BLS Algorithm Flashcard 2

A. Rationale: Administering ventilations is necessary for an infant in cardiac arrest. For two or more rescuers, the two-thumbs encircling method for chest compressions allows the other rescuer easy access to give ventilations either by mouth-to-mouth or with a self-inflating bag. When performing the two-thumbs encircling hand technique, the rescuer gently clutches the anterior-posterior diameter of the infant with their hands, being careful not to compress the diameter of the chest. Both thumbs are placed on the lower sternum, compressing the lower half of the infant’s sternum and avoiding the xiphoid process.

A. Rationale: The AHA recommends the use of devices that give instant audio and visual feedback on the quality of chest compression skills. The clicks heard in some CPR dummies provide audio feedback that signifies good chest compression depth with full chest recoil. Some digital devices make use of sensors that communicate with a smartphone. This provides instant audio and visual data on the performance of trainees so that they may adjust their execution to improve CPR quality.

B. Rationale: The conventional CPR approach for a two-rescuer team is to give 2 ventilations after 15 chest compressions. The single-rescuer method uses the 30 compressions to 2 ventilations approach. If the patient has an advanced airway, asynchronous ventilation with continuous chest compressions is optimal.

D. Rationale: The AHA has recommended measuring chest compression fraction with a goal of minimizing interruptions in chest compressions. Chest compression fraction is the time of chest compressions being given divided by the total resuscitation time, reflecting how much of the time compressions are actually being given. An acceptable chest compression fraction is 60% or more.

B. Rationale: For a one- or two-rescuer team providing CPR to an adult without an advanced airway, the chest compression to ventilation ratio is 30 to 2.

A. Rationale: Cardiac arrest in infants and children is commonly due to respiratory failure and shock, which usually result from respiratory distress, trauma, sudden infant death syndrome (SIDS), and sepsis. Option B refers to cyanotic heart malformations, which are uncommon overall. Option C is the leading cause of cardiac arrest in adults but uncommon in children. Option D is rarely a cause of respiratory arrest in children and thus is unlikely to be a common precursor for cardiac arrest in that population.

B. Rationale: Higher compression rates improve cardiac output and coronary perfusion. However, studies have shown that chest compression quality suffers as the compression rate increases. About 35% of rescuers provide inadequate chest compression when performing at a rate of 100–119 per minute. This population increases to 50% when the compression rate is 120–139 beats per minute. When performing at a rate > 140/minute, 70% of healthcare providers perform inadequate chest compressions.

B. Rationale: The recommended chest compression depth for an adult is 2 to 2.4 inches.

A. Rationale: The AHA recognizes the need for immediate diagnosing and initiating chest compressions. The trained healthcare provider is given 10 seconds to determine the presence of a pulse and normal breathing. After 10 seconds, if the provider does not detect or is unsure about finding a pulse and breathing, CPR must be initiated immediately, beginning with chest compressions.

C. Rationale: Conventional high-quality CPR with chest compressions and ventilations with a ratio of 30 compressions to 2 ventilations should be provided because it has produced the best outcomes.