BLS for Healthcare Providers

BLSForHealthcareProvidersStudentManual

BasicLifeSupportHandbook

__________

JaneJohn-NwankwoRN,MSN

BLSFORHEALTHCAREPROVIDERSSTUDENTMANUAL:

BasicLifeSupportHandbook

Copyright2014byJaneJohn-NwankwoRN,MSN

Allrightsreserved.Nopartofthisbookmaybereproducedortransmittedinanyformorbyanymeanswithoutwrittenpermissionfrom

theauthor.ISBN-13:978-1497343122ISBN-10:1497343127

PrintedintheUnitedStatesofAmerica.

Dedication

Tomylovinghusband,JohnU.NwankwoPh.D

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ThegoalofCPRistosavelives.Compressionsmustbestartedwithin10secondsofcardiacarrest

SinceitsintroductiontoAmericanphysiciansin1960,CPRhasremainedastapleofemergency

medicine.MorepeoplecontinuetobetrainedinCPRadministrationnotonlyinAmericabutother

countriesinordertosavelives.Intherecenttimes,theAmericanHeartAssociationintroducedthe

hands-onlyCPRwherebyrescueforgorescuebreaths.Despitetheadvancementsmade,the

effectivenessoftheCPRisstilllowinthecountry.Toaddressthechallengetherearecallstointroduce

CPRtraininginschoolsandincreaseaccesstoautomatedexternaldefibrillators.Thisstudyguide

examinesthekeyCPRconcepts.

WhatisCardio-PulmonaryResuscitation?

CardioPulmonaryResuscitationisanemergencyprocedurethatisperformedtorestore

spontaneousbloodcirculationandbreathinginthevictims.Thepracticeencompassescorecomponents

suchasairwaycontrol,artificialrespirationandcardiacmassage.AccordingtoMistovichandKarren

(2010)Vesaliusiscreditedwiththeearliestaccountofartificialrespirationandairwaycontrol.Lateron,

Tossachconductedthefirstdocumentedresuscitationonaninjuredcoalminer.Theseearlypioneers

popularizedtheconceptofmouth-to-mouthresuscitationbutitwaslaterdisregardedduetohygienic

reasons.Lateronin1800s,LeroydEtiollesintroducedtheideaofmanipulatingthebodytoinduce

ventilation.In1958,Safar,EscarragaandElampublishedanarticlewhichsawthere-introductionofthe

mouth-to-mouthresuscitation(Safar,1989).TheirfindingsweresupportedbytheNationalResearch

CounciloftheNationalAcademyofSciences.The1800ssawtheintroductionofthecardiacmassage.

Earlyinthe20thcentury,GeorgeWashingtonCrilewroteanarticletopopularizethecombinationofthe

thoraciccompression,artificialrespirationandparenteralepinephrineinfusion.

TheCPRprocessisusedtore-startapatientsheartafterithasstoppedpumping.Themain

essenceofCPRistocontinuetopumpbloodtovitalorgans,especiallythebraintopreventbraindeath

whichusuallyoccursinfewminuteswithoutoxygen(whichofcoursethebloodsupplies).Accordingto

HuetherandMcCance(2004)heartfailuremaybecausedbymanyfactorsincludingunhealthylifestyle,

heart-relatedillnesses,accidentsandchronicdiseases.Accordingtotheavailableliterature,CPRhas

beeneffectiveinpatientswhosufferedfromheartattacksecondarytoseverekidneyfailure,cancer,

severeheartfailureandseriousinfection.However,CPRisassociatedwithvarioussideeffects.For

instance,pushingdowntheribbonesmaycausefurtherinjurytothevictimsandsecondly,CPRcan

puncturethelungsorcausedamagetotheotherorgansinthethoraciccavity.

WhydowehavetodoCPR?

