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Chain of Survival

- The term Chain of Survival provides a useful metaphor for the elements of the emergency cardiovascular care (ECC) systems concept.

- The 6 links in the adult out-of-hospital Chain of Survival are:

  • Recognition of cardiac arrest and activation of the emergency response system (calling 91-1 in the US)
  • Early CPR with an emphasis on chest compressions
  • Rapid defibrillation
  • Advanced resuscitation by Emergency Medical Services and other healthcare providers
  • Postcardiac arrest care
  • Recovery (including additional treatment, observation, rehabilitation, and psychological support)
  • A strong Chain of Survival can improve the chances of survival and recovery for victims of cardiac arrest.

Questions on Chain of Survival

Correct Answer is A

Explanation

Incorrect. While medications play a role in advanced cardiac life support, they are not part of the initial links in the Chain of Survival. The first link focuses on early recognition and activation of the emergency response system.

Correct Answer is B

Explanation

Incorrect. Placing the pads on the lower abdomen is not the correct position for defibrillation. The pads should be positioned on the chest to deliver the electric shock to the heart.

Correct Answer is B

Explanation

Incorrect. In cardiac arrest situations, time is of the essence. Waiting for emergency medical services to arrive without initiating CPR can significantly reduce the chances of survival for the individual experiencing cardiac arrest.

Correct Answer is B

Explanation

Incorrect. While electronic devices can be used for communication, they may not be practical or necessary during CPR. Verbal and written communication are the primary modes of communication in such situations.

Correct Answer is D

Explanation

Correct. The primary goal of early recognition and response in cardiac arrest situations is to start immediate chest compressions and deliver rescue breaths to support circulation and oxygenation. These interventions are essential to maintaining blood flow and oxygen delivery to vital organs until advanced medical support is available.Questions

Correct Answer is A

Explanation

Incorrect. Administration of intravenous medications is part of advanced life support, which comes later in the Chain of Survival. The second link is focused on bystander CPR.

Correct Answer is A

Explanation

Incorrect. Determining the client's blood pressure reading is not the first step in recognizing cardiac arrest. Assessing responsiveness is the initial priority.

Correct Answer is D

Explanation

Correct. High-quality CPR is critical because it improves the likelihood of restoring blood circulation and oxygenation to vital organs during resuscitation efforts. Effective chest compressions maintain blood flow, while rescue breaths provide oxygen to the lungs, enhancing the chances of a successful resuscitation outcome.Questions

Correct Answer is A

Explanation

Incorrect. Performing a quick physical examination is not the first step when using an AED. The immediate priority is to check for responsiveness and turn on the AED.

Correct Answer is B

Explanation

Incorrect. Closed-loop communication involves active engagement and acknowledgment between the team leader and team members. In this example, the team leader expects acknowledgment or response from team members.Questions

Correct Answer is A

Explanation

Incorrect. The compression-to-ventilation ratio in adult CPR is not based on the individual's weight but follows the standard 30:2 guideline.

Correct Answer is C

Explanation

Incorrect. While maintaining a calm demeanor is important, the team leader should involve other team members in decision-making and communication. Effective team dynamics rely on collaborative efforts.

Correct Answer is B

Explanation

Incorrect. The compression-to-ventilation ratio of 10:1 is not the current guideline for adult CPR. The correct ratio involves more frequent compressions and periodic rescue breaths, as mentioned in option B.

Correct Answer is B

Explanation

Incorrect. 60 compressions per minute is lower than the recommended rate for BLS chest compressions. The correct rate, as mentioned in option B, is 100-120 compressions per minute.

Correct Answer is C

Explanation

Incorrect. While formal training in advanced life support is ideal, bystanders without formal training can still perform hands-only CPR, which involves chest compressions, until professional help arrives.

Correct Answer is A

Explanation

Incorrect. The AED is specifically designed for use during cardiac arrest when the victim is unresponsive and not conscious. Using the AED is not appropriate for conscious individuals who can follow instructions.Questions

Correct Answer is B

Explanation

Incorrect. Defibrillation is appropriate for specific cardiac rhythms, especially ventricular fibrillation and pulseless ventricular tachycardia. In these cases, early defibrillation is vital. Delaying defibrillation can significantly decrease the chances of successful resuscitation.

Correct Answer is A

Explanation

Incorrect. Sudden loss of consciousness can occur due to various reasons, including seizures or fainting, and is not solely indicative of cardiac arrest.

Incorrect. Compressing the chest to a depth of 4 inches (10 cm) is much deeper than the recommended depth for adult CPR. Excessive depth can lead to rib fractures and other injuries.

Incorrect. The compression-to-ventilation ratio of 10:1 is not the current guideline for adult CPR. The correct ratio involves more frequent compressions and periodic rescue breaths.

Incorrect. Transfer to a specialized cardiac care facility may be necessary for further management, but it is not the fourth link in the Chain of Survival. The fourth link pertains to the use of therapeutic hypothermia after resuscitation.

Correct. The correct hand placement for adult CPR chest compressions is to center the hands on the sternum, between the nipples. Proper hand placement ensures effective compression depth and allows for adequate blood flow during CPR.

Incorrect. While an AED may have basic monitoring capabilities, its primary purpose is not to monitor vital signs during resuscitation efforts. The AED is used for defibrillation to treat cardiac arrest.

Correct. High-quality CPR is critical because it improves the likelihood of restoring blood circulation and oxygenation to vital organs during resuscitation efforts. Effective chest compressions maintain blood flow, while rescue breaths provide oxygen to the lungs, enhancing the chances of a success

Incorrect. Time is critical during a cardiac arrest, and the nurse should not wait for additional healthcare providers before initiating CPR and activating the emergency response system.

Incorrect. While CPR is crucial in the immediate response to cardiac arrest, it is not a substitute for professional medical care. Timely activation of emergency medical services is essential to ensure the best possible outcome.

Incorrect. This client's statement reflects an understanding of the significance of early recognition in improving survival rates during cardiac arrest.

Incorrect. For severe allergic reactions, the primary intervention is to administer epinephrine and seek emergency medical assistance. Hands-Only CPR is not indicated for anaphylactic reactions.

Correct. The correct hand placement for adult CPR chest compressions is to center the hands on the sternum, between the nipples. Proper hand placement ensures effective compression depth and allows for adequate blood flow during CPR.

Incorrect. Immediate initiation of advanced cardiac life support (ACLS) is part of the overall resuscitation effort, but it is not the specific third link in the Chain of Survival. Prompt arrival of EMS takes precedence.

Correct. Early defibrillation is crucial because it helps to reset the heart's electrical activity, allowing the heart to resume an effective rhythm. The sooner defibrillation is performed, the better the chances of restoring a normal heart rhythm and improving the chances of survival.Questions

Incorrect. Reporting resuscitation outcomes to the hospital administration is not the primary purpose of closed-loop communication during CPR. Its focus is on effective communication within the resuscitation team.

Incorrect. Compressing the chest to a depth of 4 inches (10 cm) is much deeper than the recommended depth for adult CPR. Excessive depth can lead to rib fractures and other injuries.

Incorrect. Administering an opioid antagonist is not part of the BLS guidelines. The focus of BLS is on providing immediate chest compressions and rescue breaths to support circulation and oxygenation.

Incorrect. Long-term cardiac rehabilitation may be beneficial after a cardiac event, but it is not the fifth and final link in the Chain of Survival. The focus of the Chain of Survival is on the immediate response and resuscitation efforts.Questions

Incorrect. For severe allergic reactions, the primary intervention is to administer epinephrine and seek emergency medical assistance. Hands-Only CPR is not indicated for anaphylactic reactions.
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