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NREMT® Paramedic > EMT-P (2) Cardiology and Resuscitation > Cardiovascular Emergencies > Flashcards

Cardiovascular Emergencies Flashcards

Learn about cardiovascular emergencies and their treatments

1
Q

What are the three presentations of angina-type pain patients?

A
  • Angina
  • STEMI
  • NSTEMI
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2
Q

Define:

fibrinolysis

A

The process of breaking down and removing blood clots in the body.

It involves the enzyme plasmin which dissolves fibrin, the protein that forms clots.

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3
Q

Define:

PCI

A

Percutaneous Coronary Intervention

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4
Q

Interpret what is going on in this 12-Lead.

A

Inferior STEMI

  • Elevation in II, III, aVF.
  • Reciprocal Changes in I and aVL.
  • Elevation is >1 mm in two contiguous leads.
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5
Q

What is the treatment for inferior STEMI?

A

Determine if Right Ventricular Involvement is present

Immediate medical care, administer:

  • Oxygen
  • aspirin
  • Nitroglycerine (If no RVI, or if volume replacement has been completed)
  • Morphine/Fentanyl
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6
Q

Interpret what is going on in this 12-Lead.

A

Anterior STEMI

  • Elevation in V3, V4.
  • Reciprocal Changes in Posterior Leads if obtained.
  • Elevation is >1mm in two contiguous leads.
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7
Q

Interpret what is going on in this 12-Lead.

A

Septal STEMI

  • Elevation in V1, V2.
  • Reciprocal changes in lateral leads.
  • Elevation is >1 mm in two contiguous leads.
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8
Q

Interpret what is going on in this 12-Lead.

A

Posterior STEMI

  • Depression in anterior leads (posterior 12-lead will reveal elevation).
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9
Q

What is a benign early repolarization?

A

A fishhook appearance at the J-point with a concave ST-segment.

It is often mistaken for ST Elevation.
Reciprocal changes are never present.

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10
Q

What pathology is in the 12-Lead?

A

Pericarditis

Diffuse ST segment elevation throughout.
Results from a bacterial, viral or fungal infection.

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11
Q

What pathology is in this 12-Lead?

A

Pulmonary Embolism

  • S1Q3T3 Present
  • Deep S Wave Lead I
  • Deep Q Wave Lead III
  • T wave inversion Lead III
  • Thorough Hx and Exam pertinent to suspicion
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12
Q

What changes are seen on a 12-Lead when a patient has Hyperkalemia?

A
  • tall, peaked T waves
  • P waves can be flat
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13
Q

What changes are seen on a 12-Lead when a patient has Hypokalemia?

A

flat/absent T waves (U-wave)

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14
Q

What changes are seen on a 12-Lead when a patient has Hypocalcemia?

A

widening of QT interval

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15
Q

What changes are seen on a 12-Lead when a patient has Hypercalcemia?

A

shortened QT interval

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16
Q

How long is the QT interval in long QT syndrome?

A

>450 ms

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17
Q

What are the two placements for defibrillation pads?

A
  • Anterior-Lateral
  • Anterior-Posterior
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18
Q

What rhythm(s) is defibrillation used for?

A

Pulseless Rhythms

  • Ventricular Tachycardia (w/o Pulse)
  • Ventricular Fibrillation
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19
Q

What rhythm(s) is Synchronized Cardioversion used for?

A

Unstable Tachydysrhythmias

  • SVT
  • A-fib RVR
  • V-tach
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20
Q

What energy level (in joules) is used for adult defibrillation?

A

200-300-360

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21
Q

What energy level (in joules) are used for adult synchronized cardioversion?

A

50-100-200-300-360

22
Q

What two types of capture should you assess during transcutaneous pacing?

A

electrical and mechanical

23
Q

What are some treatments for adult symptomatic bradycardia?

A
  • Atropine 0.5-1mg (New ACLS indicates 1mg)
  • TCP (First Line if 2nd Degree II or 3rd Degree)
  • Dopamine (2-20mcg/kg/min)
  • Epinephrine (2-10mcg/min)
24
Q

What are the treatments for adult SVT?

A
  • Vagal Maneuvers
  • Adenosine (6mg, 12mg)
  • Synchronized Cardioversion
25
Q

What are the treatments of V-Tach (w/ a pulse)?