TheCPRprocessisveryimportanttothevictimandiscomposedofseveralfunctions.Thefirst

functionisneutralizinganydangersfromthesurroundings.Therescuershouldensureanyhazardsare

removedandthevictimsarewelltakencareof.Thesecondcomponentischeckingthestatusofthe

victimbyaskingquestionsandifthevictimdoesnotrespondtherescuershouldsendforhelp.Thethird

componentisunblockingtheairwayandcheckingforbreathing.Aftercheckingforbreathing,the

rescueristhensupposedtostartthecompressions.AccordingtoMistovichandKarren(2010)the

rescuershouldfirstadminister30compressionsatarateof2compressionspersecond.Allalong,the

rescuershouldmakesurethevictimsarelyingontheirbacksandtheheadandthechinislifted.The

CPRshouldberepeatedinacycleof30compressionsand2rescuebreaths.Ifthevictimfailsto

respondtotheCPR,anautomatedexternaldefibrillatorshouldbeused.Itisveryparamountthatchest

compressionsbestartedimmediately,notmorethan10secondsfromthetimeofcardiacarrest.Ifyou

dontfeelapulse,orarenotsureyoufeelapulse,startchestcompressions!

AccordingtoMistovichandKarren(2010)chestcompressionsduringCPRgeneratesmallbut

criticalamountofbloodflowtotheheartandbrain.MistovichandKarren(2010)furthersuggestthat

thequalityofthechestcompressionsdeterminesthesuccessoftheresuscitation.Thephysiologyof

chestcompressionscanbeunderstoodusingtheexternal;cardiacmassageandthoracicpumpmodels.

AccordingtoHuetherandMcCance(2004),externalcardiacmassagecompressesthecardiacstructures

henceforcingthebloodtocirculate.Ontheotherhand,thethoracicpumpmodelsuggeststhatchest

compressionsincreasetheglobalintra-thoracicpressure.DuringtheCPRprocessthebrainis

susceptibletothedecreasedbloodflowandcouldsufferfromirreversibledamagewithinfiveminutes

ofabsentperfusion.Chestcompressionsensurebloodcirculatestothebrainsandothersusceptible

organssuchasthemyocardium(themusclesoftheheart).

TheappropriatewaytodocompressionsGiventheimportanceofthe

chestcompressions,itisimportantthattherescueradministersthemintherightmanner.Chest

compressionsaresupposedtobeforcefulandshouldbeadministeredonthelowerhalfofthesternum.

Thevictimshouldbeplacedinasupinepositionwhiletherescuerkneelsbesidethevictimschest.For

compressiveforcetobeeffective,thepatientsshouldbeplacedinafirmsurface.Inaddition,

interruptionsofchestcompressionsshouldbeavoidedandtherescuershouldtakemaximumcarenotto

dislodgelinesandtubes.Therescuershouldplacethedominanthandonthecenterofthevictimschest.

Theheelofhisorherhandsshouldbepositionedinthemidlineandalignedwiththelongaxisofthe

sternum.Thenon-dominanthandshouldbeplacedoverthedominantone,withthefingerselevatedoff

thepatientsribs.Thisarrangementensurestherescuerisabletoapplyenough

compressiveforceandtominimizedamageoftheribs.The

rescuershouldavoidapplyingforceoverthexiphisternum(tipofthesternum)andtheupperabdomen.

Whileapplyingpressureonthevictimschest,therescuershouldkeephisarmsstraightandextended.

Therescuersshouldersshouldbepositionedverticallyabovethevictimschesttoensuremaximizethe

effectivenessofthecompressiveforces.Inthearticletitled,techniqueforchestcompressionsinadult

CPR,Rajab,Conrad,CohnandSchmitto(2011)suggeststhatchestcompressionsshouldbedeliveredat

arateofatleast100perminuteandanyinterruptionsshouldbeavoided.Inthesamearticle,Rajab,

Conrad,CohnandSchmitto(2011)arguethatcompressiondepthshouldbemaintainedat5cmandthe

rescuershouldallowthevictimschesttorecoilcompletely.Inaddition,therescuershouldavoid

removinghisorherhandsfromthevictimschest,inordertomaintaintherightcompressiondepth.

