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| Questão | Responda |
| Early recognition and Call for help (*to prevent cardiac arrest) | 1st step |
| Early CPR (*to buy time) | 2nd step |
| Early Defibrillation (to restart the heart) | 3rd step |
| Post resuscitation care (*to restore quality of life) | 4th step |
| 1. approach safely 2. check response 3. shout for help 4. open airway 5. check breathing 6. call 112 7. 30 chest compressions 8. 2 rescue breaths | initial steps |
| occurs shortly after the heart stops in up to 40% of cardiac arrests; described as barely, heavy, noisy, or gasping breathing recognized as a sign of cardiac arrest | Abnormal Breathing |
| Place the heel of one hand in the center of the chest; Place other hand on top; interlock fingers or avoid putting pressure on the side of the chest; compress the chest (*100-100/min + 5-6cm + equal compression and relaxation) change CPR operator every 2 minutes | Chest Compressions |
| pinch the nose; take a normal breath; place lips over mouth; blow until the chest rises; take about 1 second; allow chest to fall; repeat | Rescue Breaths |
| switch on AED; attach pads to patient's bare chest; analyzing cardiac rhythm (NO TOUCH); Stay Clear to Deliver Shock; 30 chest compressions; 2 rescue breaths | AED steps |
| if patient starts to breathe, place in recovery position (*turning to right side) | recovery position |
| adult CPR techniques compressions of 1/3 in depth | CPR in children |
| use only 8+ years old (with Adult AED) 1-8 years old with pediatric pads if available | AED in children |
| the emphasis on "high-quality chest compression" | Guidelines 2010 |
| carotid pulse check; pocket mask; bag-mask ventilation; general points of using face mask; use of oxygen; choking; drowning; two-rescuer CPR | Resuscitation Skills |
| not recommended for lay rescuers; use index and middle fingers in the groove on one side of the neck only; check for breathing and carotid pulse at the same time (*extend neck; no more than 10 seconds) | Carotid Pulse Check |
| 1) start chest compressions 2) continue 30 chest compression 3) 2 rescue breaths 4) do NOT re-check for carotid pulse | Carotid Pulse Check ABSENT / UNSURE |
| 1. Give rescue breaths on their own (*10 per minute) 2. Re-check for carotid pulse / signs of life after 1 minute | CAROTID PULSE CHECK DEFINITE / PRESENT |
| extend neck fully; create a good seal between mask and mouth/nose; deliver each breath over 1 second blow just enough to make chest rise and fall as in normal breathing (*NO Over Ventilation) Combine 30 + 2 | General Points on Using Face-Masks |
| Supplemental Oxygen can be used in cardiac arrest if available; given via a bag-vale mask or pocket-mask; give as MUCH as possible as SOON as possible (*flow rate of 10-15L/min) | USE of OXYGEN |
| Removal of Oxygen from Patient during defibrillation at least 1m away | USE of OXYGEN (*with AED) |
| encourage victim to cough; closely monitor for deterioration | Choking (mild obstruction) |
| conscious patient: 5 back blows + 5 abdominal thrusts unconscious patient: activate EMS + start CPR | Choking (severe obstruction) |
| early rescue breaths; safety of rescuer is very important; patient should be removed from water; only when trained, rescue breaths can be given in water; AED must be on dry land/rescue boat + dried chest of patient | Drowning |
| 30 chest compressions + 2 rescue breaths; 1 rescuer performs rescue breaths + 1 rescuer performs chest compressions; operating AED + performing CPR | 2-rescuer CPR |
| Basic Life Support - Defibrillation | BLSD |
| Terminal event (*natural death) or Sudden event (*unpredicted death) | Cardiac Arrests |
| appx. 700,000 cardiac arrests annually in Europe; survival to hospital discharge rate of 5-10% early resuscitation and prompt defibrillation (1-2 mins) 60+ % | Background info |
