Kettering-Emergency Care

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What are the first 4 steps for performing one rescuer CPR for adults and children over eight?: 1. Determine unresponsiveness
2. Call for help
3. Establish airway-head tilt chin lift or modified jaw thrust
4. Check for breathing (no more than 10 sec.
What are the last 4 steps for performing one rescuer CPR for adults and children over eight?: 5. Give 2 full breaths
6. Check for pulse (carotid)
7. If pulseless, begin chest compressions
8. Provide 100% oxygen and draw ABG
WIth proper CPR, what percent of patients original cardiac output can you expect?: 30%
What are the complications of artificial respirations?: **Gastric distension**, pnuemo, gastric rupture, cross contamination, aspiration
What are complications of external cardiac compression: **rib fracture**, fractured sternum, contustions to heart/lung, lacerated liver or spleen, pulm embolism, pneumo
How can you evaluate theeffectiveness of CPR?: 1. Fell Carotid pulse Best
2. Color returns to normal
*3. If pt has a cervical collar, do not remove. Check femoral pulse
4. ECG show sinus rhythm with no pulse, continue CPR
What FIo2 does mouth to mouth ventilation give?: 16-17%
How do you know if you have a pneumo when giving CPR and what do you do?: -Trachea deviated to opposite side, hyperresonance percussion and decreased BS on affected side.
-Insert chest tube
How do you know if you have a hemothorax obstruction when giving CPR and what do you do?: -Trachea deviated to opposite side, dull percussion and decreased BS on affected side.
-Insert chest tube
How do you know if you have a ET tube obstruction when giving CPR and what do you do?: - Cannot pass suction catheter, decreased BS
- Pull tube out and use alternative form of ventilation
How do you know if you have a right main stem intubation when giving CPR and what do you do?: -trachea deviated to left, hyperresonance on right, dull on left. Increase chest movement on right, less on left
- Withdraw ET tube slightly
What are the first 4 steps in performing one rescue CPR in a child 1-8 years old: 1. Determine unresponsiveness
2. SHout for help
3. Establish airway - head tilt chin lift or modified jaw thrust
4. Check for breathin
What are the last 4 steps in performing one rescue CPR in a child 1-8 years old: 5. Give 2 full breaths
6. Check pulse (carotid)
7. If pulseless, begin compressions for 1 minute or 20 cycles (5:1 ratio)
8. Provide 100% oxygen and draw ABG
What are the last 4 steps in performing one rescue CPR in an infant: 1. Determine unresponsiveness
2. SHout for help
3. Establish airway - head tilt chin lift or modified jaw thrust
4. Check for breathin
What are the first 4 steps in performing one rescue CPR in an infant: 5. Give 2 full breaths, mouth to mouth and nose
6. Check pulse (brachial)
7. If pulseless, begin compressions for 1 minute or 20 cycles (5:1 ratio)
8. Provide 100% oxygen and draw ABG
What are the steps of CPR in neonate: See page C-6
What is hypotension and how is it treated: -Low blood pressure, poor capillary refill and weak thready pulse
- treat with fluid challenge, dopamine, dobutamine
What is bradycardia and how is it treated: -heart rate <60 in and adult and <100 in an infant
- Treat adult with dopamine and epinephrine. Treat kids with epinephrine and atropine. External pacemaker
How should you treat a PVC: Oxygen and lidocaine
What is pulseless ventriular tachcardia and how is it treated: a. Defin (200, 300, 360 joules
b. If unsuccessful, give epinephrine, lodocaine or bretylium
What is pulmonary edema/CHF.: Left heart failure and lung reaction. Excessive fluids accumulate in the lungs that affect ventilation and expecially oxygenation
How can you assess pulmonary edema/CHF.: a. Orthopnea, pitting edema, distended neck veins and increased resp. distress
b. pink/frothy/watery secretins
c. fine crepitant audible rales or crackles
How do you treat pulmonary edema/CHF.?: 1. Increase gas exchange-give 100% O2 via non-rebreather, IPPB with 100% O2 and ethanol, PEEP/CPAP if necessary
3. Decrease venous return-give lasix, body positon (Fowlers)
What is pulmonary emboli: Deadspace disease (ventilation without perfusion. Caused bu blood clots in the lungs and will affect oxygenation and perfusion
How do you assess pulmonary emboli: 1. Sudden onset of dyspnea, tachypnea, anxious, chest pain
2. Pt appears to hyperventilate (but ABG normal)
How do you treat pulmonary emboli: 1. anticoagulation therapy (heparin/coumadin
2. Oxygen therapy
3. thrombolytic drugs/screens/surgery
What is pneumothorax: Presence os gas in the pleural space that can seriously affect ventilation
How do you assess pneumothorax: 1. Sudden onset of dyspnea, decreased breath sounds, tracheal shift away from affected site
2. Decreased vocal fremitus, percussion hyperresonant
3. Xray shows hyperlucency w/o vascualr markings, flat diaphragm
How do you treat pneumothorax: 1.100% O2 with non-rebreather
2. **Immediate chest tube/thoracentesis, or relieve pressure with needle and tubing inserted into a glass of water
What is CO Poisoning: The inability of hemoglobin to bind with oxygen due to the binding of carbon monoxide. This can seriously affect oxygenation
How do you assess CO poisoning: -History of present illness
- Redness of skin
-Breathing labored and deep
-Tachcardia, normal ABG
increase COHb of co--oximeter (>20%0
How do you treat CO poisoning?: -100% O2 via non-rebreather, CPAP mask
-hyperbaric oxygen
What is status asthmaticus: Sustained asthma attack unresponsive to bronchodilator therapy. Will have marked affect of ventilation and oxygenation
How do you assess status asthmaticus: -diagnosis made by history
- retractions and pulsus paradoxus
- ABG indicates resp. acidosis or resp failure (PCO2>45)
How do you treat status asthmaticus: -100% O2 via non-rebreather
-subcutaneous epinephrine X3
-Mechancial ventilation (sedate and paralyze if need)
-Bronchodilator therapy and steroids
How do you treat trauma: -start with A,B,C's
- 100% oxygen
-Admininster drugs/fluids

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Number of cards 36