Therescuershouldobserveadutycycleof50%andthecompressorshouldberotatedeverytwo

minutes.ChestcompressionisterminatedafterthepatientrecoversorwhentheEmergencyResponse

TeamarrivestocontinueACLS(AdvancedCardioVascularLifeSupport).TheBLS

SurveyTheAmericanHeartAssociation

recommendstrainingofpersonstoequipthemwiththenecessaryskillstosavelives.Receivingthe

CPRtraininggivestherescuerstheabilitytoperformbasicactivitiessuchasrestoringtheblood

circulation,clearingtheairway,andconductingrescuebreathing.Oneofthemajorcomponentsofthe

BLSsurveyischeckingtheresponsivenessofthepatientbytappingorshouting.Therescuerisalso

supposedtodeterminewhetherthepatientisbreathingornot.Todeterminewhetherthepatientis

breathingornot,therescuershouldlistenforbreathsounds.Alternatively,therescuershouldusethe

cheekstofeeltheflowofairfromthepatientsbreaths.ThenextkeycomponentoftheBLSsurveyis

activatingtheemergencyresponsesystemandobtaininganautomatedexternaldefibrillator(AED).

Accordingtotheacceptableprinciples,therescuerisrequiredtoactivatetheEmergencyResponse

SystemandbegintheCPRafterestablishingthatthepatientisunresolvedandisunabletobreathe.

Anotherkeystepischeckingforthecarotidpulses.Ifthepatientisunresponsiveorifheorsheisnot

breathingwell,therescuershouldtakenotmorethan10secondsincheckingforapulse.Intheabsence

ofapulse,chestcompressionsshouldbeadministeredimmediately.Assuggestedbythe2010s,AHA

guidelinesforCPRandECC,therescuershouldadheretotheC-A-Bsequence(Compressions-Airway-

Breathing).ThelastcomponentoftheBLSsurveyisdefibrillation.AdefibrillatororAEDisusedto

checkforashockablerhythmandisnormallyusedintheabsenceofapulse.

Pocketmasks

Asearlierindicated,mouth-to-mouthresuscitationisthecornerstoneoftheCPR.However,there

isreluctancebythemedicalprofessionalstousethistypeofresuscitation.Oneofthecommonreasons

givenbynursesandthephysiciansisthefearofcontractingdiseasesandinfections.Theirobservations

aresupportedbyastudyconductedbyHandley(2002)whichshowsthatHIVtransmissioncanoccur

duetotrauma,orallesionsandcontactwithblood.Itisforthisreason,thatthemedicalpractitionersare

advisedtocarrypocketmasks.Pocketmasksareconsideredtobeeffectiveindeliveringrescuebreaths

tothepatientduringcardiacorrespiratoryarrest.Thepocketmaskshaveapre-inflatedcufftoprovide

aneffectivesealaroundthemouthandthenose.Theone-wayvalvereducecontaminationwhilethein-

linefilter,filterstheair.Apocketmaskalsohasanoxygeninletporttodeliverhigh-flowoxygentothe

patient.Thepocketmaskisplacedonthepatientsfacewiththebaseofthemaskrestingbetweenthe

casualtyschinandthelowerlip.Themasksarere-usablebutthefiltersandthevalveshouldbe

discardedafteruse.AccordingtoHandley(2002)themasksarepreferredastheycreateacomfortable

distancebetweenthepatientandtherescuer.Thedevicealsoallowstherescuertoobservethechest

movementsandmonitorthepatient.

However,whilepocketmasksarepreferredbythemedicalpractitioners,astudyconductedby

Adelborgetal(2011)indicatesthatmouth-to-mouthventilationissuperiortomouth-to-pocketmasks.

Inthisstudy,Adelborgetal(2011)usedasampleof60lifeguardstoperformthreesessionsofsingle

rescuerCPR.AccordingtoAdelborgetal(2011)significantlymoreventilationweredeliveredbythe

mouth-to-mouthventilationscomparedtothemouth-to-pocketmasks.Butforsafetyandhealthcare

reasons,Mouthtomaskbreathingisresortedto.

Usingthebagmask Thisdeviceprovidespositive

pressureventilationtothepatients,andmadeupofabagandvalvecombinations.Bagmaskshave

provedtobeeffectiveinairwaymanagementandprovidingpatientswithenoughair.Bagmaskscome

indifferentsizesandaretheresponsibilityoftherescuerstochoosethemostappropriateone.Bag

masksareeitherattachedtotheoxygentankordrawroomair.Thedeviceisoperatedbyonewhereby

therescuerholdholdstheBVMwithonehand,whiletheotherhandcompressesthebagdeliveringthe

oxygen.Thetwo-personbagventilationmaskhasbeenshowntobemoreeffectivethanasingly-

operatedbagmaskindeliveringgreatertidalvolumesandintroducinglessairleak.Whenusingabag

mask,oneisrequiredtopositionhimselforherselfabovethevictimshead.Therescuerthenplacesthe

maskonthevictimsheadandholdsitinpositionusingtheE-Cdevice.Oncethemaskisinplace,the

rescueristhenrequiredtopressthebagandwatchforthechestrise.

