Basic BLS questions

[patzyboi]

Hi, Im new to the forum and new to the field as well. Just a few patient assessment/scenario questions Id like answered.

1) So the classic example of a man down. You observed for scene safety and assessed the ABC's. Before you do any interventions do you give him the two breaths, or is that only for an airway obstruction case?

Because in Red Cross EMR course, you give two breaths, but only if they are Child/Infant/Cyanotic or drowning victim.

2) Now that we have the CAB's, does that mean we assess their pulse first, before anything? Does that mean we have to open or not open the airway and assess for pulse?

3) Do we assess pulse and breathing and the same time, or 5-10 seconds each, separately?

4) In my schools medical scenario, after you assess for breathing and determine if the patient is breathing, you would still assess for a pulse up to 10 seconds. Whats the point of this?

5) On the JB leaning test prep, we had an foreign body airway obstruction scenario. So after doing abdominal thrusts and the patient became unconscious, you had two good choices A.) Tongue lift to see if theres anything in the mouth or B.) Begin chest compression.

I chose A because you would normally open the mouth to see if theres anything inside there, give two breaths and go from there, but I had that answer wrong. Why would you start chest compression right away?

6) For a cardiac arrest case when doing CPR, do you ever recheck for a pulse? Again Red Cross standards say that you dont check for a pulse, but Ive had lifeguard training some time ago and you check ABC's every two minutes.

Sorry im very new. Ive had an EMR course and certificate, but some things are different, between EMR and EMT, Red Cross and AHA and National standards. Please certify and help if you can. No flames please... or you can too if you want. Thanks

 

[JPINFV]

Hi, Im new to the forum and new to the field as well. Just a few patient assessment/scenario questions Id like answered.

1) So the classic example of a man down. You observed for scene safety and assessed the ABC's. Before you do any interventions do you give him the two breaths, or is that only for an airway obstruction case?

Because in Red Cross EMR course, you give two breaths, but only if they are Child/Infant/Cyanotic or drowning victim.

You're a health care professional now. You act based off of your assessment. Does the patient respond to verbal or painful stimuli? Is the patient breathing? Is there a pulse rate? What does your assessment tell you?

2) Now that we have the CAB's, does that mean we assess their pulse first, before anything? Does that mean we have to open or not open the airway and assess for pulse? [/quote]

In theory, yes. If the patient is obviously breathing and it's not agonal then a pulse is present.

3) Do we assess pulse and breathing and the same time, or 5-10 seconds each, separately?

I guess if you can run a count on both, then great. I'll be honest, though, breathing I generally characterize as normal, too fast, or too slow. If it's a normal speed and effort, I really don't care about the actual rate.

4) In my schools medical scenario, after you assess for breathing and determine if the patient is breathing, you would still assess for a pulse up to 10 seconds. Whats the point of this?

I think 10 seconds is too little of time. 15 or more should be what you're looking for. In my opinion, pulse rate quantity (in contrast to too fast, normal, too slow) is more important than respiration quantity.

5) On the JB leaning test prep, we had an foreign body airway obstruction scenario. So after doing abdominal thrusts and the patient became unconscious, you had two good choices A.) Tongue lift to see if theres anything in the mouth or B.) Begin chest compression.

I chose A because you would normally open the mouth to see if theres anything inside there, give two breaths and go from there, but I had that answer wrong. Why would you start chest compression right away?

How would lifting the tongue help visualize the oropharnyx?

Chest compressions increases intrathoracic pressure. Think about what the resulting effect that has on airway pressure when an airway obstruction is present.

6) For a cardiac arrest case when doing CPR, do you ever recheck for a pulse? Again Red Cross standards say that you dont check for a pulse, but Ive had lifeguard training some time ago and you check ABC's every two minutes.

Sorry im very new. Ive had an EMR course and certificate, but some things are different, between EMR and EMT, Red Cross and AHA and National standards. Please certify and help if you can. No flames please... or you can too if you want. Thanks

It changed in the most recent update (2010). With an AED you don't check until you get a "no shock advised" message... or the patient starts fighting back.

 

[Christopher]

5) On the JB leaning test prep, we had an foreign body airway obstruction scenario. So after doing abdominal thrusts and the patient became unconscious, you had two good choices A.) Tongue lift to see if theres anything in the mouth or B.) Begin chest compression.

I chose A because you would normally open the mouth to see if theres anything inside there, give two breaths and go from there, but I had that answer wrong. Why would you start chest compression right away?

In order for a foreign body to obstruct the airway, it reeaaally has to be in there. That means it is up against the glottic opening (or in the glottic opening).

When somebody opens their mouth and goes AAHHHHHHH, can you see their vocal cords? No. Can you even see their epiglottis? Usually not.

Basically, the junk is going to be stuck way down in there and you have no means of seeing it without direct laryngoscopy.

Better you pump on the chest to work to dislodge it (probably won't) and to circulate blood/O2 until somebody arrives who can see it.