Cardiac Emergencies Flashcards
3 parts of the circulatory system AKA cardiovascular system
- Heart
- Blood vessels
- Blood
Sinoatrial node (SA)
Located in the upper portion of right atrium and is the primary peacemaker of the heart
Atrioventricular Node (AV)
Located @ the crux and is the secondary peacemaker
Purkinje fibers
Located throughout the ventricles and is the final peacemaker
What happens if the left ventricle is damaged?
It will cause fluid to back up into the lungs
Coronary arteries
Are the first 2 arteries off the aorta, and are responsible for supplying the heart with oxygenated blood (Does not come from the blood pumped through the chambers).
Ischemia
- Too little O2 reaching the tissue
- when encountered in the heart muscle it will become hypoxic and die
Heart attack also known as?
Myocardial infarction (MI)
Abnormal electrical can be?
Fatal
What is the most common rhythm for full arrest?
Ventricular fibrillation (VF)
Platelets do what?
Helps in clotting process to stop bleeding
Clots form at the bleeding sight are called ?
Thrombus
Thrombin
A protein responsible for activating the formation of a clot.
Fibrin
Protein strands that form a mesh that strengthens a clot.
Electrocardiogram
- ECG/EKG
- Graphic representation of the heart’s electrical activity
P wave
Depolarization(Contraction) of the atria.
QRS complex
Depolarization of the ventricles repolarization(relaxation) of the atria underneath.
T wave
Repolarization of the ventricles
Coronary artery diseases (CAD)
The narrowing and hardening of the coronary arteries.
Arteriosclerosis
Hardening of the arteries which causes narrowing.
Atherosclerosis
Plaque forming in the arteries which causes narrowing.
What happens if plaque that formed in the coronary artery rips off?
It will cause clotting to start and form thrombus which can completely occlude the artery.
Acute coronary syndrome (ACS)
- When the problem actually starting to happen from the coronary arteries narrowing.
- Unstable angina
- Myocardial infarction
Angina pectoris
“Pain in the Chest” occurs when Increased workload is placed on the heart.
Unstable Angina
Prolonged and worsening, or occurs without exertion & when Pt is at rest.
Pathophysiology of Angina Pectoris
- inadequate O2 supply to the heart muscle (myocardium)
- Generally during periods of stress, physical/emotional
- Usually felt under the sternum, can radiate to the jaw and arm
- Once the stress is removed and the pt rests the pain will usually go away.
Angina S/Sx
- Steady discomfort
- described as: Pressure,tightness,aching, crushing, or heavy.
- radiate to shoulder, back, jaw, or arm
- cool clammy skin
- Anxiety
- SOB
- Diaphoresis
- N/V (Nausea/Vomiting)
Angina may present different for these people:
- Women
- Diabetics
- Elderly
Angina Rx
- O2 usually 2-6lpm
- NTG if pt has Rx EMT may assist
- Aspirin 160-325mgs not for EMTs in SD, National Registry allows with medical direction
Give O2 for angina Pts if you see these signs:
- SOB
- Hypoxemic
- Signs of heart failure
- O2 sat <94%
- O2 sat unknown
Nitroglycerin should not be given (contraindicated) with these conditions
- systolic Bp less than 100mmhp (SD)
- Pt with head injury
- Pt who uses ED drugs: viagra, cialis, or lavitra within the last 48hrs
- If pt has taken 3 doses already
EMTs may Assist Pt with nitroglycerin if they’re _________
- Systolic BP is greater than 90mmHg (National)
- Systolic BP is greater than or equal to 100mmHg (SD)
- Max dose 3
Nitroglycerin
- Dilates blood vessels
- Decreases work load of the heart
- Decreases cardiac oxygen demand
Aspirin
- 324mgs baby aspirin in SD by paramedics, oral chewable
- EMTs will not give in SD, but for national registry it allows with medical direction
- Aspirin Decreases the ability of the platelets in the blood to form clots.
Myocardial Infarction (MI)
- Portion of the heart muscle begins to die due to lack of O2
- Coronary artery disease narrowing leads to MI
- 20-30 without proper O2 supply tissue will die
Ischemia can produce abnormal electrical conduction called?
Dysrhythmias which can be fatal
Myocardial infarction (MI)
- same as angina but longer
- Often described as pressure
- Pain may radiate to jaw, L arm, or epigastric region
- CP may only be relieved or not at all by NTG
- sense of impending doom
- poor skin signs-pale,cool,moist
- possible for the MIs to be “silent” without pain. PT may not know they are having a MI
MI Rx
- NTG When indicated
- O2 but be careful not to give to much
- Aspirin with medical direction (National)
CP Rx
Make sure to recognize the possibility of “cardiac compromise” and provide proper care. Death of heart muscle is permanent and irreversible.
Aortic aneurysm
- weakened section of the aortic wall begins to dilate or balloon outward from pressure
- commonly caused by atherosclerosis
- Most often occur in the ABDM region, can have a tearing pain radiating to the back
- Aneurysms may be present for long periods of time without S/Sx
- Suddenly burst causing rapid and fatal internal bleeding
- Late Sx would be pulsating mass in the ABDM
Aortic dissection
- Tear in the inner lining of the aorta, blood enters and begins to separate the layers
- tearing/ripping pain to the back
- May see a profound difference in Systolic Pressures in both arms.
- Differences in pulses
- Late Sx also a pulsating mass
Congestive Heart Failure (CHF)
Is a medical diagnosis that refers to the condition in which there is a buildup fluid (congestion) in the body resulting from the pump failure of the heart.
Congestive heart failure (CHF) cause & effects right side
- Right side Failure where the R ventricle is failing as a pump, caused by L ventricle Failure,COPD,Hypertension
- which causes a systemic back up and will eventually cause the L ventricle to become less effective
Congestive heart failure (CHF) cause & effects Left side
- Left side failure where the left ventricle fails as a pump, pt will present with crackles/rales, possibly with swelling to the ankles & SOB with Jugular vein distinction
- causes a back up into the lungs and eventually the body, due to R ventricle Failure
Rx for CHF
- O2
- Assis with NTG, Aspirin
- Fowler’s position
- PPV and dangle their legs
How much dosage Of epinephrine for an adult?
0.3mg
Epinephrine dosage for pediatric
0.15mg