| 80% of cardiac arrests occur known or unknown underlying heart diseases; in western countries, 80%+ of cardiac arrest due to coronary diseases; 20% of congenital heart diseases, myocarditis, valvular disease, and electrophysiological anomalies such as prolonged QT and pre-excitation syndrome | background (continued) |
| few cardiac arrest due to acute failure of pulmonary gas exchange or type I/II acute respiratory failure, or hypothermia/electrocution; most frequently by drowning, smoke inhalation, sedation, narcotic overdose, pulmonary embolism, cerebrovascular accident | background (*continued) |
| sudden cardiac arrest --> loss of consciousness --> no breath or gasping --> loss of central pulses --> pale cyanosis --> mydriasis (*fixed) --> biological death | clinical and biological deaths |
| abnormal pattern of breathing; occurs shortly after cardiac arrest (up to 40%) barely, heavy, noisy, gasping; a sign of cardiac arrest | Agonal Breathing (gasping) |
| loss of cerebral blood flow --> (15 sec) loss of consciousness --> (1 min) loss of brainstem functions (*gasping, mydriasis) --> (4-5 min) ATP depletion and anaerobic metabolism --> irreversible damage | Brain and Cardiac Arrest |
| Shockable (80%) --> VF (*ventricular fibrillation) Non-shockable (20%) --> pulseless ventricular tachycardia, "asystole (: no electrical activity" / only P waves, large QRS complexes (6/min) | Types of Cardiac Rhythms |
| Airway Breathing Circulation | ABC approach |
| head tilt (*not for suspected trauma) + chin lift + jaw thrust (*professional) + finger sweep (*NO, unless object seen) | Airway |
| 30 chest compression (*15-20 sec) + 2 rescue breaths (*500-600 ml); look, listen, and feel for normal breathing; AGONAL breathing (*gasping) | Breathing |
| qualified help arrives and takes over; return of spontaneous circulation (*patient has NO longer signs of clinical death); rescuer becomes exhausted | CPR continues until |
| lateral safety position (*right) | Breathing Unconscious Patient |
| Foreign Body Airway Obstruction mild or severe | FBAO |
| answer of "Yes" + can speak, cough, and breathe | MILD FBAO |
| unable to speak (*may nod) + no breathing or wheezy breathing, silent attempts to cough + unconsciousness | SEVERE FBAO |
| 1) severe / ineffective cough --> unconscious (: CPR start) or conscious (: 5 back blows + 5 abdominal thrusts or Heimlich maneuver) 2) mild / effective cough --> encourage to cough (*continue to check for deterioration to ineffective cough or until obstruction removed) | Adult FBAO treatment |
| heart beat + respiratory rate + temperature + blood pressure + O2 saturation | Vital Signs |
| normal vital signs change with AGE, SEX, WEIGHT, EXERCISE TOLERANCE, and CONDITION | Vital Signs (normal changes) |
| Patient at seated posture; 5 mins prior rest; observation before measuring patient (*anxious, painful, upset); | Vital Signs (measurement) |
| control by hypothalamus; age/infection/medication affect; core temperature different from anatomical sites | Temperature |
| reflects circulating volume and strength of contractility; intravascular volume/contractility/oxygen demand affect; at least for 30 sec, regularity, strength, and equality should be checked | Pulse |
| regulated by vasomotor center in the medulla; intravascular volume/vascular tone/contractility affect; automated monitors less reliable | Blood Pressure |
| controlled by respiratory centers in the medulla and pons; hypercapnia/hypoxemia/acidosis affect; establish baseline, critical illness, change in oxygenation, and evaluate response to treatment | Respiratory Rate |
| above 37 orally or 37.5 rectally | Fever |
| below 35 | hypothermia |
| bradycardia < 60-100 /min < tachycardia 40 - 60 for athletes female has higher babies up to 1 (*100-160) / 1-10 (*60-140) | Pulse Rate |
| rate; rhythm; volume; synchronous with other pulse (*radio-femoral delay); state of the vessel wall | Pulse Quality |
| altered mental status; fast respiratory rate; low blood pressure | qSOFA scores |
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