1. The Cardiac Chain of Survival consists of a sequence of steps that are activated in response to an emergency in which a person suffers sudden cardiac arrest. Each link in the chain is critical. Put the links in the Cardiac Chain of Survival in the correct order.

1) Early defibrillation — delivers an electrical shock to the heart with an automated external defibrillator (AED)
2) Early advanced medical care — a team of medical professionals arrives and takes over by providing advanced care and transport to a medical facility
3) Early CPR — keeps oxygenated blood flowing to the brain and other vital organs
4) Early recognition and early access — a bystander recognizes an emergency and calls 9-1-1 or the local emergency number

A. 1, 3, 2, 4
B. 3, 2, 4, 1
C. 4, 3, 1, 2

Answer: C. As a responder, you must first recognize an emergency before the rest of the Cardiac Chain of Survival can be put into motion. Early access to care is an important component to a successful outcome. Out of the remaining options in the list, early CPR is next. CPR keeps oxygenated blood flowing to the brain and other vital organs and tissues. Early defibrillation with an AED (automated external defibrillator) is the third step out of those listed. An AED administers a shock that can allow the heart to restore an effective rhythm. In many states, AEDs are now available in public places for use by trained laypersons. Early advanced medical care is the next step. In this step, a team of emergency medical personnel provides care at the scene and transports the person to a hospital.

2.  A person is unconscious. Put the following steps in the correct order:

1) Tap the person and shout
2) Open airway
3) Check for signs of life (movement and normal breathing)
4) Check the scene for safety

A) 3, 2, 1, 4
B) 3, 2, 4, 1
C) 4, 1, 2, 3
D) 1, 3, 1, 2

Answer: C. When an emergency happens, Check-Call-Care are the three basic steps for you to take. As a responder, you must always check to make sure the scene is safe for you and any bystanders. Next, call your local emergency number for help. Then care for the person. Always care for life-threatening emergencies before those that are not life-threatening. The ABCs, which stands for airway, breathing and circulation, will aid you in determining what care the person needs. Determine if the person's airway is open. Check for signs of life (movement and normal breathing).

3. If a choking person is coughing forcefully, what should you do?

A) Pat the person on the back forcefully
B) Give abdominal thrusts
C) Encourage the person to continue coughing
D) None of the above

Answer: C. If the person is coughing forcefully, he or she may cough the object up, eliminating the need for you to give care. Use a combination of back blows and abdominal thrusts when the person cannot cough forcefully, speak or breathe.

4. CPR is a combination of —

A) Chest compressions and abdominal thrusts
B) Chest compressions and rescue breaths
C) Abdominal thrusts and finger sweeps
D) Rescue breaths and abdominal thrusts

Answer: B. Chest compressions help to circulate blood containing oxygen to the vital organs. Rescue breaths supply the blood with oxygen until advanced medical personnel arrive and take over. When giving CPR, give cycles of 30 compressions and 2 rescue breaths. Continue CPR until —

• Another trained responder takes over CPR for you.
• Emergency medical services (EMS) personnel arrive and take over care of the person.
• An automated external defibrillator (AED) becomes available.
• You are exhausted and unable to continue.
• The scene becomes unsafe.
• Signs of life return.
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5. You come upon a person who has pale or bluish skin color, cold skin and dull or sunken eyes. These are symptoms of which medical emergency?

A) High fever
B) Shock
C) Heart attack
D) None of the above

Answer: B, shock. Even if a person's injuries aren't life threatening, the person can go into shock and possibly die. Shock occurs when the person's organs and tissues don't get an enough of blood or oxygen. The person may be unconscious, but not always. Call for emergency help first, then follow these steps:

• Maintain an open airway for breathing
• Control obvious bleeding
• Elevate the legs about 12 inches, unless the injury makes that impossible
• maintain normal body temperature (prevent person from getting chilled or overheated)
• Keep the person on his or her back, unless the person vomits (move person onto his or her side at that point).

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Knowing CPR and first aid can save a life.