Hint: unstable vs. stable

A

Stable:

  • Amiodarone: 150mg/10 (1mg/min maintenance infusion) or Lidocaine 1-1.5mg/kg (MAX 3mg/kg)

Unstable:

  • Synchronized Cardioversion 50-100-200-300-360
26
Q

What is the treatment for Asystole and PEA?

A
  • Epinephrine: 1mg
  • CPR
27
Q

What are the American Heart Association’s termination criteria for conducting CPR in the field?

A
  1. No witnessed collapse
  2. No bystander CPR
  3. No ROSC after ALS care
  4. No shocks administered
28
Q

What is the leading cause of death in the U.S.?

A

Coronary Artery Disease

29
Q

What is the cause of Prinzmental Angina?

A

Coronary Artery Vasospasm

It is characterized by chest pain at rest.

30
Q

Define:

Unstable Angina

A

It is identified by changes in duration, severity and frequency of chest pain felt by the patient.

31
Q

Fill in the blank.

The therapy in which a clot is dissolved is called ______ ______.

A

fibrinolytic therapy

32
Q

Define:

Congestive Heart Failure

A

The heart is unable to properly empty its chambers.

33
Q

Left or right.

Pulmonary edema is a result of ____ sided heart failure

Peripheral edema is a result of ____ sided heart failure

A

left

right

34
Q

Treatment:

Left Sided Heart Failure

A
  • Oxygen
  • CPAP
  • sit patient up while feet is dangling
  • Nitroglycerine .4mg
  • Lasix 20-40mg
  • Morphine 3mg
  • Dopamine 2-20mcg/kg/min (low BP)
35
Q

Define:

cardiac tamponade

A

Fluid accumulates in the pericardium.

36
Q

What are the signs/symptoms of cardiac tamponade?

A
  • Dyspnea
  • Weakness
  • Chest Pain
  • Beck’s Triad
37
Q

What are the clinical signs of Beck’s triad?

A
  1. Muffled heart sounds
  2. Jugular venous distention
  3. Narrowing pulse pressure
38
Q

Treatment:

cardiac tamponade

A

pericardiocentesis

39
Q

Define:

aortic aneurysm

A

Abnormal bulging of aortic vessel from a weak spot in the aortic wall.

40
Q

What are the signs/symptoms of aortic aneurysm?

A
  • sudden substernal “pressure”
  • weakness
  • sweating
41
Q

What are the signs/symptoms of ruptured aortic aneurysm?

A
  • Sudden lower back pain.
  • Pain radiating into thigh and groin.
  • Possible palpable mass in abdomen.
42
Q

Treatment:

ruptured aortic aneurysm

A
  • Administer oxygen.
  • IV/consider crystalloid bolus if px is hypotensive.
  • Keep the patient calm.
43
Q

What is considered a hypertensive emergency?

A

A sudden elevation of BP that causes end-organ damage.

44
Q

What are the signs/symptoms of hypertensive end-organ damage?

A
  • blurred vision
  • headache
  • epistaxis
  • tinnitus
45
Q

Fill in the blank.

A MAP > ____ mmHg breaches the blood brain barrier.

Mean Arterial Pressure

A

150 mmHg

46
Q

Define:

hypertensive encephalopathy

A

An acute neurological symptoms resulting from a sudden and severe elevation in blood pressure.

BP >200/130 mmHg

MAP >150 mmHg

47
Q

Treatment:

hypertensive emergency

A
  • 12-Lead
  • Labetalol 20mg slow IVP
  • Labetalol 2 mg/min infusion
  • Nitroglycerine .4mg SL
48
Q

Define:

endocarditis

A

Inflammation of the endocardium.

49
Q

Define:

rheumatic fever

A

Inflammatory response to streptococcal bacteria.

It can cause stenosis of the mitral valve.

50
Q

Define:

scarlet fever

A

An infection caused by Streptococcus Pyogenes

group A Streptococcus

51
Q

What are the signs/symptoms of scarlet fever?

A
  • sore throat
  • fever
  • rash
  • “strawberry” tongue

EMT-P (2) Cardiology and Resuscitation (8 decks)

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