EMT (Emergency Medical Technician) Crash Course with Online Practice Test by Christopher Coughlin

Author:Christopher Coughlin
Language: eng
Format: epub
Publisher: Research & Education Association
Published: 2013-04-06T04:00:00+00:00

RESUSCITATION

A. CPR Standards and Requirements

1. Candidates for NREMT certification must have a current and valid CPR credential equivalent to the American Heart Association’s (AHA) CPR for Healthcare Providers (HCP).

2. Effective January 1, 2012, the NREMT certification exam for EMTs will reflect the 2010 AHA guidelines.

3. The 2010 AHA Healthcare Provider Manual provides the standards for cardiopulmonary resuscitation that will be included on the NREMT exam.

i. Note: There may be other publications equivalent to the AHA 2010 guidelines for CPR. Contact the NREMT (www.nremt.org) to determine what is considered equivalent to the AHA’s Healthcare Provider CPR certification.

ii. For additional information about the 2010 guidelines for Healthcare Provider CPR, including a summary of steps, visit www.heart.org.

B. Highlights of 2010 Healthcare Provider CPR Guidelines

1. Emphasis is on high-quality compressions

i. Rate of compression: at least 100 per minute

ii. Depth of compression

At least 2 inches for adults

At lease 1/3 depth of chest for infants and pediatric patients

— About 2 inches for pediatric patients

— About 1½ inches for infants

iii. Minimum interruption in chest compressions

Maximum 10-second interruption in chest compressions when possible

Minimize interruption in chest compressions before and after shock with automatic external defibrillator (AED)

iv. Compression to ventilation ratio

Single rescuer (any age): 30:2

Two rescuers with infants and children: 15:2

v. Allow full recoil between each compression.

2. CAB sequence, not ABC sequence, is used for unresponsive patients

i. Circulation first, then airway and breathing

ii. No look, listen, feel for respirations prior to beginning chest compressions

3. AED is indicated for infants as well as pediatric and adult patients in cardiac arrest.

4. Avoid hyperventilation.

i. Patients with a pulse but inadequate breathing

Adults: 1 breath every 5 to 6 seconds (10 to 12 breaths per minute)

Infants and pediatric patients: 1 breath every 3 seconds (20 breaths per minute)

ii. Patients with advanced airway

1 breath every 6 to 8 seconds (8 to 10 breaths per minute).

No pause in compressions with advanced airway

C. Automated External Defibrillation (AEDs)

1. Types of AEDs

i. Fully automated external defibrillators. These AEDs do not require the operator to push a button to deliver a shock.

ii. Semi-automated external defibrillators. These AEDs will not shock until the operator pushes the shock button.

2. Features of AEDs

i. Most have two buttons: power and shock.

ii. Adult and pediatric pads for hand-free defibrillation.

iii. Visual and audio prompts.

3. Indications: pulseless infant, child, or adult patient

4. Contraindications

i. Unsafe environment

ii. Any patient with signs of circulation

5. Utilizing AED

i. Follow standard assessment guidelines, confirm cardiac arrest, and safe conditions for use of the AED.

ii. Initiate CPR; obtain an AED.

iii. Turn on the AED and follow prompts.

iv. Apply the AED.

Expose the chest.

Remove medication patches and piercings as needed.

Dry the chest if wet; shave excessive hair as needed.

Apply appropriate pads per manufacturer’s instructions.

— Sternum / apex position

— Anterior / posterior position

— Biaxillary position

Avoid placing pads directly over pacemaker, implanted defibrillator, etc.

v. Deliver shock as indicated. Ensure everyone is clear prior to delivery of shock.

vi. Resume CPR immediately.

vii. Reanalyze following two minutes of CPR.

viii. Initiate transport after third shock or “no-shock” advisory, or per local protocol.

6. Special circumstances

i. Hypothermic patients should typically be transported after only one shock.

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