Health And Safety Protocols Flashcards
What is the risk of a cardiac event during supervised exercise in cardiovascular rehabilitation?
Extremely low
However, physical exertion may trigger an acute myocardial infarction or sudden cardiac death in clients with established coronary artery disease.
Why is it important for exercise instructors to know basic first aid?
To manage potential cardiac emergencies, including cardiac arrest
Early defibrillation significantly increases the chance of survival.
What is the primary cause of most cardiac arrests?
Ventricular fibrillation
This condition requires direct current defibrillation for resolution.
What type of defibrillator is commonly used in long-term exercise classes?
Automated external defibrillator (AED)
Shock-advisory defibrillators are also included in this category.
What essential training should staff supervising patients in exercise programs have?
Training in CPR to at least the level of Basic Life Support (BLS) and AED use
This training must be maintained to ensure competency.
What is the minimum standard for immediate response to cardiac arrest in any setting?
- Prompt recognition of cardiorespiratory arrest
- Immediate initiation of CPR
- Summoning appropriate help without delay
- Providing clear directions to the emergency response team
- Availability and application of a defibrillator without delay
- Attempting defibrillation within 3 minutes of collapse
These steps are critical for effective emergency response.
What should all cardiovascular prevention and rehabilitation programmes have in place regarding cardiorespiratory arrest?
A clear policy defining procedures to follow in response to cardiorespiratory arrest
All staff should be familiar with and know how to implement these procedures.
What should cardiovascular prevention and rehabilitation programme staff be aware of regarding patients’ emergency care plans?
Plans regarding whether or not to attempt CPR
These plans should be readily available to ensure person-centred care.
True or False: All staff involved in structured exercise must have received training in CPR.
True
This is essential for ensuring safety during exercise programs.
Fill in the blank: The majority of cardiac arrests are attributable to _______.
ventricular fibrillation
What should be accessible without delay whenever patients attend a cardiovascular prevention and rehabilitation programme?
Essential Clinical Health and Safety Protocols
These protocols ensure patient safety and effective emergency responses.
What is promoted among patients and their families in emergency care planning?
Conversations that underpin the development of an emergency care plan
Important for ensuring understanding and preparedness.
What must cardiovascular prevention and rehabilitation programmes based in hospitals ensure?
Rapid access to the resuscitation team
This includes trained individuals with current competency in Advanced Life Support (ALS).
What is required for cardiovascular prevention and rehabilitation programmes without immediate access to a resuscitation team?
Prompt response via a 999 emergency protocol
This ensures quick medical assistance when needed.
What should be identified prior to a cardiovascular prevention and rehabilitation programme?
The venue with the local emergency services
This facilitates quicker emergency response.
What equipment should be readily available at the cardiovascular prevention and rehabilitation programme venue?
Immediate on-site access to an AED
Automated External Defibrillators are crucial for emergency cardiac situations.
What must each patient undergo before entering a cardiovascular prevention and rehabilitation programme?
An individual risk assessment
This helps determine safe exercise intensity and resource allocation.
What factors determine the appropriate exercise intensity for patients?
Risk classification
This is based on the individual risk assessment conducted prior to participation.
What should be informed to the local ambulance service regarding cardiovascular rehabilitation classes?
Days, times, and site of the classes
This ensures preparedness for potential emergencies.
What should clients bring to each class related to their medication?
GTN spray (or tablets)
Clients need to notify if they have used it more frequently.
What should be avoided when dealing with clients’ medication during classes?
Administering GTN to a client yourself
Clients should manage their own medication.
What should the action plan for incidents include?
Recommendations for untoward incidents/scenarios
This ensures preparedness for emergencies during exercise sessions.
What is important to remember when contacting a client’s GP?
Keep communication professional, short, and to the point
State facts without suggesting a diagnosis.
What should not be allowed during exercise sessions as per absolute contraindications?
Clients with specific scenarios outlined in Table 11.1
These scenarios must be assessed before every exercise session.
What is unstable angina?
A condition characterized by chest pain due to reduced blood flow to the heart that is unpredictable and can occur at rest
It is often a sign of an impending heart attack.
What defines unstable or acute heart failure?
A rapid deterioration in heart function leading to symptoms such as shortness of breath and fluid retention
This condition requires immediate medical attention.
What is unstable diabetes?
A situation where blood glucose levels are poorly controlled, leading to extreme highs or lows
This can result in serious health complications.
