BLS Principles Flashcard 1

D. Rationale: More than 350,000 out-of-hospital cardiac arrests are recorded in the United States every year, and 90% of them are fatal. In the adult, lethal arrhythmias usually cause cardiac arrest. Research shows that cardiac arrhythmias in these cases are typically caused by ischemic heart disease secondary to coronary artery disease.

D. Rationale: An essential component in Basic Life Support is immediate defibrillation. Automated external defibrillators are available in areas with an increased risk of out-of-hospital cardiac arrest. The AED is applied immediately after being retrieved and brought to the scene.

B. Rationale: In the out-of-hospital cardiac arrest setting, compression-only CPR is a technique that a single untrained rescuer can perform. Compression-only CPR has better survival rates compared to no CPR at all. For option A, it must be remembered that CPR must be initiated immediately when the rescuer does not witness the cardiac arrest. Searching for an AED and activating EMS comes later in the process. Both options A and C require activating EMS after initiating CPR. It is best not to wait for paramedics to arrive on the scene before initiating CPR, especially when the arrest was not witnessed. Option D, ET tube placement is typically performed by those with CPR training and requires multiple rescuers to ensure asynchronous ventilation and chest compressions.

A. Rationale: Untreated ischemic heart disease causes cardiac cells to die and disrupts the normal anatomy and physiology of the heart. It may lead to lethal arrhythmias such as ventricular fibrillation and ventricular tachycardia.

C. Rationale: Treatment of cardiac arrest in the out-of-hospital setting is difficult because it relies heavily on the skills of the community. The lack of potential rescuers and equipment can hamper efforts to give optimum treatment in the field. The AED’s intuitive design means the public can use it even without formal training. However, survival in the out-of-hospital setting has not improved despite these advances. 70% of sudden cardiac arrests happen in the home, where the number of trained healthcare providers is limited.

C. Rationale: After delivering a shock that causes a successful conversion to a regular rhythm, the patient’s heart will not immediately return to sufficient perfusing function. Coronary artery perfusion should be assisted via chest compressions. Thus, after shocking the patient, rescuers should immediately perform 2 minutes of chest compressions.

D. Rationale: Studies have shown that there is no difference in outcomes if patients were shocked first or received chest compressions first. The key to successful CPR is minimizing interruptions in chest compressions and immediate defibrillation.

C. Rationale: If the trained lay rescuer cannot feel a pulse, they should immediately begin chest compressions. The lay rescuer does not need to attempt breathing and pulse checks. If there are no obvious signs of spontaneous breathing, the lay rescuer must assume that the patient is already apneic and continue providing chest compressions.

B. Rationale:

Compression-only CPR is not recommended for infants and children because the cause of sudden cardiac arrest in these patients is typically respiratory, and thus ventilations are necessary for these patients.

D. Rationale: The advantage of performing compression-only CPR is that it circumvents any reluctance a lay or untrained rescuer may have from performing CPR. This reluctance may come from anxiety about performing CPR incorrectly or fear of contracting certain diseases when giving mouth-to-mouth ventilation. Providing CPR is better than no CPR at all. The Good Samaritan Law is one of the basic rules that protect rescuers from litigation.