BLS Algorithm Flashcard 2
Rationale
B. Rationale: In BLS, the rescuer is given 10 seconds to assess the patient’s breathing and pulse before attempting CPR, which allows the rescuer to immediately give chest compressions when needed and avoid prolonged interruptions in chest compressions while performing conventional CPR.
Question
Success in PALS requires the rapid evaluation and treatment of the patient. The maximum amount of time allotted for a rescuer to assess the pulse and breathing in the seriously ill pediatric patient is:
a. 5 seconds
b. 10 seconds
c. 20 seconds
d. 30 seconds
Answer
b. 10 seconds
Rationale
C. Rationale: One of the provisions in the Pediatric BLS guidelines recommends the rescuer ensure scene safety. There may be situations such as a burning building or multiple vehicular crash that may put the rescuer’s life in danger.
Question
The American Heart Association BLS algorithms provide procedures to protect the rescuer from possible harm when rescuing the seriously ill pediatric patient. Which of the following is one of these procedures?
a. Activating EMS
b. Providing 2 rescue breaths
c. Ensuring scene safety
d. Performing high-quality CPR
Answer
c. Ensuring scene safety
Rationale
D. Rationale: The correct chest compression depth for children less than 8 years old is 1/3 the anteroposterior diameter of the child’s chest, or about 2 inches (5 cm).
Question
The appropriate chest compression depth in children below 8 years old is:
a. 1 inch
b. 2.5 inches
c. 3 inches
d. 1/3 anteroposterior diameter of the chest
Answer
d. 1/3 anteroposterior diameter of the chest
Rationale
B. Rationale: While the AED is charging, it is recommended the rescuer continue with chest compressions and minimize any interruptions. Once the AED is charged, it is ready to deliver the shock. Rescuers must clear the patient, ensuring no one is touching the patient before pressing the shock button to deliver the shock.
Question
The automated external defibrillator has recommended a shock for the pediatric patient in cardiac arrest. What should you do while the AED is charging?
a. Clear the patient
b. Continue compressions
c. Push the shock button
d. Connect the dose attenuator
Answer
b. Continue compressions
Rationale
A. Rationale: The current recommendations are to give the willing community responder just-in-time instructions for compressions-only CPR. At the same time, the dispatcher will dispatch an EMS crew to respond to the emergency.
Question
The dispatcher is on the phone with an untrained community member who has witnessed a child’s collapse. The responder is willing to help the child and states that the child is not breathing. They cannot feel a pulse. The dispatcher should:
a. Give the community responder instructions for performing child CPR.
b. Tell the responder to continue trying to rouse the child.
c. Instruct the responder to run to get help.
d. Instruct the responder to wait for EMS to arrive.
Answer
a. Give the community responder instructions for performing child CPR.
Rationale
A. Rationale: The American Heart Association PALS BLS guidelines suggest that, for 2 rescuers, each cycle is composed of 15 compressions and 2 breaths. Before checking for a pulse or breathing, 5 cycles must be accomplished, which is roughly 2 minutes. For a single rescuer, a complete cycle is composed of 30 chest compressions and 2 breaths.
Question
The Pediatric guidelines recommend that a cycle of CPR performed by two rescuers includes which of the following actions?
a. 15 chest compressions and 2 ventilations
b. 30 chest compressions and 2 ventilations
c. Asynchronous ventilations of 10 breaths per minute
d. 1 ventilation every 3 to 5 seconds with continuous chest compressions
Answer
a. 15 chest compressions and 2 ventilations
Rationale
B. Rationale: High-quality CPR requires a chest compression rate of 100 to 120 per minute.
Question
The recommended push fast terminology refers to which aspect of basic and advanced cardiac life support?
a. Chest compressions at a rate of 60 to 100 per minute
b. Chest compressions at a rate of 100 to 120 per minute
c. Chest compressions at a rate of 120 to 140 per minute
d. Chest compressions at a rate of more than 140 per minute
Answer
b. Chest compressions at a rate of 100 to 120 per minute
Rationale
B. Rationale: Continue with 5 cycles of CPR after giving a shock. Ventricular fibrillation that does not convert after defibrillation is due to poor cardiac perfusion. Hence, chest compressions are vital because they maintain blood flow to the brain and coronary circulation. Chest compressions increase the chance of spontaneous circulation and have become the mainstay for resuscitation instead of repetitive shock. Also, it is imperative to resume chest compressions for 2 minutes even after the conversion of VF to sinus rhythm because most patients with VF convert to PEA immediately after shock delivery.
Question
The team leader recommends shocking a pediatric patient in cardiac arrest with ventricular fibrillation. While charging the device, chest compressions must continue. Once charged, the patient is cleared, and the provider gives a shock. What is the next course of action in this situation?
a. Check pulse and breathing
b. Continue with 5 cycles of CPR
c. Check the ECG tracing
d. Give another shock
Answer
b. Continue with 5 cycles of CPR
Rationale
C. Rationale: The C-A-B sequence (circulation-airway-breathing) in BLS and PALS resuscitation is recommended in the guidelines with an emphasis on high-quality CPR to provide adequate blood flow to the brain, heart, and other vital organs. Chest compressions generate blood flow, and a brief pause in chest compressions can significantly reduce blood flow, especially in children for whom blood volume is limited compared to that of adults. Chest compressions can often be initiated more quickly than breathing so the guidelines direct the rescuer to start with compressions. Unlike adults, airway and breathing are more likely to be at the root cause of the arrest and the rescuer should quickly move to address each in turn.
Question
What sequence is recommended by the American Heart Association guidelines for the BLS and PALS approach toward resuscitating pediatric patients in cardiac arrest?
a. Airway-breathing-circulation
b. Breathing-circulation-airway
c. Circulation-airway-breathing
d. Circulation-breathing-airway
Answer
c. Circulation-airway-breathing
Rationale
A. Rationale: The brachial artery is on the medial side of the upper arm midway between the shoulder and elbow. It is the recommended location for checking a pulse in infants.
Question
When checking for the pulse, the rescuer must be familiar with the location of each major artery to obtain an accurate reading. The brachial artery in the infant under 1 year of age is located in the:
a. The medial side of the upper arm between the shoulder and the antecubital fossa
b. The inner thigh midway between the hip bone and the pubic symphysis
c. Lateral to the thyroid cartilage in the anterior neck area
d. The lateral side of the wrist
Answer
a. The medial side of the upper arm between the shoulder and the antecubital fossa