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Cardiac Emergency > Second PP > Flashcards

Second PP Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

what is the cardio vascular system?

A

made up of the heart and the blood vessels, circulation of blood into the right atrium to the right ventricle out to the lungs back into the left atrium to the left ventricle out through the body.

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2
Q

What is the Anatomy & Physiology of the Cardiovascular System?

A

heart, arteries & arterioles, veins & venules, capillaries, and blood, Conductive System – Myocardium
* Muscle & Heart
– Contract & Conduct – Produces Electrical
Impulses
* Only Muscle Able to
Produce it’s Own Electrical Stimulation

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3
Q

Explain how the Atrium works

A

Right-Receives Blood from Lungs. Left- Receives Blood from Body

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4
Q

Explain how the Ventricle works

A

Pumps to the lungs and to the body

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5
Q

What does Asystole Mean

A

No electrical activity

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6
Q

What is the job of the pulmonary artery?

A

Pulmonary Artery
* From Right Ventricle, Carries O2 Poor Blood

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7
Q

What is the carotid?

A

Carotids
* Supplies Head & Neck

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8
Q

What is the Femoral artery?

A

Femoral
* Supply Legs, Palpated in Groin

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9
Q

What does the Radial Artery apply to?

A

Lower Arm, Follows Radius, Thumb Side

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10
Q

What does the4 Brachial Artery apply to?

A

Upper Arm, Follows Humerus Between Bicep & Tricep Muscles, Used For BP

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11
Q

What does the Posterior Tibal refer to?

A

Posterior Medial Malleolus – Back, Inside Ankle

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12
Q

Where is the Dorsalis Pedis located?

A

Anterior Foot

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13
Q

What is the job of your veins?

A

-Carries Blood Back to the Heart – Pulmonary Vein
* Carries O2 Rich Blood From Lungs to Left Atrium

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14
Q

What is the job of the Venae Cava?

A
  • Superior & Inferior
  • From Body to Right Atrium
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15
Q

What are the red blood cells?

A

-Oxygen to Organs
– CO2 from Organs
– Gives Color

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16
Q

what are the white blood cells responsible for?

A

– Fights Infection

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17
Q

what is the job of the plasma?

A

Fluid carries blood

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18
Q

What are Platelets?

A

Clotting

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19
Q

What are Peripheral Pulses?

A

– Radial
– Brachial
– Posterior Tibial – Dorsalis Pedis

20
Q

Central Pulses?

A

– Carotid
– Femoral

21
Q

What is Systolic blood pressure?

A
  • Pressure Exerted on Walls of Artery When Left Ventricle Contracts
22
Q

What is Diastolic blood pressure?

A
  • Pressure Exerted on Walls of Artery When Left Ventricle Relaxes
23
Q

what does ACS stand for?

A

Acute Coronary Syndrome

24
Q

What is ACS?

A

– Catch All Phrase
– Describes any problem of the heart when it does
not receive enough oxygen

25
Q

What is Coronary Artery Disease (CAD)

A

– Arteries are Narrowed or Blocked
* Reduced Blood Flow
* Reduced O2 to Heart Muscle
– Fatty Deposits Form Plaque
– Calcium and Plaque Causes Hardening
– Thrombus May Form – Blood Clot
– Thrombus May Break Off and Travel - Embolism

26
Q

What causes cardiovascular Compromise-Atherosclerosis?

A

Hardening of the Arteries Build-up of Calcium and Plaque

27
Q

What are the risk factors for CAD?

A

– Obesity
– Lack of Exercise
– Elevated Cholesterol and Triglycerides – Cigarette Smoking

28
Q

Physiology of Pulse

A

– Left Ventricle
Contracts
– Systolic BP
– Pulse Palpated Where
Artery is Close to Skin Surface

29
Q

Inadequate circulation, profound depression of the vital processes, what are they symptoms and signs?

