Cardiology in the ED Flashcards
What defines a ‘heart’ emergency?
- Chest pain
- Palpitations
- Breathlessness
- Collapse/cardiac arrest
Primary management of cardiac presentation to ED
DRS ABCDE
- Danger
- Response
- Airways
- Breathing
- Circulation
- Disability
- Exposure
ABC are the main components.
Recognising a deteriorating patient essential and time critical.
How do you differentiate from cardiac and other causes of chest pain?
History
Examination
Bedside tests: ECG
Investigations: pathological and radiological tests used carefully with pre-test probabilities taken into consideration.
Further specialised investigations as indicated based on probability.
Management of palpitations.
Paients clinical status determines immediate management regardless of diagnosis - cardioversion in dysrhythmia where the patient is compromised.
Make diagnosis in parallel or after that.
Most of the time palpitations are caused by stimulants (e.g. caffeine) - check for hyperthyroidism.
Causes of breathlessness
There are many causes, not all are heart related:
- Acute pulmonary oedema
- CCF
- Pulmonary embolism
- Pneumonia
- Upper airway obstruction
Principles of management
- Early recognition of problem
- Early definitive mangement
- Early referral
Role of the doctor in principles of management
- Work with the patient to solve problems
- Work as part of a team
- Make sensible, coherent and logical referrals in a timely fashion.
- Be able to be flexible and recognise when the situation changes
- Anticipate