What are new or uncontrolled arrhythmias?
Irregular heartbeats that are either newly diagnosed or not adequately managed
These can increase the risk of stroke or heart failure.
What is resting tachycardia?
A condition where the heart rate exceeds 100 beats per minute while at rest
This can indicate underlying health issues.
What blood pressure defines hypertension in this context?
> 180/100 mmHg
This level of hypertension is concerning and may require medical intervention.
What does symptomatic hypotension refer to?
Low blood pressure that leads to symptoms such as dizziness or fainting
This condition can be dangerous if not addressed.
What is a febrile illness?
An illness characterized by fever
It can indicate an underlying infection or other serious conditions.
What key signs should be looked for during assessment?
Signs of pitting oedema and dyspnoea
These signs indicate fluid retention and difficulty breathing, respectively.
What should clients be aware of regarding blood sugar levels?
They should be aware of uncontrolled blood sugar levels
This can lead to serious complications.
What should clients report regarding their pulse?
Any irregular pulse or new bradycardia
This can indicate a serious underlying condition.
What should be done after taking a pulse?
Retake the pulse after 5 minutes of seated rest
This helps to confirm a consistent heart rate.
What is essential when assessing symptoms?
Only consider symptoms relevant if they are symptomatic, e.g., dizzy
This ensures that only significant issues are addressed.
What should clients report regarding illnesses?
Any flu-like illness, fever, or colds
These can complicate other underlying health issues.
What is the significance of these clinical health protocols?
They indicate the risk of provoking ischaemia or myocardial infarction (MI)
This necessitates a GP review.
What should be done if a patient is acute and symptomatic?
Refer to Accident & Emergency (A&E)
Immediate action is crucial in these cases.
What are the risks associated with unstable diabetes?
Risk of hypo or hyperglycaemia
Both conditions can have serious health implications.
What diagnostic tool is needed for serious arrhythmias?
An ECG (Electrocardiogram)
This helps in assessing heart rhythm and function.
What is the risk associated with increased myocardial workload?
The patient may faint
This is due to the heart’s inability to cope with the increased demand.
What is indicated by increased heart rate?
Increased myocardial workload
This can lead to fatigue and other cardiovascular issues.
What are the signs and symptoms of stable angina?
Tightness/burning/dull sensation in chest, shoulders/arms, jaw/teeth, throat, abdomen, dyspnoea. Predictable in pattern, frequency and severity. Reproducible at same workloads.
What characterizes unstable angina?
New onset < 1 month, angina at rest, no pattern or a change in pattern of frequency and severity, occurs at lower level of exertion.
What is the first action to take when a patient experiences stable angina during exercise?
Stop exercise and sit patient down on the floor, back against a wall, knees up to chest.
What should be suggested if a stable angina patient has no relief after stopping exercise?
Suggest taking a dose of GTN if patient uses it. Repeat at 5-minute intervals up to a total of 2 doses.
What action should be taken if there is no relief from angina symptoms after administering GTN?
Dial 999.
What should be done if the symptoms of stable angina are relieved?
Rest for 5 minutes and re-warm before resuming exercise if they want to and you are happy they have recovered.
What is an absolute contraindication to exercise?
Unstable angina.
What should you do to reassure other class members during an angina attack?
Reassure other class members.
What should you never allow during an angina attack?
Allow exercise.
What should you inform ambulance control if a patient has chest pain?
Tell them there is a cardiac patient with chest pain.
When is it safe to resume exercise after an angina episode?
If the patient has fully recovered and feels fine, but after a re-warm as the heart rate will have dropped.
What is one of the conditions in acute coronary syndromes?
Unstable angina.
How might GTN usage change in patients with unstable angina?
They may be using GTN more often and it may be less effective, needing more doses to relieve symptoms.
Fill in the blank: Stable angina symptoms are ________ at the same workload.
reproducible
True or False: Unstable angina symptoms are predictable in pattern.
False.
What is the primary symptom of myocardial infarction?
Central chest pain, crushing, tight, or gripping pain lasting >10mins that is not relieved by rest or GTN.
List possible additional symptoms of myocardial infarction.
- Pale
- Cold
- Clammy
- Nausea/vomiting
- Agitated, anxious
- Fear of impending doom
- Increase in angina severity or frequency
- Dyspnoea on minimal exertion
- Reduced exercise capacity
- Rapid weight gain due to fluid retention
- Sudden or increased pitting oedema in both ankles
What action should be taken if a patient shows severe distress during a suspected myocardial infarction?
