CH7 Circulatory Emergencies Flashcards
how does a circulatory emergency develop
appears sudden, but can have underlying cause that has developed over a period of years or decades
which side of the heart does what
right side receives from body and pumps to lungs
left side receives from lungs and pumps to body
definition of cardiovascular disease
refers to broad range of conditions affecting heart and blood vessels.
one of leading causes of death worldwide
what are 5 examples of cardiovascular diseases
coronary heart disease (CHD)
cerebrovascular disease
congenital heart disease
deep vein thrombosis and pulmonary embolism
peripheral arterial disease
what does cardiovascular disease increase risk of
CVD increases risk of stroke and myocardial infarctions (heart attack)
what is arteriosclerosis
occurs when arteries become hardened, narrowed, and less elastic
occurs gradually, caused by buildup of cholesterol and plaque in arteries
when occurring in a coronary artery it results in coronary heart disease (CHD)
what are some controllable cardiac disease risk factors
hypertension
high cholesterol
diabetes
heart disease
weight
alcohol consumption
exercise
smoking
stress
what are some uncontrollable cardiac disease risk factors
age
gender
family medical history
ethnicity
history of stroke or TIA
diabetes
what is the main cause of myocardial infarctions (heart attack)
O2 cant get to heart muscle, causing cardiac muscle death
why is hypertension a “silent killer”
pressure inside blood vessels causes scarring and promotes buildup of fatty plaque, leading to arteriosclerosis
what causes a stroke to occur
brain doesn’t get enough O2.
can be caused by a blockage (ischemic) or a bleed (aneurysm)
what is angina
intermittent chest pain or pressure
occurs when demands of heart exceeds supply = more blood out than in to CORONARY ATERIES
what are common MOI’s of angina
physical activity & exercise
stress
periods of extreme cold or hot
heavy meals
drinking alcohol or smoking
what are the 2 types of angina
stable angina
unstable angina
what defines stable angina
follows predictable pattern of pain
can be relieved with rest and medication
usually not life threatening
lasts less than 10 minutes
what defines unstable angina
pain is not typical for patient
may occur at rest and lasts longer than 10 mins
does not respond to medication
more painful and lasts longer than previous
warning sign that a myocardial infarction is imminent.
what should you do if you suspect either unstable angina or a myocardial infarction
because S\S are similar, treatment is the same.
what are the S\S of angina
pain in center of chest
tightness, pressure, squeezing, aching in chest or arms
persistent feeling of moderate to severe indigestion
nausea, vomiting
cool, pale skin
discomfort in neck or between shoulder blades
numbness in arms, wrists, shoulders
unstable angina treatment
place in position of comfort
assist patient with prescribed medication - nitroglycerin - max doses 3 per 5 min.
aspirin if no nitro - 160-325mg
O2 administration
what is nitroglycerin
a vasodilator
comes as a pill or sublingual spray
increases quality of O2 to heart, reduces chest pain
what should you check before administering nitroglycerin
check blood pressure
check for erectile dysfunction drugs - is a vasodilator
check how many doses patient has already taken
how much can aspirin (ASA)
reduce risk of death during myocardial infarction
up to 25%
what will patient likely have if they have unstable angina
nitroglycerin prescription
treatment for myocardial infarction
same as unstable angina treatments, but patient will likely not have nitroglycerin.
activate EMS EARLY
what is congestive heart failure
hearts pumping ability is diminished
can be left or right side failure
what happens during left sided congestive heart failure
often caused by myocardial infarction or chronic hypertension
left ventricle loses ability to pump blood to system.
blood coming into left ventricle backs up, causing fluid buildup in lungs
S\S
increased breathing rate
cyanosis
coughing up blood
increased HR
wheezing
panic or agitation
high blood pressure
confusion
what happens during right side congestive heart failure
usually occurs due to left side failure and increased pressure back thru the lungs
blood backs up in veins of system, causes edema of feet and lower leg
by itself is rarely life threatening
S\S
shortness of breath
edema of lower legs
more frequent urination
jugular vein bulging
tachycardia or arrhythmia
weakness or fatigue
fainting
what is a cerebrovascular accident
a stroke
disruption of blood flow to part of brain, quickly becomes hypoxic and damaged.
