway will allow the rescuer to achieve one or more of the following goals(6): deliver ventilations that are nonsynchronous with chest compressions, restore airway patency, maintain adequate ventilation, isolate and protect the airway from aspiration, provide access for clearance of secretions, and provide an alternate route for administration of selected drugs

53. after giving drugs how many ml of IV fluid and elevation of the extremity: 20mls

54. as long as air exchange is present, the patient should be reassured and allowed to clear his or her own airway by: coughing

55. Assuming mouth-to-mouth ventilation is successful and the patient remains apneic (not breathing), continue the effort at a rate of one breath every__to __ seconds to maintain the minimal adult rate of __ to __ breaths/min: 5-6, 10-12

56. cardioversion similar to defibrillation with two exceptions what r they: countershock is synchronized with the heart,s electrical activity(the R wave) The energy used during cardioversion usually is less than that applied during defibrillation

57. Chest compressions on a neonate are indicated if the heart rate falls below____ beats/min, or remains between ___ and ___ beats/min despite adequate ventilation with ____ % oxygen for ___ seconds: 60, 60 and 80, 100%, 30

58. Defibrillation: unsynchronized shock used to simultaneously depolarize the myocardial fibers

59. Drugs should be given by: rapid bolus injection

60. During respiratory arrest, the victim must be provided with oxygen within: 4 to 6 min or biological death will follow

61.Exhaled air provides approximately ______ oxygen, which is sufficient to achieve an arterial oxygen tension of __ to __ mmHg: 16%, 50 to 60

62. Gastric inflation: increase intrathoracic pressure

63. The goal of BLS is: to restore ventilation and circulation

64. If the adult victim with FABO becomes unresponsive, the rescuer should: move the patient to the ground, activate the EMS system, and begin CPR

65. In adults compress the sternum: 1.5 to 2 inches (3.8 to 5cm)

66. In an adult chest compressions should be done on the _____ _____ of the sternum, At a rate of ____ compressions/min: Lower half, 100

67. in an infant compress the sternum____ to ____ at a rate of____: 1/2 to 1 inch, 120/min

68. in infants and children, two rescuers should use a compression/ventilation ratio of ____: 15:2

69. The most common cause of airway obstruction is: Loss of muscle tone, which causes the tongue to fall back into the pharynx

70. Neonatal chest compressions are given to a depth approximately ___ of the anteroposterior diameter of the chest: 1/3

71. Pharyngeal airways restore airway patency by separating the _____ from the posterior pharyngeal wall.: tongue

72. The ratio between downstroke/upstroke is: 1:1

73. Rescue attempts continue until (3): advanced life support is available, the rescuers note spontaneous pulse and breathing,or a physician pronounces the victim dead

74. Three steps for administering BLS are: Check for movement or response, Activate emergency medical services, if no response, check pulse within 10 seconds

75. what 4 drugs may be given through an ET tube: Epinephrine, lidocaine, atropine, narcan

76. What artery should be used to evaluate pulselessness in Adults___ and in infants____: Cartoid, Brachial

77. what is another complication associated with abdominal thrusts: Vomiting

78. what is the most common and one of the most useful types of monitoring used during ACLS: Electrocardiography

79. what is the primary procedure recommended for the layperson when spinal trauma is not suspected: The head-tilt/chin-lift

80. what is the universal distress signal for foreign body obstruction: clutching the throat

81. What should be used when neck injuries are suspected (only done by trained clinicians): The jaw thrust

82. what three types of electrical therapy are used in emergency cardiac care(3): unsynchronized countershock, or defibrillation, synchronized countershock,or cardioversion, and electrical pacing