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ALS Paramedic CPG cards > cardiac > Flashcards

cardiac Flashcards

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1
Q

equation for cardiac output

A

CO = HR x SV

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2
Q

How often is GTN tablets administered?

A

5/60, unless the onset of side effects or titrated to pain

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3
Q

outline Management of Acute coronary syndrome

A

12 Lead ECG - Transmit if STEMI (mica if STEMI)

300mg aspirin

if have pain 
SBP >110mmHg 
600mcg (prev. admin)
300mcg (no prev. admin) 
repeat 5/60, titrating to pain/side effects

SBP >90mmHg
GTN patch 50mg (0.4mg per hour)

IV access
Pain relief
antiemetic

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4
Q

Define acute coronary syndrome (ACS

A

ACS is a broad term, used to cover a spectrum of conditions such as STEMI, NSTEMI, unstable angina, leading to the narrowing and occlusion of coronary arteries

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5
Q

risk factors of Acute coronary syndrome

A
  • Age
  • Gender
  • Ethnicity
  • Hypertension
  • High cholesterol
  • Diabetes
  • Family History
  • Sedentary lifestyle
  • Obesity
  • Smoking
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6
Q

Signs & symptoms of Acute coronary syndrome

A
  • Pain - chest, back, shoulder, jaw, epigastric
  • Shortness of Breath
  • Diaphoresis
  • Anxiety
  • Lightheaded
  • Fatigue
  • Near/fainting
  • ECG changes
  • Nausea
  • Vomiting
  • Dizziness
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7
Q

Define Atherosclerosis

A

Atherosclerosis is defined as the thickening/ hardening of vessel walls, with the accumulation of lipid laden layer, impeding blood flow

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8
Q

contraindications for CPAP

A 
GCS <13 
Facial trauma
Pt requiring airway management 
Actively vomiting 
Hypoventilation 
Life threatening arrhythmias 
Pneumothorax
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9
Q

Management of SVT

A

Reassurance
12 lead ECG
Stable: Valsalva/modified 3 times 2/60, max 2 attempts
Unstable: adenosine/cardioversion
IV access
Pain relief, antiemetic, fluid Mx if hypotensive
IV should be placed as far up the arm as possible.

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10
Q

Signs of deteriorating SVT

A

Less than adequate perfusion/shock
APO
Ischaemic chest pain
ACS/collapse

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11
Q

Bradycardia criteria

A

Heart rate less than 40BPM & APO
Heart rate <20Bpm
Runs of PVCs or VT
less than adequate perfusion

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12
Q

Mx of bradycardia

A 
Reassurance 
12 lead ECG 
Request mica 
IV access 
symptomatic relief - hypotensive/pain/antiemetic
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13
Q

Criteria for SVT

A 
Rate: >100bpm
Rhythm: Regular 
P wave: not discernible
P-R interval: not discernible 
QRS: present, upright, less than 0.12secs
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14
Q

management of Pulmonary oedema

A

Reassure
Position; upright
Oxygen if SPo2 less than 92%

SOB with crackles
SBP >110mmHg GTN 300 or 600mcg repeat 5/60 titrate to side effects/symptoms
SBP >90mmHg GTN patch 50mg (0.4mg/hr)

Full field crackles/no improvement
CPAP

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15
Q

cardiogenic VS non-cardiogenic Pulmonary oedema

A

cardiogenic is cause secondary to LVF or CCF or other cardiac cause
non-cardiogenic is cause by altered permeability
Smoke inhalation
toxic gases
anaphylaxis
sepsis
near drowning/aspiration

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16
Q

What some differential diagnosises for chest pain?

A 
Pe
Percarditis
Chest infection
Cardiac tampons 
Arotic aneurysms
Endocarditis 
Pericardial effusion
Anxiety 
GORD
Asthma 
Trauma 
Oesophageal rupture
17
Q

If a cardiac muscle cells dies, what does it release?
Myosin
Actin which has tropinon on it and around it creating CK-Mb which are essential for engery transfer

A

When cells dies, it release tropinon and CKMB into the bloodstream, measured to see if necrosis has occurred

Trops rise rapidly, lasting up to 8 days, peaks day 2
Ckmb, rises but drops faster

18
Q

What are the cardiac markers looked for in MI?

A

Myoglobin - peaks 4-6 hrs, found in both heart and skeletal muscles, can be unreliable

Ck-MB (creatine kinaesthetic MB isoenzyme)- primarily occurs after myocardial necrosis, usually show after 4hrs after 4 hours unreliable as if pt having a stemi, most damage has already occurred

Troponin, remains elevate 5-14days, myocardial specific, 3 subunits, but troponin T and 1 helps clearly indicate whether skeletal or myocardial tissue is involved

Order of peak myoglobin, combined, trops

19
Q

What ECG changes are common in STEMi?

A

St elevation Greater than 1square or 0.1mv, above j point, peaked T waves in 2 or more contiguous leads

20
Q

What ECG changes are common in NStemi?

A

St depression of 0.1mv below j point or biphasic/ inverted T waves in 2 or more leads

ALS Paramedic CPG cards (22 decks)

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