Cardiac Emergencies Flashcards
The conduction system
SA, AV, Bundle of HIS, Purkinje
SA node
Pace Maker
AV node
Pauses the impulses so the ventricles can fill with blood
Bundle of HIS
Elongated segment connecting the AV and the left and right bundle branches
Intrinsic Rates
Set unless sympathetic NS has an effect
What dysrhythmias can lead to sudden cardiac arrest
Ventricular fibrillation (V-Fib)
Ventricular Tachycardia (V-Tach)
How do occluded coronary arteries occur?
When damage is caused to the artery wall (hypertension/ smoking), plaque can build (high cholesterol), vessels are narrowed so less blood reaches the heart
Coronary Artery Diseases
Atherosclerosis
Arteriosclerosis
Atherosclerosis
Fatty plaque build up
Arteriosclerosis
Hardening of the arteries, mostly due to age
What can come from Coronary Artery Diseases?
The plaque can cause a rupture and platelets will attempt to remain resulting in clotting (blockage) that then leads to a heart attack
Angina Pectoris
Inadequate O2 supply to the heart (Myocardial Ischemia), can be stress induced, pain will go away with rest and nitroglycerin
Angina S/S
-Chest discomfort, possibly radiating to L arm or neck
-Cool, clammy skins/ possibly sweating profusely
-Shortness of breath
-Nausea or vomiting
Angina Treatment
-O2, low flow, maintain O2 Sat of >94% (UNLESS difficulty breathing or ineffective respiratory= high flow)
-Patient remain calm
- Assist with nitroglycerin and/ or aspirin if prescribed
What does it mean if Angina doesn’t go away
Worsening or no relief may mean myocardial infarction
What is a Silent MI?
No chest pain or vague symptoms. Common in elderly, women, or diabetics
Aortic Aneurysm
- Weakening in lining of Aorta (caused from hypertension)
- Leads to ballooning
- If balloon ruptures => life threatening
Aortic Dissection
- Tear in inner lining of Aorta (shreds)
- Blood enters opening causing separation of the lining
Aortic Dissection S/S
- Chest pain (described as tearing or ripping; will radiate to back, flank, arm)
Aortic Dissection Treatment
- High flow O2
- Rapid Transport
Congestive Heart Failure (CHF)
- Heart no long pumps blood effectively (previous myocardial infarction)
Two types: Left and Right Heart Failure
Left Heart Failure
- Affects lung side
-Cannot pump blood to the rest of the body - Traffic jam in the lungs (RALES)
- Fluid will build in alveoli
What causes LHF?
- Hypertension/ HTN
- Coronary artery disease
- Heart attack history
LHF S/S
- Chest pain/ shortness of breath
- rales
- pale, cool, sweaty skins
- anxiety
- high BP/ rapid HR
- pink frothy sputum (LATE sign/ SERIOUS)
Right Heart Failure
- Systemic side
- Cannot pump blood to the lungs
- from right ventricular AMI or pulmonary hypertension
RHF S/S
- Lower extremity edema
- JVD
- Abdominal distension
RHF Treatment
- Sit up, dangle legs
- Rapid transport
- High flow O2, PPV
Nitroglycerin (NTG)
- Trade names: nitrostat, nitro-bid, nitrolingual spray
Indications for NTG
- SS of chest pain or discomfort, consistent with acute coronary syndrome
- Prescription
- Approval to administer
Contradictions for NTG
- Viagra in the past 24 h (can cause DEATH)
- HR less than 50 bpm or more than 100 bpm
- 3 doses have been taken
Side effects of NTG
- Headache
- BP drop
- Change in pulse rate
Aspirin
- Trade names: ASA, Bayer, Ecotin
Indications for ASA
- Chest pain/ discomfort that is suggestive of acute coronary syndrome
- Medical direction to give
Contradictions for ASA
- Not given to patient who are known to be allergic (hypersensitive to drug)
Side effects of ASA
- Overall a very good drug
- Stomach irritation
How is NTG given?
- Sublingual
- Spray, tablet, or paste
How is ASA given?
- Oral or chewable
What does NTG do?
- Relieves chest pain
- Dilates coronary arteries, allowing for increase of blood flow
- Reduces workload of heart
What does ASA do?
- Does not allow platelets to combine together, prevent vessel blockage
- Makes platelets slippery
