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EMRG 1230 > Chest Pain and Injury > Flashcards

Chest Pain and Injury Flashcards

1
Q

Heart disease

A

includes congenital defects, hypertensive heart disease, angina, heart attacks, arrhythmias

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2
Q

Antherosclerosis

A

Thickening of the artery wall from accumulation of fatty material

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3
Q

Angina

A

Occurs when there is deficiency of O2 for heart, causes chest pain

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4
Q

Stable angina

A

Follows same pattern for pt, typically lasts less than 5mins, usually relieved by rest

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5
Q

Unstable angina

A

Doesn’t follow same pattern, not as easily relived by rest

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6
Q

Angina treatment

A

Full assessment, O2, ASA, 12 lead, nitro, IV

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7
Q

Acute coronary syndrome (ACS)

A

Results from prolonged cardiac disorder causing myocardial ischemia or infarction
STEMI, NSTEMI or unstable angina

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8
Q

AMI s/s

A

Chest pain, nausea, jaw/neck pain, SOB, drop in CO, pallor, diaphoresis,

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9
Q

ASA

A

Platelets aggregating inhibitor, orally administer, 160mg, one dose

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10
Q

Nitro

A

Vasodilation, reduced after load, symptom relief, not life saving

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11
Q

-lol ending

A

Beta blocker - decrease rate and strength of contraction for HTN, angina, heart failure

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12
Q

-ine ending

A

Calcium channel blocker - block of calcium ions into cardiac muscle, prevents spasms

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13
Q

-ide ending

A

Diuretics - can be used for HTN

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14
Q

-pril

A

Anti HTN

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15
Q

Chest pain directive considerations

A

ACS or MI
DAA
Pneumothorax
Pulmonary embolism
Pericarditis

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16
Q

Chest pain directive assess chest for

A

Subcutaneous emphysema
Accessory muscle use
Urticaria
In drawing
Shape
Symmetry
Tenderness

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17
Q

STEMI bypass protocol indications

A

Over 18 years old
Chest pain
Time of onset less than 12 hours
12 lead indicating STEMI

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18
Q

STEMi bypass contraindications

A

CTAS 1
LBBB
Transport is more than 60mins
Patient is requiring PCP diversion

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19
Q

Dissecting aortic aneurysm

A

Middle layer of aorta tears and blood flows between middle and outer layer until outer tears

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20
Q

Pericardium

A

Sac consists of visceral and parietal layer

21
Q

Flail chest

A

Two or more adjacent ribs are broken creating free floating area, creating paradoxical movement

22
Q

Pneumothorax

A

Chest wall allows air to enter thoracic space creating pressure. Bubbling at sight

23
Q

Tension pneumothorax

A

Air accumulation in intrapleural space, one way valve, JVD, Trach deviation

24
Q

Hemothorax

A

Blood filling thoracic cavity, lack of JVD, hemoptysis, dull to percussion

25
Q

Pulmonary contusion

A

Capillary damage results in reduced area for gas exchange

26
Q

Pericardial tamponade

A

Excessive fluid in pericardial sac, reduced stroke volume

27
Q

Becks triad for pericardial tamponade

A

Muffled heart tones, Hypotension, JVD

28
Q

Traumatic asphyxia

A

Sudden forceful impact in thoracic cavity that causes pressure to be translated up

29
Q

Commotio cordis

A

Immediate cardiac arrest caused by blunt force trauma during depolarization period

30
Q

Chronic heart failure

A

Occurs when heart is unable to pump to meet bodies metabolic needs

31
Q

Left Sided Heart Failure

A

Left ventricle is unable to pump enough blood sufficiently from pulmonary vessels
As result pulmonary veins become engorged with blood causing ACPE

32
Q

Causes LSHF

A

Left ventricle was damaged from MI
Chronic HTN

33
Q

Results of LSHF

A

Fluid in lungs
SOB
Crackles in lungs
Pt may cough up fluid

34
Q

How does body’s compensation mechanisms affect heart failure

A

Panic and SOB trigger SNS causing BP to rise and tachycardia causing heart to work harder

35
Q

Management of LSHF

A

O2
Decreasing workload on heart
Reducing preload so LV is less burdened
12 lead
Iv

36
Q

CPAP

A

Continuous positive airway pressure
Holds alveoli open for gas exchange to happen normally
Causes slight decrease in BP

37
Q

CPAP starting setting

A

5cmH2O

38
Q

Paroxysmal nocturnal dyspnea

A

Severe SOB and coughing that happens at night

39
Q

Conditions for ASA

A

Greater than 18 and able to swallow

40
Q

Conditions for nitro in cardiac ischemia

A

Greater than 18 years, HR 60-159, Normotension, prior history of nitro or IV

41
Q

Contraindications for ASA

A

Active bleeding, CVA in past 24 hours, if asthmatic no prior use of ASA

42
Q

Contraindications of Nitro

A

SBP drops by one third initial value after nitro administered, right ventricular MI, phosphodiesterase inhibitors in last 48 hours

43
Q

ASA Tx

A

PO
160mg
1 dose

44
Q

Nitro use for NO STEMI

A

SBP greater than 100
SL
0.3 or 0.4mg
Every 5 mins
6 doses

45
Q

Nitro Tx for a STEMI

A

SBP greater than 100
SL
0.3-0.4mg
every 5 mins
Max of 3

46
Q

How long should it take to get first 12 lead

A

Less than 10 mins

47
Q

nitro Tx for ACPE if BP is between 100-140

A

IV Yes
SL
0.3mg
Every 5 mins
6 doses

48
Q

Nitro Tx for ACPE with no IV and BP greater than 140

A

SL
0.3mg
Every 4 mins
6 doses

49
Q

Nitro Tx WITH IV and BP greater than 140

A

0.6mg
Every 5 mins
Max of 6 doses

EMRG 1230 (15 decks)

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