A

– Pale, Cyanotic, Cool Clammy Skin, Rapid Weak Pulse, Rapid Shallow Breathing, Restlessness, Anxiety, Mental Dullness, Nausea, Vomiting, Reduction in Blood Volume, Subnormal Temperature, Low or Decreasing BP

30
Q

CONGESTIVE HEART FAILURE – CHF

A
  • Poor Pump That Backs-up Fluid
  • Right Sided Failure – JVD
    – Unexplained Weight Gain – Urinary Output (Night)
  • Left Sided Failure
  • Lungs / Breathing - Dependent Edema
  • Sleepless
31
Q

Symptoms of CONGESTIVE HEART FAILURE – CHF

A
  • Anxiety
  • Confusion
  • Increased Respiratory Rate * Dyspnea
  • Diff. Breathing While Flat – Pillows???
  • Distended Neck Veins
  • Pink Sputum
  • Rapid Heart Rate
  • Normal to High Blood Pressure
  • Abdominal Distention
  • Edema of the Lower Extremities
32
Q

What is PULMONARY EDEMA

A
  • Fluid Backing Up In the Lungs * Usually Starts In the Bases
  • Gradually Fills Lungs
  • The Patient Is Drowning
33
Q

What are CHF medication and its complications ?

A

– Digoxin, Lanoxin (Cardiac Glycosides)
* Actions – Slows Heart Rate, Increases Filling Volume & Contraction, Greater Velocity
– “Pril’s”, Vasotec, Prinivil (ACE Inhibitors) * BP Regulation
– Lasix, Furosemide, Bumex (Diuretics) * Removes Salt – Water Follows Salt

34
Q

What are the Signs & Symptoms of Cardiac Chest Pain?

A

Chest Pain, Dull, Squeezing, Tight, Heavy, Pressure
* Commonly Radiates – Left Arm, Neck, Jaw, Upper Back
* Sudden Onset of Sweating
* Difficulty Breathing
Anxiety, Irritability, Impending Doom * Epigastric Pain, Nausea, Vomiting
* Palpitations / Fluttering
* Abnormal Pulse or BP
– Tachycardia (Above 100 Beats per Minute) – Bradycardia (Below 60 Beats per Minute)

35
Q

Assessing Cardiac Compromise

A

No history of cardiac problems, OR
* History of cardiac problems but no nitroglycerin,
OR
* Systolic blood pressure is <100

36
Q

Assessing Cardiac Compromise, transport decision

A

If available, transport patient to hospitals that have:
– “Clot-buster” capabilities
– Ability to perform angioplasty
* Local protocols will provide guidance.

37
Q

What falls under emergency care?

A

If Unresponsive & Pulse is Absent – Start CPR, Use AED
– Use Pediatric Pads On Small Children
* Responsive with Known Cardiac History – Perform Initial Assessment
– Perform Focused History & Physical Exam – Place Patient in Position of Comfort

38
Q

Questions to ask when determining emergency care

A
  • Chest Pain / Discomfort – Treat as Cardiac
    – Apply O2
    – Assess Baseline Vitals
  • Questions
    – O, P, Q, R, S, T – S, A, M, P, L, E
  • Prescribed NTG ?
39
Q

When to use NTG?

A

BP Must Be Above 100 Systolic to Use NTG!!!
– May Assist With 1 Dose
– Reassess Patient and Vital Signs
* BP Must Remain Above 100 Systolic to Continue w/ NTG
– Contact Medical Command
– Normal Dose of NTG is 1 Every 3-5 Minutes,
Maximum of 3 Tablets or Sprays

40
Q

What are the medication forms that an EMT can assist in NTG?

A

-tablet
-spray=1 spray=1 tablet

41
Q

What are the forms of medication that EMT can not assist is NTG?

A

-patch
-ointment/paste

42
Q

Contradictions in NTG?

A

Hypotension – BP 100 mmHg Systolic
– Head Injury
– Infants & Children
– Patient Has Already Taken Maximum Dose – Men Taking Viagra or Other E.D. Meds
* Max Dose
– 3 Tablets or Sprays

43
Q

What does NTG do?

A

– Relaxes / Dilates Coronary Arteries
* Perhaps Allowing More Blood Past Blockage – Decreases the Workload of Heart
– Dilates All Blood Vessels

44
Q

What are the side effects of NTG?

A

Hypotension
– Headache
– Pulse Rate Changes

45
Q

What is the Maximum dosage of NTG?

A

THREE DOSES

46
Q

When is chest pain protocol applied?

A

only when NTG is given

47
Q

cardiac related issues

A

Pacemaker
– Regulates Heart Rate
– Usually Near a Clavicle
– If It Malfunctions Pt May Have Rate/Pressure Problem
* Defibrillator
– Chest or Abdomen
– Most are Pacemaker/Defibrillator Combo – Low Energy No Danger to You
* Cardiac Bypass Surgery
Ventricular Assist Device
– Mechanical Device That Pumps Blood for the Heart – Located in the Chest – External Power Supply

Cardiac Emergency (3 decks)

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