OnerescuerCPRand2rescuersCPR

TherearetwobasicwaysofperformingCPR:1-personCPRandthe2-personCPR.Ofthetwo

techniques,the2-PersonCPRisthebest,asthevictimisabletoreceiveenoughairvolumeandisless

tiring.Oneoftherescuersadministersthechestcompressionswhiletheotherperformstherescue

breaths.Alternatively,thetworescuerscanswitchabouteverytwominutes.

AdultCPRandChildCPRandInfantCPR

Inallthepatients,thechestcompressionrateandthesequenceisthesame:Atleast100

compressionsperminute.Inaddition,duringtheCPR,chestwallrecoilshouldbeallowedbetween

compressionsandinterruptionshouldbelimitedtolessthan10seconds.ThewayCPRisadministered

variesaccordingtotheage.TheCPRprocedurevariesamongtheadults,childrenandtheinfantsand

thesedifferencesareshowninthetablebelow.

CPRCOMPONENT

ADULTS CHILDREN INFANTS

ActivatingEMSandgettinganAED

CallforhelpandifalonephoneEMSimmediately

Callforhelpbutifalone,phoneEMSaftergiving5cyclesofCPR

Callforhelpbutifalone,phoneEMSaftergiving5cyclesofCPR

COMPRESSIONDEPTH

5CM

5CM

4CM

COMPRESSION-VENTILATIONRATIO

30:21or2rescuers

30:2Singlerescuer15:22rescuers

30:2Singlerescuer15:22rescuers

Compressionlocation

Centreofchest Centreofchest Justbelownipplelineonbreastbone

Compressionmethod

2hands:heelof1hand,otherhandontop

2fingers:middleandringor2thumbs

1hand.Or2handsifthechildisobese.heelof1hand,otherhandontop

WhiletheaboveshowsthedifferencesinCPRentitiesthereareanumberofCPRcomponents

thatarecommonamongtheadults,childrenandtheinfants.Onesuchcomponentisthetypeofthe

response.Itistheroleoftherescuertoensurethattheenvironmentissafeenoughandtoestablishifthe

victimisresponsiveornot.Tocheckforbreathingandopentheairway,therescuerisrequiredtotiltthe

chinandshouldnottakemorethanfiveminutestocheckforthevisualcuessuchaschestrise.

Compressionrateinadults,childrenandtheinfantsshouldbemaintainedatarateofatleast100

compressionsperminutewhilethecompressionventilationrationshouldbeheldat30:2.However,for

thedrowningpatients,CPRsequenceshouldstartwith2initiationbreathsbeforechestcompressions.

Rescuebreathing

Althoughsomeoftheinstructorsmaynotemphasizeonrescuebreathing,itisconsidered

importantinresuscitatingthepatients.Twobreathsareadministeredforevery30chestcompressions.

Tobreatheairintothepatient,therescuerpincheshisorhernoseandtheclosesonthevictimsmouth.

Therescuerbreathesslowlyintothevictimleadingtotherisingofthechest.However,astudy

conductedbyReaetal(2010)insiststhatthereisnoneedofrescuebreathingiftherescuersarenot

competentenough.Thesefindingsarecapturedinarandomizedtrialwhere981oftheparticipants

receivedchestcompressiononlywhile960receivedchestcompressionplusrescuebreathing.Intheend

Reaetal(2010)concludedthatadministeringchestcompressionsaloneespeciallyincancerpatients

increasestheoverallsurvivalrate.

Chokingforaninfant

Chokingisverycommoninsmallchildrenandiscausedbyswallowingofhugechunksoffood.

Someoftheotherobjectsthatsmallchildrenchokeoninclude:buttons,carrotsandtoys.Symptomsof

chokinginchildrenincludehighpitchedbreathing,coughing,colorchangesandlackofbreathing.