Call 999.
If there is no relief after 2 doses of GTN at 5-minute intervals, what should be done?
Call 999 and state ‘suspected MI’.
What questions should be asked to assess a patient’s condition during a suspected MI?
- Find out the frequency and severity of symptoms
- Have they noticed any change in pattern of angina?
What considerations should be taken regarding the patient’s GTN usage?
Does GTN still work as well, using it more often or needing more doses?
What should be done if there is no logical explanation for the patient’s symptoms?
Seek advice and refer back to GP.
What is important to do if a patient has not seen their GP?
Ask them to make an appointment.
What should be prepared in case of a cardiac emergency?
Have AED ready.
True or False: It is important to reassure other class members during a suspected MI.
True.
Fill in the blank: The reduction in LV function is associated with the ______ of CADICVD.
Progression
What are some signs of fluid retention in a patient experiencing myocardial infarction?
Rapid weight gain and sudden or increased pitting oedema in both ankles.
What should be reinforced regarding patient care?
Reinforce the importance of compliance.
What actions should be taken to manage a group during a cardiac emergency?
Take charge of the situation and be prepared to perform CPR.
What subtle changes should caregivers be observant for in clients?
Consider that you may notice subtle changes in clients before they do.
What is the heart rate considered tachycardia?
Tachycardia is defined as a heart rate of 100 bpm at rest.
What is the heart rate considered bradycardia?
Bradycardia is defined as a heart rate of less than 60 bpm.
What should be done if a client experiences an irregular heartbeat?
If new, stop exercise, check BP and refer to GP. If symptomatic, refer to A&E for investigation.
What action should be taken for hypotension if the client is dizzy or lightheaded?
Lie client down, elevate feet, retake BP. If remains low, do not exercise and refer to GP.
What is the recommended action if a client’s blood pressure is 180/100?
Do not exercise and refer to GP.
What should be done if a client has hypoglycaemia or hyperglycaemia?
Refer to British Diabetic Association Guidelines for specific actions.
What is the protocol for bradycardia if the heart rate is normal for the individual?
If normal for them and no symptoms, no action is needed.
What is the recommended action if tachycardia persists above 100 bpm?
Do not exercise and refer to GP.
What should be monitored for individuals with a known arrhythmia?
Ensure heart rate is within normal limits.
What does the action plan require for fast uncontrolled AF?
Need to exclude fast uncontrolled AF.
What are some possible causes of hypertension that requires further investigation?
Overmedicating or heart block requiring pacemaker.
What is important to know about a client’s normal health parameters?
Know what is normal for the individual and their normal BP range.
What should be done if a client experiences symptoms during exercise?
Stop exercise if dizzy or lightheaded.
Fill in the blank: If a client is asymptomatic with a new irregular heartbeat, refer to _______.
GP for investigation.
True or False: If a client has a normal blood pressure, they are always okay to exercise.
False.
What should be done after a client sits and rests for 5 minutes?
Retake blood pressure.
What is the action for symptomatic hypotension?
Lie client down, elevate feet, retake BP.
What is a clinical reason for referring clients back to their GP related to functional capacity?
Deteriorating functional capacity
This indicates a decline in the patient’s ability to perform daily activities.
What symptom worsening may necessitate a referral to a GP?
Worsening of angina or development of unstable angina
Unstable angina is a medical emergency that requires immediate attention.
List symptoms that could indicate a need for GP referral.
- Suspected arrhythmia
- Excessive breathlessness
- Pitting oedema
- Any further cardiac event
These symptoms can signify serious underlying health issues.
What should be checked if a patient shows signs of worsening symptoms?
Check compliance with prescribed exercise regime and medication changes
Ensuring the patient follows their treatment plan is crucial for their health.
Why is it essential to check the reason for a patient’s absence from class?
Absence may indicate stopped home programme or lost fitness
Regular attendance is important for monitoring progress.
What might a patient stopping their home programme suggest?
They may have stopped taking some medications or changed dosages
Medication adherence is critical for managing chronic conditions.
What does a patient’s absence potentially indicate regarding CAD/CVD?
It may indicate progression of CAD/CVD or reduction in LV function
CAD/CVD refers to coronary artery disease/cardiovascular disease.
What might a further cardiac event require for the patient?
Need to go back through Phase II
Phase II often refers to a structured rehabilitation program.
