Cardiovascular Emergencies - Assessment & Monitoring

Question 1

If the cardiac patient is having any difficulty breathing or their oxygen saturation is below 94%, ___

Answer 1

Administer oxygen at 4 L/min via nasal cannula, increase concentration as needed

Question 2

If you cannot get a pulse oximetry reading for a cardiac patient ___

Answer 2

Apply a non-rebreathing mask at 15 L/min

Question 3

If the cardiac patient is not breathing, ensure ___

Answer 3

Adequate ventilations with a bag-mask device and 100% oxygen

Question 4

Cardiac patients experiencing pulmonary edema may require ___

Answer 4

Positive-pressure ventilation with a bag-mask device or CPAP

Question 5

Most effective way to assist a person with CHF to breath effectively and prevent the need to use an invasive airway management technique

Answer 5

CPAP

Question 6

Specific questions to ask for a cardiovascular emergency

Answer 6

1. Have you ever had a heart attack
2. 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
3. Have any risk factors for coronary artery disease, such as smoking, high BP, or high cholesterol
   - Family history of heart disease
   - Current medications

Question 7

The secondary assessment of a conscious patient with chest pain or discomfort will likely focus on ___

Answer 7

The patient’s cardiac and respiratory systems

Question 8

Recommended dose of aspirin

Answer 8

162 to 324 mg

Question 9

Goal timeline to obtain the ECG

Answer 9

Within 10 minutes of first contact

Question 10

ECG tracing with waves that are the result of interference, such as patient movement, rather than the heart’s electrical activity

Answer 10

Artifact

Question 11

Largest, usually narrow, deflections on the ECG

Answer 11

QRS complexes

Question 12

Each small (1-mm) box on the ECG printout represents ___

Answer 12

0.04 seconds

Question 13

Each larger (5-mm) box on the ECG printout represents ___

Answer 13

0.20 seconds

Question 14

The QRS complex should be less than ___

Answer 14

3 mm wide from where it starts to leave the baseline to where it returns

Question 15

QRS complexes that are wider than 3mm are usually signs of ___

Answer 15

Dangerous rhythms

Question 16

If two QRS complexes are less than ___ apart, the heart rate is over 100 BPM

Answer 16

15mm (three large boxes)

Question 17

If two QRS complexes are more than ___ apart, the heart rate is less than 60 BPM

Answer 17

25mm (5 large boxes)

Question 18

Small rounded wave before the QRS

Answer 18

P wave

Question 19

P wave

Answer 19

Represents the contraction of the atria

Question 20

After each QRS complex, you should see a ___

Answer 20

T wave

Question 21

T wave

Answer 21

Represents the depolarization of the ventricles

Question 22

The horizontal line between all of the waves

Answer 22

Baseline

Question 23

Segments of the baseline are identified by ___

Answer 23

The waves they connect

Question 24

A blood vessel from the chest or leg is sewn directly from the aorta to a coronary artery beyond the point of the obstruction

Answer 24

Coronary artery bypass graft

Question 25

Aims to dilate, rather than bypass, the coronary artery

Answer 25

Percutaneous transluminal coronary angioplasty

Question 26

A worn out pacemaker may cause ___

Answer 26

Syncope, dizziness, or weakness

Question 27

If an ALS service is not responding to the scene of cardiac arrest, you should begin transport when ___

Answer 27

1. The patient regains a pulse
2. 6 to 9 shocks have been delivered
3. The AED gives 3 consecutive messages that no shock is advised on a pulseless patient

Question 28

If you are traveling to the hospital with an unconscious cardiac arrest patient, check the verse every ___

Answer 28

30 seconds

Question 29

If during transport a pulse is not present ___

Answer 29

1. Stop the vehicle
2. Perform CPR until AED is ready
3. Call for ALS support
4. Analyze the rhythm
5. Deliver one shock and immediately resume CPR
6. Continue resuscitation according to local protocol

Question 30

If during transport with a conscious adult patient with chest pain becomes unconscious ___

Answer 30

1. Check for pulse
2. Stop the vehicle
3. Perform CPR until AED is ready
4. Analyze the rhythm
5. Deliver one shock and immediately resume CPR
6. Continue resuscitation accord to local protocol including transport

Question 31

If you are able to obtain ROSC

Answer 31

1. Monitor for spontaneous respirations
2. Provide oxygen via bag-mask device at 10 breaths/min
3. Maintain oxygen saturation between 95% and 99%
4. Assess BP
5. See if they can follow simple commands such as “squeeze my fingers”
6. Transport to hospital

Question 32

ROSC

Answer 32

Return of Spontaneous Circulation