BLS Algorithm Flashcard 3
Rationale
C. Rationale: The team leader should always keep in mind to minimize interruptions in chest compressions. The most critical interventions for ventricular fibrillation and pulseless ventricular tachycardia are primarily cardiopulmonary resuscitations and defibrillation, especially early during the first few minutes of cardiac arrest.
Question
The team leader has decided to give a shock to a 45-year-old man in cardiac arrest with ventricular fibrillation secondary to a myocardial infarction. The defibrillator fails to charge. What is the appropriate next step?
a. Charge the defibrillator once more
b. Give amiodarone 300 mg bolus IV injection
c. Continue high-quality CPR
d. Wait for a new defibrillator
Answer
c. Continue high-quality CPR
Rationale
B. Rationale: The trained healthcare provider should limit pulse checks to within 10 seconds. Ideally, this should be assessed together with the patient’s breathing status. If no pulse is felt by then, the provider must assume the patient is in cardiac arrest and begin chest compressions immediately.
Question
The trained healthcare provider should limit pulse checks to within how many seconds?
a. 6 seconds
b. 10 seconds
c. 30 seconds
d. 60 seconds
Answer
b. 10 seconds
Rationale
C. Rationale: More chest injuries have been observed if compression depth exceeded 6 cm.
Question
To avoid injury to the patient, chest compression depth should not exceed:
a. 3 cm
b. 5 cm
c. 6 cm
d. 4 cm
Answer
c. 6 cm
Rationale
A. Rationale: Studies have shown that if the waveform capnogram reads between 10 and 20 mm Hg, this indicates the CPR quality is good enough to achieve a return of spontaneous circulation.
Question
Waveform capnography in CPR can be used to monitor:
a. CPR quality
b. Oxygenation
c. Venous oxygen saturation
d. Blood pressure
Answer
a. CPR quality
Rationale
D. Rationale: Trainers remind rescuers to push hard, push fast, at the center of the chest. This entails providing chest compressions in the lower half of the sternum; at a depth of 2–2.4 inches, at a rate of 100–120 per minute, with full chest recoil.
Question
What does it mean when the instructor tells the trainers to push hard, push fast, at the center of the chest?
a. Compression depth of 3 inches
b. Compression rate of 75 per minute
c. Lean on the patient’s chest after each stroke
d. Apply chest compressions at the lower half of the sternum
Answer
d. Apply chest compressions at the lower half of the sternum
Rationale
B. Rationale: According to the AHA guidelines, the recommended compression-to-ventilation ratio is 30:2.
Question
What is the recommended compression-to-ventilation ratio?
a. 15:2
b. 30:2
c. 10:2
d. 10:1
Answer
b. 30:2
Rationale
B. Rationale: The trained healthcare provider should limit pulse checks to within 10 seconds, and the patient’s breathing status should be checked at the same time.
Question
When does a trained healthcare provider check the patient’s breathing status during BLS?
a. Before checking for a pulse
b. At the same time as the pulse check
c. After checking for a pulse
d. There is no need to check the patient’s breathing status as rescue breaths are always part of CPR
Answer
b. At the same time as the pulse check
Rationale
C. Rationale: After shocking the patient, responders should immediately perform high-quality CPR, starting with chest compressions. After 2 minutes or about 5 cycles of CPR, the providers perform a rhythm check, pulse check, and breathing check.
Question
When is a rhythm check performed after delivering a shock to the patient?
a. Immediately after the shock
b. At any time during the resuscitation
c. After 5 cycles of CPR
d. After 10 minutes of CPR
Answer
c. After 5 cycles of CPR
Rationale
D. Rationale: As per the guidelines, the hands should be positioned over the lower half of the sternum.
Question
Where should the hands be positioned when performing chest compressions?
a. 5th intercostal space at the left mid-clavicular line
b. On top of the manubrio-sternal junction (angle of Lewy)
c. Anywhere on the sternum
d. Lower half of the sternum
Answer
d. Lower half of the sternum
Rationale
B. Rationale: High-quality CPR means providing a compression rate of 100–120/min, compression depth of 2 to 2.4 inches, full chest recoil, and asynchronous ventilations at 10 breaths/min when the patient is intubated. Providers aim to achieve an end-tidal CO2 between 10 and 20 mm Hg.
Question
Which of the following actions ensures that the patient is receiving high-quality CPR?
a. Chest compression rate of 75/minute
b. Visible chest rise after each positive pressure ventilation
c. Compression depth of at least 3 inches
d. Ensuring fast chest compressions by limiting chest recoil
Answer
b. Visible chest rise after each positive pressure ventilation