patient experiences deficits related to part of brain damaged (speech, motor function, memory, etc.)
can be minor or catastrophic
what are the 2 types of cerebrovascular accidents (stroke)
ischemic (blockage) 80%
hemorrhagic (bleed) 20%
what are hemorrhagic strokes, and what are the 2 areas they happen in
20% of strokes caused by bleeding in the brain
happens in subarachnoid space - artery at the SURFACE of brain bursts, manifests as severe and sudden headahe.
happens in intracerebral space - artery bursts in brain tissue, disrupting typical flow, tissues become hypoxis
what are ischemic strokes
80% of strokes
caused by physical blockages of arteries.
can be Thrombotic - blockage created inside brain (clot)
or Embolic - blockage flowed to brain from body (solid, liquid, or gas)
what is a TIA
transient ischemic attack
caused by reduced flow to brain, most commonly a clot
S\S last minutes to hours (hence transient)
referred to as a warning-stroke or a mini-stroke
stroke and TIA S\S
weakness
altered speech
pupils not PEARL
headache
dizziness
confusion
change in mood
ringing ears
change in responsiveness
loss of bowel or bladder control
to care for stroke or TIA patient
Rapid transport ASAP
help managing airway
NO food or drink
Patient positioning with effected side DOWN
NO aspirin
how to tell difference between ischemic or hemorrhagic stroke
only way is a CAT scan
how to assess a stroke or TIA
F - face numbness, sagging, or weakness
A- arm numbness or weakness, most commonly one-sided
S- speech effected, slurred speech or difficulty speaking
T - time. when did S\S first occur
what is cardiac arrest
when heart stops circulating blood
what is clinical death
cessation of both circulation and respiration. CAN BE REVERSED with CRP and AED interventions
what is biological death
irreversible death
when does clinical death become biological death if no interventions take place
somewhere between 6-11 minutes
what are some common causes of cardiac arrest
stroke
brain damage
cardiovascular disease
respiratory failure
poison
electrocution
drowning
suffocation
certain drugs
chest trauma
severe blood loss
what are some warning signs of imminent cardiac arrest
sudden cold sweat
chest pain or pressure
shortness of breath
nausea
tingling in jaw, back, shoulder, neck, or arms
what does an AED do
analyzes hearth rhythm and administers a shock
what is heart fibrillation
heart arrhythmia that prevents it from circulating blood
what are the parts of a AED
pads connector
defibrillation pads
shock button
on\off button
active status indicator
usb port
data card
data card access door
what are the 4 different heart rhythms
normal
asystole
ventricular fibrillation
ventricular tachycardia
what is heart asystole
no electrical activity - no pumping, no pulse
what is heart ventricular fibrillation
chaotic discharge of electricity, heart quivers - no pulse
what is heart ventricular tachycardia
ventricles contracting too rapidly, heart cant refill properly - rapid or no pulse
what are shockable and non-shockable heart rhythms
shockable are ventricular fibrillation and tachycardia
non-shockable are normal or asystole (no pulse present)
what is CPR
cardiopulmonary resuscitation
what are the keys to good CPR
chest compressions at 120bpm
patient on back on a HARD surface
compression fraction time - % time patient is receiving chest compressions, keep this high
hand position centered on sternum at nipple line
responder position to the side of patient
chest fully recoils between compressions
chest compression depth is 5cm for adults, 1\3rd of chest depth for children or infants
when can you stop CPR
when more highly trained rescuer arrives and takes over
too exhausted
scene becomes unsafe
pulse now present
how to do CPR on pregnant woman
put blanket of cushion under RIGHT hip to let gravity help blood get back to heart, perform chest compressions
when not to use AED
you are in a vehicle
there are flammable materials (O2, etc)
you are touching the patient
