ECare - Chapter 18 (Cardiac Emergencies)

Question 1

acute coronary syndrome (ACS) aka cardiac compromise

Answer 1

blanket term for symptoms relating to lack of oxygen (ischemia) in the heart muscle

Question 2

symptom: chest pain/pressure (crushing, dull, heavy, squeezing)

Answer 2

most likely: heart problem

Question 3

pain of heart problems usually radiate down the…

Answer 3

arms, upper abdomen, or jawn

Question 4

common presentation of heart problems

Answer 4

chest pain/pressure with dyspnea and history of heart problems

Question 5

symptoms of ACS

Answer 5

1. chest pain/pressure
2. epigastric pain/pressure
3. difficulty breathing
4. palpitations
5. sweat, nausea, or vomit
6. a anxiety
7. irregular pulse or BP

Question 6

dyspnea

Answer 6

shortness of breath; labored/difficult breathing

Question 7

Providing care for someone with suspected ACS

Answer 7

1. place patient in comfortable position
2. give oxygen until levels are at 94% if necessary
3. transport asap if no heart history, has history but no nitro, or systolic BP is less than 90-100
4. If equipped, use ECG to check for STEMI
5. give nitro if meet criteria; give second if needed
6. give aspirin if criteria met

Question 8

when to give nitro to patient with cardiac problems

Answer 8

1. chest pain
2. history of cardiac problems
3. has prescription from doc
4. has nitro with patient
5. systole BP is above 90-100
6. no ED drugs
7. medical direction gives thumbs up

give repeat in 5 minutes if no relief, systolic BP is still above 90-100, and medical direction gives thumbs up

Question 9

when to give aspirin to patient with cardiac problem

Answer 9

1. chest pain
2. no allergies to aspirin
3. no history of asthma
4. not taking clot-preventing meds
5. no contraindications
6. can swallow
7. medical direction gives thumbs up

Question 10

coronary artery disease

Answer 10

diseases affecting the arteries of the heart

Question 11

heart muscle receives oxygen from

Answer 11

blood pumping through coronary arteries

Question 12

two common sites of an aneurysm

Answer 12

aorta and brain

Question 13

consequence of artery rupture from an aneurysm

Answer 13

shock

Question 14

myocardial infarction

Answer 14

mechanism pump failure

Question 15

electrical malfunctions of the heart

Answer 15

dysrhythmia

Question 16

angina pectoris

Answer 16

chest pain due to lack of blood supply to the heart; pain usually goes away after stopping exertion

Question 17

acute myocardial infarction

Answer 17

portion of myocardium dies due to lack of oxygen

Question 18

medications for patients with AMI

Answer 18

fibronolytics (dissolve clot), aspirin (preventative measure), beta blocker (slows heart and beats less)

Question 19

congestive heart failure

Answer 19

failure of heart to pump efficiently, leading to excessive blood/fluids in the lungs and/or body

Question 20

edema

Answer 20

swelling from fluid build up

Question 21

progression of congestive heart failure

Answer 21

1. AMI; myocardium in left ventricle dies
2. blood backs up to pulmonary circulation and then the lungs (SOB or dyspnea occurs)
3. left failure failure and eventually right heart failure

Question 22

pulmonary edema

Answer 22

accumulation of fluid in the lungs

Question 23

symptoms of CHF

Answer 23

tachycardia
dyspnea
normal/high BP
cyanosis
diaphoresis
pulmonary edema 
anxiety/confusion due to hypoxia
pedal edema
engorged pulsating neck veins
enlarged liver/spleen

Question 24

chain of survival for cardiac arrest paitents

Answer 24

1. immediate recognition and activation
2. early CPR
3. rapid defibrillation
4. effective advance life support
5. integrated post-cardiac arrest care

Question 25

when is CPR not useful?

Answer 25

if defibrillation arrives within 2 minutes

Question 26

intervention to reduce brain damage in resuscitated patients

Answer 26

controlled hypothermia

Question 27

ventricular fibillation

Answer 27

heart’s electrical impulses are disorganizes; heart muscle can’t contract normally

Question 28

ventricular tachycardia

Answer 28

heartbeat is very fast, if fast enough it wont allow heart’s chambers to fill with enough blood between beats to produce sufficient blood flow

Question 29

pulseless electrical activity

Answer 29

heart’s electrical rhythm remains normal, but mechanical pumping activity fails to follow electrical activity; causing cardiac arrest

Question 30

asystole

Answer 30

heart has ceased generating electrical impulses (flatline)

Question 31

when to use ABC vs. CAB

Answer 31

ABC: signs of life
CAB: cardiac arrest

Question 32

contradictions of using a defibrillator

Answer 32

cardiac arrest due to trauma

Question 33

patient has an LVAD

Answer 33

will not have pulse, rely on consciousness and breathing of patient. do not do CPR

Question 34

when to stop resuscitation efforts

Answer 34

1. spontaneous circulation occurs (with or without breathing)
2. trained rescuer takes over
3. turn care of patient to higher level
4. too tired
5. no resuscitation order from physician

termination criteria: arrest not witnessed, no pulse after 3 rounds of CPR, AED did not detect rhythm to shock