Question 1

When should respiratory support begin during cardiac arrest?

Accepted Answer

Respiratory support, including airway establishment and rescue breathing, begins only after chest compressions are underway and defibrillation has been performed. This follows the CAB mnemonic—circulation first, then airway and breathing. High-quality basic life support cardiopulmonary resuscitation and defibrillation are the most important interventions for cardiac arrest patients.

Question 2

What is the correct hand position for the C/E technique with a bag-valve-mask?

Accepted Answer

Make a C with your dominant thumb and forefinger around the mask stem, and an E with your third through fifth fingers along the patient's mandible, placing the fifth finger behind the angle. Pull the patient's face up into the mask rather than pushing the mask down. This creates a firm seal allowing air to enter the lungs without leaking into the room.

Question 3

How do you open an airway when cervical spine injury is suspected?

Accepted Answer

Use the jaw thrust maneuver, which displaces the mandible anteriorly without causing neck extension. Place your fingers behind the angle of the mandible and move it forward. If jaw thrust fails to open the airway, use head tilt-chin lift despite theoretical cervical concerns, since airway occlusion is immediately life-threatening and takes priority.

Question 4

What compression-to-ventilation ratio should be maintained during CPR?

Accepted Answer

Perform 30 chest compressions followed by 2 rescue breaths. Continue this 30:2 ratio for 5 cycles, approximately 2 minutes, then pause for a rhythm check. If the rhythm is shockable, perform defibrillation; if not, resume CPR with the same compression-to-ventilation pattern.

Question 5

How do you know if bag-valve-mask ventilation is effective?

Accepted Answer

Visible chest rise with each breath is the only reliable indicator of effective ventilation, since pulse-oximetry cannot be used when the patient lacks a pulse. Insufflate only enough air to produce visible chest rise. Hyperventilation raises intrathoracic pressure, which impedes blood return to the heart and reduces cardiac output, so avoid excessive ventilation.

Question 6

What should you do if the patient's chest does not rise during ventilation?

Accepted Answer

Resume chest compressions and troubleshoot by checking patient and rescuer positioning. Verify you are standing at the head of the bed with the patient supine and no obstructions. Reposition your hands and retry airway opening maneuvers. If unsuccessful, switch to the two-person technique with one rescuer sealing the mask while an assistant squeezes the bag.

Question 7

When should an oropharyngeal airway be inserted during resuscitation?

Accepted Answer

Insert an oropharyngeal airway if the two-person ventilation technique fails to produce chest rise. Select the correct size by measuring from the corner of the mouth to the earlobe. Insert the hooked end over the base of the tongue to pull it forward out of the hypopharynx, or insert it upside-down and rotate it as it passes over the tongue base.

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