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First Responder > Chapter 16-Cardiovascular Emergencies > Flashcards

Chapter 16-Cardiovascular Emergencies Flashcards

1
Q

How does the heart control heart rate?

A

It has control over its own electrical impulses which allow the atria and ventricles to work together

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2
Q

Where do the electrical impulses of the heart start?

A

Sinoatrial (SA) node

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3
Q

After an electrical impulse starts at the SA node, where does it go?

A

Across the atria, causing them to contract

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4
Q

Where does the electrical impulse of the heart go after causing the atria to contract?

A

The atrioventricular (AV) node

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5
Q

What happens to the impulse at the AV node?

A

It gets slowed for 0.1-0.2 seconds to allow blood to pass from the atria to the ventricles

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6
Q

After passing through the AV node, where does the heart’s electrical impulse go?

A

It spreads across the ventricles via the bundle of His, the right and left bundle branches, and the purkinje fibers

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7
Q

How is the initial electrical impulse at the SA regulated?

A

By the brain via the autonomic nervous system

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8
Q

What is blood made up of?

A

Red blood cells (move oxygen), white blood cells (fight infection), platelets (help with clotting), and plasma (fluid)

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9
Q

What’s happening during diastole?

A

The aortic valve closes and blood flow between the left ventricle and aorta stops while the left ventricle refills with blood

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10
Q

Where can peripheral pulses be felt?

A

Brachial, radial, posterior tibialis, and dorsis pedis arteries

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11
Q

Where can central pulses be felt?

A

Carotid and femoral arteries

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12
Q

What are the three components require for good perfusion?

A

Well-functioning heart
Adequate volume of blood
Appropriately-sized vessels

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13
Q

What is atherosclerosis?

A

A condition in which calcium and cholesterol build up and form plaque inside a vessel

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14
Q

When plaque build up, what part of the vessel decreases in size?

A

The lumen, or diameter

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15
Q

What happens when an atherosclerotic plaque cracks?

A

It triggers a blood clotting response that can obstruct the vessel or cause the plaque to get dislodged and flow through the vessel

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16
Q

What is it called when an atherosclerotic clot gets dislodged and starts flowing through a vessel?

A

Thromboembolism

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17
Q

What is it called when a thromboembolism gets stuck in a coronary artery?

A

Acute myocardial infarction (AMI)

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18
Q

What does infarction mean?

A

Tissue death

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19
Q

What are controllable risk factors for AMI?

A

Cigarette smoking, high cholesterol, high blood pressure, high blood glucose, lack of exercise, obesity

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20
Q

What are uncontrollable risk factors for AMI?

A

Old age, family history, race, ethnicity, sex (male)

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21
Q

What is acute coronary syndrome?

A

a group of symptoms that are caused by myocardial ischemia?

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22
Q

What is myocardial ischemia?

A

reduced blood flow to the heart

23
Q

What are the terms for the two types of myocardial ischemia?

A

Angina pectoris and acute myocardial infarction

24
Q

What are two causes for angina pectoris?

A

spasm of an artery or atherosclerotic coronary artery disease

25
Q

How is angina pectoris pain described?

A

A crushing/squeezing pain in chest that can radiate to jaw, left arm, center of back, or upper middle abdomen

26
Q

How long does angina pain usually last?

A

3-8 minutes

27
Q

What are two subcategories of angina

A

Unstable, occurs in absence of triggers and leads to AMI, and stable, occurs only in the presence of triggers and goes away when triggers are removed or nitroglycerin is administered

28
Q

What are triggers for angina?

A

exertion (physical or emotional), large meal, sudden fear

29
Q

What are three ways in which AMI pain differs from angina pain?

A

Lasts longer (30 min to several hours), Can’t always be relieved by nitroglycerin, and can occur in absence of trigger

30
Q

What is the first thing you do for someone with chest pain?

A

Position: supine or Fowler’s (remove or loosen tight clothing)

31
Q

After you have positioned a patient with chest pain, what other things do you have to do?

A

Administer oxygen and constantly reassess patient’s oxygen saturation and breathing and administer low dose aspirin or nitroglycerin

32
Q

What does aspirin do for a patient with chest pain?

A

Reduces blood clots to prevent clots from getting bigger

33
Q

What is the recommended dose of aspirin?

A

2-4 81 mg tablets

34
Q

What do you have to make sure of before administering aspirin?

A

(1) patient isn’t allergic (2) no history of internal bleeding

35
Q

What does nitroglycerin do for a patient with chest pain?

A

relaxes the muscles of vessel walls, dilates coronary arteries, increases blood flow and reduces the workload placed on the heart

36
Q

In what forms does nitroglycerin come?

A

Pill, sublingual spray, patch

37
Q

What are the side effects of nitroglycerin?

A

headache, low bp, changes in hr

38
Q

What do you do between doses of nitroglycerin?

A

Check bp 5 minutes after administering each dose and if systolic is under 100, do not continue administering

39
Q

What are some reasons to not give a patient nitroglycerin?

A

Head injury, they used erectile dysfunction drugs in the past 24 hours, or if you’ve already administered the maximum three doses

40
Q

Step 1 of administering nitroglycerin:

A

Obtain permission from medical control

41
Q

Step 2 of administering nitroglycerin:

A

Check bp to make sure it’s under 100

42
Q

Step 3 of administering nitroglycerin:

A

Check expiration date, contamination, and prescription

43
Q

Step 4 of administering nitroglycerin:

A

Ask patient how many doses they’ve already taken

44
Q

Step 5 of administering nitroglycerin:

A

administer or help patient administer medicine, and warn them not to chew tablet

45
Q

What should you be doing throughout the entire time you’re administering nitroglycerin?

A

Recording times of administration and checking bp 5 minutes after each dose

46
Q

Most AEDs regulate the _____ based on the _____

A

voltage, impedance

47
Q

What are shockable rhythms?

A

Ventricular fibrillation and ventricular tachycardia

48
Q

What are not shockable rhythms?

A

asystole, pulseless electrical activity

49
Q

What is the chain of survival for cardiac arrest?

A 
Activation of EMS
CPR
AED
Basic and Advanced EMS
ALS and post arrest care
50
Q

What are 6 common mistakes/challenges associated with using a defibrillator?

A
  • Failure of machine to detect shockable rhythm
  • Applying pads to a moving patient
  • Turning off AED before shock/analysis is complete
  • Not pushing the shock/analyze button when needed
  • Failing to keep battery charged
  • Using on a responsive patient with a pulse but whose hr is high enough to confuse the AED into thinking they’re in V-tach
51
Q

What usually causes cardiac arrest in children?

A

respiratory failure

52
Q

How should you modify defibrillation of children if possible?

A

Use pediatric pads

53
Q

How should you modify defibrillation of infants if possible?

A

Use manual defibrillator if available, if not use AED with pediatric dose attenuator, if not use adult pads

First Responder (16 decks)

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