Chokingininfantsistreatedusingbackslapsandchestthrusts.Toadministerthebackslapsthebabyis

supportedusingonehand,facingupsidedown.Thebabyisplacedonthelapsandthebackslapsare

thenadministeredusingtheheelofhand.Ontheotherhand,chestthrustsareadministeredwiththe

babyfacingup.Thechestthrustsareappliedusingtwofingersjustbelowthenippleline.So,fivechest

thrusts,thenfivebackslaps(Onecycle).Fivecyclesmustbedone.Afterthefifthcycle,theinfants

mouthisopenedtoseeiftheobjecthasbecomevisible.Iftheobjecthasbecomevisible,itiscarefully

removed.Blindsweepingshouldneverbeattempted.Ifitisnotvisible,continuethebackslapsand

chestthrustsuntilhelparrives.Ifchestbecomesunresponsive,commenceCPR.

Chokingforanadult

Chokinginadultsoccurswhenfoodsandothersolidspartiallyorcompletelyblocktheairway.

Accordingtotheavailablestatistics,chokingisaleadingcaseofhomeinjurydeathintheUnitedStates

andadultsareatanincreasedriskofchokingduetodentalproblemsandage-relatedillness.

Othercausesofchokinginclude:

-eatingtoofast

-talkingwithfoodinthemouth

-wearingdenturesandeatingfoodswithwrongtexture.

Symptomsofchokinginclude:

-inabilitytotalk,coughing,faintingandclutchingofbothhandstothethroat,usuallyreferredto

theuniversalchokingsign.

Inadultsandchildrenchokingistreatedusingbackblowsandabdominalthrusts.Blowsand

thrustsareadministereduntiltheobstructionisdislodged.Toapplytheblows,thevictimismadeto

benduntilheorsheisnearparalleltotheground.Thevictimissupportedwithonearmandthenthe

backblowsareadministeredbetweentheshoulderblades.Alternatively,abdominalthrustsshouldbe

given,orchestthrustsiftheindividualispregnant.

Conclusion

CPRisanimportantcomponentofemergencyresponseandleadstosignificantsurvivalratesof

thepatients.Despiteitssuccesssomeoftheproceduresarestillarchaicandinfringeontherightsofthe

rescuers.Forthisreason,thereisneedtoaddresssomeoftheconcernsraisedbythemedical

practitionersandconductextensiveresearchinordertosimplifytheentireprocess.Thebestthingone

candoforanunresponsiveindividualistostartchestcompressionsbeforehelparrives.THATSINGLE

ACTCANSAVETHEVICTIMSLIFE!!!References

Adelborg,K.,Dalqas,C.,Grove,E.,Jorqensen,C.,Al-Mashhadi,R.&Lofqren,B.(2011).

Mouth-to-mouthventilationissuperiortomouth-to-pocketmaskandbag-valvemaskventilation

duringlifeguardCPR:arandomizedstudy.Resuscitation,82(5),618-622

Handley,A.J.(2002).Teachinghandplacementforchestcompression--asimplertechnique.

RESUSCITATION,53(1),29-36

Huether,S.,&McCance,K.L.(2004).Understandingpathophysiology.StLouis:Mosby

Mistovich,J.J.,&Karren,K.J.(2010).Pre-hospitalemergencycare.NewJersey:Pearson

education

Rajab,T.,Pozner,C.,Conrad,C.,Cohn,L.&Schmitto,J.(2011).Techniqueforchest

compressionsinadultCPR.WorldJournalofEmergencySurgery,6,41

Safar,P.(1989).Initiationofclosed-chestcardiopulmonaryresuscitationbasiclifesupport.A

personalhistory.Resuscitation,18,720.

