Float Nurse

396. How do you determine the correct length of a nasopharyngeal airway? The length of the nasal airway can be estimated as the distance from the nares to the meatus of the ears.   397.   What are the advantages of using a nasopharyngeal airway over an oropharyngeal airway? The NPA is preferred to the OPA in conscious patients because it is better tolerated and less likely to induce a gag reflex and they are better tolerated than oropharyngeal airways in awake or lightly anesthetized patients. 398.   What are some contraindications against inserting a nasopharyngeal airway device? They are contraindicated in patients who are on anticoagulants, patients with basilar skull fractures, patients with nasal infections and deformities as well as in children (because of risk of epistaxis). 399. Describe some techniques for inserting an oropharyngeal device. The preferred technique is to use a tongue blade to depress the tongue and then insert the airway posteri...

391. What is the value of measuring the quantitative waveform capnography on an intubated patient during CPR? Therefore, it is reasonable to consider using quantitative waveform capnography in intubated patients to monitor CPR quality, optimize chest compressions, and detect ROSC during chest compressions or when rhythm check reveals an organized rhythm. 392. During CPR the rescuer notices that the patient's PETCO2 increases and remains between 35-45mm Hg.   What might a potential cause of this? If PETCO2 abruptly increases to a normal value (35 to 40 mm Hg), it is reasonable to consider that this is an indicator of ROSC. 393. What are some advantages of endotracheal intubation during cardiac resuscitation? Advantages of advanced airway placement include elimination of the need for pauses in chest compressions for ventilation, potentially improved ventilation and oxygenation, reduction in the risk of aspiration, and ability to use quantitative waveform capnography to ...

386. What is the most common reason for obtaining a false negative reading on an end-tidal CO2 detector device after intubating the trachea? The most common reason for a false negative reading is that blood flow and delivery of CO2 to the lungs is low.   387. How is a false negative reading defined when using an end tidal CO2 device False-negative readings are defined in as failure to detect CO2 despite tube placement in the trachea.   388. What are some acceptable reasons for interrupting cardiac compressions during CPR? Periodic pauses in CPR should be as brief as possible and only as necessary to assess rhythm, shock VF/VT, and perform a pulse check when an organized rhythm is detected, or place an advanced airway. 389. What is the meaning of the term End-tidal CO2?   End-tidal CO2 is the concentration of carbon dioxide in exhaled air at the end of expiration. It is typically expressed as a partial pressure in mm Hg (PETCO2).   390. What is ...

381. Describe the technique for providing ventilations by a lone rescuer? Use of bag-mask ventilation is not recommended for a lone provider. When ventilations are performed by a lone provider, mouth-to-mouth or mouth-to-mask are more efficient.   382. How does gastric inflation interfere with providing adequate ventilations? Gastric inflation can elevate the diaphragm, restrict lung movement, and decrease respiratory system compliance. 383. What is the reason an oropharyngeal might be used in an unresponsive victim?   The use of oropharyngeal airways in patients with cardiac arrest, airways may aid in the delivery of adequate ventilation with a bag-mask device by preventing the tongue from occluding the airway.   384. What are the indications for using a nasopharyngeal airway? Nasopharyngeal airways are useful in patients with airway obstruction or those at risk for developing airway obstruction, particularly when conditions such as a clenched jaw preven...

376. When two health care providers are present, what is the compression to ventilation ratio for a child victim of cardiac arrest? The compression to ventilation ratio for a child is 15:2. 377. A single rescuer is performing CPR on an unresponsive infant that is pulseless and apneic.   What is the correct depth of chest compression on an infant? The rescuer should compress the chest at least 1/3 the AP depth or about 1 ½ inches (4 cm) 378.   You are a health care provider who was called to the scene of a child who suddenly collapsed.   After determining the child is unresponsive and not breathing, you check for a pulse on the child.   Where would you perform a pulse check and how long should it take you? On an unresponsive child, you would check for a carotid pulse and it should take you no longer than 10 seconds to perform the pulse check. 379.   When is it acceptable to use a precordial thump? The precordial thump should not be used for unw...

371.   If multiple rescuers are present, how often should they rotate their tasks? If multiple rescuers are available, they should rotate the task of compressions every 2 minutes. 372. What are two methods for opening the airway in an unresponsive victim who is not breathing? The airway of an unresponsive victim can be opened using the head tilt– chin lift or jaw thrust followed by rescue breaths. 373.   After inserting an advance airway into the victim, how do the rescuers modify their CPR technique? Once an advanced airway is in place, healthcare providers will deliver ventilations at a regular rate 1 breath every 6 seconds (10 breaths/minute) and chest compressions can be delivered without interruption. 374.   The victim’s chance of survival decreases with an increasing interval between the arrest and defibrillation.   True or False True. Thus early defibrillation remains the cornerstone therapy for ventricular fibrillation and pulseless ventric...

366. What are the links in the American Heart Association Chain of Survival? ● Immediate recognition of cardiac arrest and activation of the emergency response system ● Early CPR with an emphasis on chest compressions ● Rapid defibrillation ● Effective advanced life support ● Integrated post– cardiac arrest care 367. What is the difference in the etiology of cardiac arrest between and adult and child victim of cardiac arrest? Most cardiac arrests in adults are sudden, resulting from a primary cardiac cause; circulation produced by chest compressions is therefore paramount.16 In contrast, cardiac arrest in children is most often asphyxial, which requires both ventilations and chest compressions for optimal results. 368.   What are the key components the lone rescuer should perform when he/she comes upon a victim of cardiac arrest? ·          Recognize that the victim has experienced a cardiac arrest, based on unresponsiven...

361.   What are some criteria for not starting resuscitative efforts on a victim of an in hospital cardiac arrest? Few criteria can accurately predict the futility of continued resuscitation. In light of this uncertainty, all pediatric and adult patients who suffer cardiac arrest in the hospital setting should have resuscitative attempts initiated unless the patient has a valid DNAR order or has objective signs of irreversible death (eg,dependent lividity). A licensed physician’s order is necessary to withhold CPR in the hospital setting 362.   Does a DNR order carry any implications about all forms of medical treatment and care? DNAR orders carry no implications about other forms of treatment. DNAR orders do not automatically preclude interventions such as administration of parenteral fluids, nutrition, oxygen, analgesia, sedation, antiarrhythmics, or vasopressors, unless these are included in the order. Some patients may choose to accept defibrillation and chest compr...

351. While the general rule is to provide emergency treatment to a victim of cardiac arrest, what are a few exceptions where withholding CPR might be appropriate? ● Situations where attempts to perform CPR would place the rescuer at risk of serious injury or mortal peril ● Obvious clinical signs of irreversible death (eg, rigor mortis, dependent lividity, decapitation, transection, or decomposition) ● A valid, signed, and dated advance directive indicating that resuscitation is not desired, or a valid, signed, and dated DNAR order 352. Once rescuers start BLS, how long should they continue resuscitative efforts? ● Restoration of effective, spontaneous circulation ● Care is transferred to a team providing advanced life support ● The rescuer is unable to continue because of exhaustion, the presence of dangerous environmental hazards, or because continuation of the resuscitative efforts places others in jeopardy ● Reliable and valid criteria indicating irreversible death...