Cardiac Treatments Flashcards
Afib
O2 titrate to 94-99%, vitals, fluid tko, 12 lead, PMH, HPI meds, allergies
Rate for uncontrolled Afib?
> 100bpm
What rate do we treat new onset uncontrolled A-Fib, and with what medication?
> 170 cardizem - 0.25mg/kg, transport, monitor for changes
170 verapamil - 2.5-5mg
If unstable we Cardiovert at 120-200J
Treatment for A-Flutter
Stable, fluid and O2 (94-99%)
> 170 cardizem - 0.25mg/kg, transport, monitor for changes
170 verapamil - 2.5-5mg
If unstable or symptomatic cardiovert (AHA says 50-100J)
Junctional Rhythm
If pt is symptomatic:
- Atropine (1mg max dose 0.04mg/kg 3mg)
- Dopamine (5-20mcg/min or Epi (2-10mcg/min Drip
Unstable - Pace (80bpm - increase J until capture)
Ventricular Rhythms
Symptomatic/ unstable: Pace (80bpm, J until capture)
- Epi (2-10mcg/min)
- dopamin (5-20mcg/min)
- O2 (94-99%)
- 12-lead
1st Degree Heart Block
Supportive, nothing to really do, most likely not the reason for the call.
2nd Degree Type 1 Heart Block
- Supportive
- O2 (94-99%)
HYPOXIA is normally a big reason for the Heart Block - Aspirin (if they have chest pain, 324mg)
2nd Degree Type 2 Heart Block
- Supportive if stable
- O2 (94-99%)
- chest pain (324mg aspirin)
- Slow: Epi (2-10mcg/min) or Dopamine (5-20mvg/min)
- Unstable Brady, PACE
3rd Degree (complete heart block)
- O2
- IV
- Chest Pain (324mg aspirin)
- Fluid Bolus 250-500ml
- Dopamine (5-20mcg/ml) Epi (2-10mcg/min) drip
Unstable: PACE
Transport
S/s
Cause
Treatment
for
Pulmonary Embolism
S/s: SOB, sudden onset, do they have a hx of recent surgery, travel, life style?
Cause: air, thrombosis, fat
Treatment: Assessment, Lung sounds, 12-Lead, O2, supportive, IV, transport
S/s
Cause
Treatment
for
Angina Pectoris
S/S: Stable (< 30mins) vs Unstable (> 30mins) Substernal Chest Pain
Causes: MI, Atherosclerosis, Hypoxia, Anything that causes the hearts O2 demand to go up
Treatment: Assessment, History, Aspirin (324 mg), 12 Lead for possible MI, Nitro (0.4mg PRN), O2 (>94%), IV, Transport
S/s
Cause
Treatment
for
Thoracic Dissection
SS: Acute severe pain, sensation of tearing/ ripping/ shearing/ radiates to neck or back, LOC, SOB
DIFFERENT BILATERAL BP (20 Points)
Causes: chronic hypertension, congenital (Marfan syndrom)
Treatment: O2, bilateral large bore IV, treat for shock, get to proper ED for OR.
S/s
Cause
Treatment
for
Myocardial Infarction
SS: Chest Pain, chest heaviness, SOB, Radiation of pain to the back or shoulder, arm pain, nausea, anxious, lethargic, diaphoretic, ST elevation
Cause: CAD, atherosclerosis, coronary artery spasms (cocaine)
Treatment: O2 (94-99%), ECG, Assessment and History, Aspirin (324mg), 12-lead, Nitro (0.4mg) not in right sided MI, IV, fluids, analgesics (fentanyl 1-2 mcg/kg), rapid transport and alert
S/s
Cause
Treatment
for
Abdominal Aneurysm:
S/S: Pain in the abdomen or back. The pain may be severe, sudden, persistent, or constant. It may spread to the groin, buttocks, or legs. Syncope, nausea/vomiting,
Causes: Smoking, chronic HTN, Male gender, Congenital.
Treatment: O2, treat for shock, get to an OR.
S/s
Cause
Treatment
for
Valvular Diseases/ Failure:
Causes:
Valvular stenosis, also called heart valve disease or narrowed valve, occurs when there is narrowing, stiffening, thickening, fusion or blockage of one or more valves of your heart. As a result, the defective valve may make your heart work very hard to pump blood through it. Valvular stenosis may occur in any of the four valves of your heart: the aortic valve, the mitral valve, the tricuspid valve or the pulmonic valve.
S/S:
Mild valvular stenosis may not show any symptoms, but as the stenosis worsens, symptoms of heart failure may develop.
Shortness of breath in the middle of the night while lying down
Fatigue
Chest pain
Swelling (edema) of the legs, ankles or other parts of the body
Dizziness and fainting
Palpitations
Heavy coughing, sometimes with blood-tinged sputum
Cyanosis (a bluish tint to the lips, skin and other areas of the body)
Multiple heart failure symptoms
Stroke
Treatment:
Nitro (0.4mg)
CPAP
If symptomatic:
Cardiogenic Shock Dopamine (2-10mcg/kg/min)
Or Epi 1:1,000 (1mg in a 250mL, 2-10mcg/kg/min)
S/s
Cause
Treatment
for
Atherosclerosis
S/S:
chest pain or angina.
pain in your leg, arm, and anywhere else that has a blocked artery.
shortness of breath.
fatigue.
confusion, which occurs if the blockage affects circulation to your brain.
muscle weakness in your legs from lack of circulation.
Causes:
begins with damage to the endothelium caused by high blood pressure, smoking, or high cholesterol. That damage leads to the formation of plaque. When bad cholesterol, or LDL, crosses the damaged endothelium, the cholesterol enters the wall of the artery.
Treatment:
Pre-hospital: Supportive
Long-term:
Lifestyle changes: diet, exercise and stopping smoking can prevent the progression of the disease.
Medications: Antihypertensives and antihyperlipidemics can slow or stop the progression of the disease.
Surgical intervention: angioplasty- a tube with a balloon on it, and stenting, can be used to reopen occluded arteries.
S/s
Cause
Treatment
for
Hypertensive Crisis
S/S: Headache or blurred vision. Increasing confusion. Seizure. Increasing chest pain. Increasing shortness of breath. Swelling or edema (fluid buildup in the tissues)
Causes:
O.D.s
Treatment:
Metoprolol (5mg IV, push until desired effect.)
Furosimide (20-40mg SIVP)
Mannitol-for ICP (0.5-2 g/Kg)
