Cardiovascular Emergencies - Assessment & Monitoring Flashcards
If the cardiac patient is having any difficulty breathing or their oxygen saturation is below 94%, ___
Administer oxygen at 4 L/min via nasal cannula, increase concentration as needed
If you cannot get a pulse oximetry reading for a cardiac patient ___
Apply a non-rebreathing mask at 15 L/min
If the cardiac patient is not breathing, ensure ___
Adequate ventilations with a bag-mask device and 100% oxygen
Cardiac patients experiencing pulmonary edema may require ___
Positive-pressure ventilation with a bag-mask device or CPAP
Most effective way to assist a person with CHF to breath effectively and prevent the need to use an invasive airway management technique
CPAP
Specific questions to ask for a cardiovascular emergency
- Have you ever had a heart attack
- Have you been told that you have heart problems
- Diagnosed with angina
- Ever had high BP
- Diagnosed with an aneurysm
- Respiratory diseases such as emphysema or chronic bronchitis
- Have diabetes or blood sugar problems
- Had kidney disease - Have any risk factors for coronary artery disease, such as smoking, high BP, or high cholesterol
- Family history of heart disease
- Current medications
The secondary assessment of a conscious patient with chest pain or discomfort will likely focus on ___
The patient’s cardiac and respiratory systems
Recommended dose of aspirin
162 to 324 mg
Goal timeline to obtain the ECG
Within 10 minutes of first contact
ECG tracing with waves that are the result of interference, such as patient movement, rather than the heart’s electrical activity
Artifact
Largest, usually narrow, deflections on the ECG
QRS complexes
Each small (1-mm) box on the ECG printout represents ___
0.04 seconds
Each larger (5-mm) box on the ECG printout represents ___
0.20 seconds
The QRS complex should be less than ___
3 mm wide from where it starts to leave the baseline to where it returns
QRS complexes that are wider than 3mm are usually signs of ___
Dangerous rhythms
If two QRS complexes are less than ___ apart, the heart rate is over 100 BPM
15mm (three large boxes)
If two QRS complexes are more than ___ apart, the heart rate is less than 60 BPM
25mm (5 large boxes)
Small rounded wave before the QRS
P wave
P wave
Represents the contraction of the atria
After each QRS complex, you should see a ___
T wave
T wave
Represents the depolarization of the ventricles
The horizontal line between all of the waves
Baseline
Segments of the baseline are identified by ___
The waves they connect
A blood vessel from the chest or leg is sewn directly from the aorta to a coronary artery beyond the point of the obstruction
Coronary artery bypass graft
Aims to dilate, rather than bypass, the coronary artery
Percutaneous transluminal coronary angioplasty
A worn out pacemaker may cause ___
Syncope, dizziness, or weakness
If an ALS service is not responding to the scene of cardiac arrest, you should begin transport when ___
- The patient regains a pulse
- 6 to 9 shocks have been delivered
- The AED gives 3 consecutive messages that no shock is advised on a pulseless patient
If you are traveling to the hospital with an unconscious cardiac arrest patient, check the verse every ___
30 seconds
If during transport a pulse is not present ___
- Stop the vehicle
- Perform CPR until AED is ready
- Call for ALS support
- Analyze the rhythm
- Deliver one shock and immediately resume CPR
- Continue resuscitation according to local protocol
If during transport with a conscious adult patient with chest pain becomes unconscious ___
- Check for pulse
- Stop the vehicle
- Perform CPR until AED is ready
- Analyze the rhythm
- Deliver one shock and immediately resume CPR
- Continue resuscitation accord to local protocol including transport
If you are able to obtain ROSC
- Monitor for spontaneous respirations
- Provide oxygen via bag-mask device at 10 breaths/min
- Maintain oxygen saturation between 95% and 99%
- Assess BP
- See if they can follow simple commands such as “squeeze my fingers”
- Transport to hospital
ROSC
Return of Spontaneous Circulation