ReviewQuestions

1. WhatdoesCPRstandfor?a.CardioPrecisionRescueb.CardioPulmonaryResuscitationc.CriticalPulmonaryResuscitationd.CriticalPrecisionResuscitation

2. WhatisthepurposeofCPR?a.Torestorespontaneousbloodcirculationonlyb.Torestorespontaneousbreathingc.Torestorespontaneousbloodcirculationandbreathingd.Torestoreconsciousness

3. WhatisthemainessenceofCPR?a.Toprovideoxygentothelungsviamouthtomouthb.Toprovidebloodtothelungstotransportoxygenc.Toprovideelectricalstimulationtotheheartd.Tocontinuetopumpbloodtothevitalorgansandthebrain

4. WhichofthefollowingmaybeasideeffectofCPR?

a.CPRmaybreakribsandpuncturethelungsorotherthoracicorgansb.CPRmaycauseaheadwoundc.CPRmaycauseaheadwoundandbruisetheribsd.Alloftheabove

5. ThefirststepinCPRisto:a.Startchestcompressionsb.Startwithrescuebreathsc.Unblocktheairwaysd.Neutralizeanydangersfromthesurroundings

6. Afterthefirststepisaccomplishedyoushould:a.Startchestcompressionsb.Startrescuebreathsc.Checkthevictimforresponsivenessd.Noneoftheabove

7. Howlongcanthebrainsurvivewithoutoxygen?a.Afewhoursb.Afewminutesc.Afewdaysd.noneoftheabove

8. WhichaspectofCPRdeterminesthesuccessofresuscitation?a.Qualityofchestcompressionsb.Numberofrescuebreathsc.SpeedofCPRd.ThemuscletoneofthepersonprovidingCPR

9. Thebraincouldsufferdamagefromdecreasedbloodflowinhowmanyminutes?a.3minutesb.5minutesc.7minutesd.10minutes

10. Whereshouldcompressionsbeadministeredonthebody?a.Ontheupperhalfofthesternumb.Ontheabdomenc.Onthelowerhalfofthesternumd.Onthecollarbone

11. Thenon-dominanthandshouldbeplaced:a.Inthemiddleofthesternumwithfingersontheribs

b.Overthedominanthandwithfingerselevatedoffoftheribsc.Underthedominanthandwithfingerselevatedoffoftheribsd.Ontheupperhalfofthesternum

12. Therescuershouldavoidapplyingforceonthe:a.Upperabdomenb.Thexiphisternumc.Thelowersternumd.AandBonly

13. Howmanycompressionsshouldyouperformperminute?a.50b.75c.100d.Noneoftheabove

14. Compressorsshouldbeswitchedout:a.Every30secondsb.Every2minutesc.Everyminuted.Every5minutes

15. Compressiondepthshouldbe:a.2cmb.5cmc.7cmd.1inch

16. Thechestshould:a.Recoilcompletelyduringcompressionsb.Notrecoilduringcompressionsc.Recoilhalfwayduringcompressionsd.Noneoftheabove

17. Whenshouldcompressionsbeterminated?a.Neverb.After2minutesofcompressionsc.Afterthepatientrecoversd.After3minutes

18. Inordertofindoutifthepatientisbreathingyoushould:a.Askthepatientifhe/sheisbreathingb.Listenorfeelforbreathingc.Askabystanderifthepatientisbreathingd.ChecktheAEDreadout

19. WhichofthefollowingisinvolvedinCPR?

a.Clearingtheairwayb.Restoringbloodcirculationc.Conductingrescuebreathingd.Alloftheabove

20. Howlongshouldyoutaketocheckforapulse?a.Notmorethan10secondsb.15secondsc.Notmorethan20secondsd.Noneoftheabove

21. WhatisthelastcomponentoftheBLSsurvey?a.Chestcompressionsb.Rescuebreathingc.Defibrillationd.Tappingandshouting

22. Whenisadefibrillatorused?a.Absenceofbreathb.Absenceofpulsec.Absenceofconsciousnessd.Absenceofthesoul

23. Whichofthefollowingisareasonthatpeoplearesometimeshesitanttoperformmouthtomouth?a.Possibilityofsalivaswappingb.Possibilityofvomitc.Possibilityofcontractingadiseased.Possibilityofbeingcaughtbyaspouse

24. Whataremedicalprofessionalsadvisedtodoinordertopreventcontractingadisease?a.NeverperformCPRb.Carryanduseapocketmaskc.TeachsomeoneelsetodoCPRd.Noneoftheabove

25. Whichofthefollowingarecharacteristicsofapocketmask?a.Pre-inflatedcufftoprovideasealaroundthemouthandnoseb.Onewayvalvetopreventcontaminationc.Anin-linefiltertofiltertheaird.Alloftheabove

26. Whichofthefollowingstatementsaretrue?a.Themaskisnotreusable

b.Themaskisreusable,butmustbesterilizedc.Themaskisreusable,butthefilterandvalveshouldbediscardedafterused.Thefilterandvalvearereusable,buttherestofthemaskisnot

27. Whichofthefollowingstatementsaretrue?a.Studiessuggestthatmasksarejustaseffectiveasmouthtomouthb.Studiessuggestthatmouthtomouthisstillsuperiortomasksc.Studiessuggestthatmasksaresuperiortomouthtomouthd.Studiessuggestthatlettingsomeoneelsedomouthtomouthismosteffective

28. WhichisthebestwaytoperformCPR?a.TwopeopleperformingCPRb.OnepersonperformingCPRc.Usingadefibrillatord.Anyoftheabove

29. IfyouarealonewithachildorinfantwhoneedsCPR,whenshouldyoucallforhelp?a.BeforebeginningCPRb.Aftergiving5fullcyclesofCPRc.Aftergiving10fullcyclesofCPRd.After1fullcycleofCPR

30. HowshouldyouadministerCPRtoaninfant?a.Withtwohandsb.Withonehandc.Withtwofingersd.Noneoftheabove

31. HowshouldyouadministerCPRtoanaveragesizedchild?a.Withtwohandsb.Withonehandsc.Withtwofingersd.Noneoftheabove

32. Indrowningpatients,CPRshouldbeginwith:a.Chestcompressionsb.Defibrillationc.Tworescuebreathsd.Noneoftheabove

33. Howoftenshouldarescuebreathbeadministered?a.Twobreathsforeverythirtycompressionsb.Onebreathforevery15compressionsc.Threebreathsforeveryfivecompressionsd.Twobreathsforevery50compressions

34. Whichofthefollowingisasymptomofchoking?

a.Highpitchedbreathingb.coughingc.Colorchangesd.Alloftheabove

35. Howisachokinginfanttreated?a.TheHeimlichmaneuverb.CPRc.Backslapsandchestcompressionsd.Alloftheabove

36. Afterfivecyclesoftreatingachokinginfantyoushould:a.Blindsweepofthebackofthethroatb.Lookintothemouthtoseeiftheobjectisvisiblec.Usetweezerstoattempttofindtheobjectd.Useasticktoattempttodislodgetheobject

37. Howischokingtreatedinchildrenandadults?a.Backblowsandabdominalthrustsb.Backblowsonlyc.Turnthepersonupsidedowntodislodgetheobjectd.CPR

38. Whichofthefollowingisasignofchokingamongstadults?a.Inabilitytotalkb.Clutchingthethroatc.Coughingorfaintingd.Alloftheabove

39. Whendoeschokingoccur?a.Whenbreathingstopsforunknownreasonsb.Whenbloodcirculationstopsforunknownreasonsc.Whenanobjectcompletelyorpartiallyblockstheairwayd.Whenthebrainceasestofunction

40. Ifachokingvictimispregnantoneshould:a.Performabdominalthrustsb.Performmouthtomouthc.PerformCPRd.Performchestthrusts

AnswerKey1. B

2. C3. D4. A5. D6. C7. B8. A9. B10. C11. B12. D13. C14. B15. B16. A17. C18. B19. D20. A21. C22. B23. C24. B25. D26. C27. B28. A29. B30. C31. B32. C33. A34. D35. C36. B37. A38. D39. C40. D

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3. CNAExamPrep:NurseAssistantPracticeTestQuestions.Vol.OneandTwo

4. PatientCareTechnicianExamReviewQuestions:PCTTestPrep

5. ACLSProviderManual

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8. PhlebotomyTestPrepVol1,2,&3

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DedicationOTHER TITLES FROM THE SAME AUTHOR:The goal of CPR is to save lives. Compressions must be started within 10 seconds of cardiac arrestWhat is Cardio-Pulmonary Resuscitation?Why do we have to do CPR?The appropriate way to do compressionsThe BLS SurveyPocket masksUsing the bag maskOne rescuer CPR and 2 rescuers CPRAdult CPR and Child CPR and Infant CPRRescue breathingChoking for an infantChoking for an adultConclusionReferencesReview QuestionsAnswer Key