Unit 8 - Circulatory Emergencies Flashcards
What are cardiovascular diseases
diseases and injuries of the heart and blood vessels
stroke
form of CVD
- disruption of blood flow to to brain
- 1 person every 7 min die
- 10-15% survive; most happen outside hospital
controllable CVD factors
hypertension (high BP)
high cholesterol
diabetes
heart disease
over weight
alcohol, smoking
lack of exercise
stress
uncontrollable CVD factors
age
gender
family history
ethnicity
diabetes
history of stroke or TIA
cardiovascular disease
blockage of coronary artery depriving an area of myocardium of oxygenated blood, rich blood producing chest pain.
complete blockage lead to myocardial infarction (death of the heart/ heart attack) due to lack of O2 blood
hypertension
- Known as “silent killer”
high BP > blocked arteries > brain hemorrhage >
stroke > brain damage
atherosclerosis
inner arterial linings are damaged as fatty substances, cholesterol, calcium, etc make plaque build up
- Contributing factors:
High BP, high levels of Cholesterol and triglycerides in blood, and smoking
angina
(angina pectoris)
1+ coronary artery blocked > not enough O2
blood in heart> chest pain
-PA, stress, hot/cold temps, alcohol/smoke, heavy meal
- not last >10 min if rest and take medication (nitroglycen) other wise it becomes an active MI
- can receive o2 after 10 mins
angina s/s
- pain mid chest, jaw, arms (squeezing/suffocating/burning)
- tight, pressure, squeezing in arms/chest
- moderate to severe indigestive feelings
- nausea, vomit
- pale, cool, clammy
- discomfort in neck and btwn scapula
- numb in arms/wrist/shoulder/jaw (radiating)
angina treatment
- comfortable position for patient
- assist w medicine if syst > 100 mmHg (nitroglycerin) (3 in 10 min)
- dose 2 also gets 1, 160 mg of aspirin or 1, 325mg of ASA
- O2 w NRB (if MI, NRB if >95% saturation)
-Monitor vitals, be ready to give A/R or CPR
myocardial infarction
MI / heart attack
- death of myocardial tissue when O2 supply shut off due to clot blocking coronary vessel
myocardial infarction s/s
Simular to Angina but won’t respond to meds.
- tired
- general malaise
- moist/sweaty & pale/blue skin
- pain to arm/shoulder/neck/jaw
- persistent chest pain (squeeze, pressure, tightness)
- GI discomfort
- difficult breathing
- flu like symptoms
- bend over or breathe deeper
myocardial infarction treatment
- comfortable position for patient
- assist w medicine if syst > 100 mmHg (nitroglycerin) (3 in 10 min)
- dose 2 also gets 1 aspirin (vasodilator) if Nitroglycerin is n/a
- O2 w NRB (if MI, NRB if >95% saturation)
- quickly activate EMS
congestive heart failure (CHF)
-impaired cardiac pumping
- sudden onset, ineffective breathing, respiratory arrest
- due to MI, ischemic heart disease (no 02 to heart), cardiomyopathy (heart disorder)
- LV fails, fluid backs up in circ syst > fluid build up in lungs (pulmonary edema) / body tissues
congestive heart failure s/s
- SOB
- increase HR, respiratory rate
- cyanosis
- cough up sputum (foamy, blood, tinged)
- pale, cool, clammy
- confused, panic, agitated, restless, disoriented
- high blood pressure
- wheezing
right sided heart failure
Due to:
- left side failure (CHF)
- pulmonary edema / MI / longstanding COPD
- blood back up in veins cause swelling in body (peripheral edema)
- swell in feet if sit/stand (most noticeable in lower limbs)
Transient Ischemic Attack (TIA)
(mini stroke)
- temporary interruption of blood flow to brain
- s/s similar to an ischemic stroke but come and go (for hours),
- increase risk for full stroke
thrombotic stroke
brain deprived of blood due to blood clot (thrombus) and blocks flow into brain
embolic stroke
area of brain deprived of blood due to fatty plaque/blood clot (embolism) that broke away from elsewhere in body to cause blockage
hemorrhagic stroke
Areas of hemorrhage: Subarachnoid or intracerebral
- Hemorrhage interrupts normal blood flow in brain -> “flooding” of the brain -> Death of brain cells
-20% of strokes
ischemic stroke
a type of stroke that occurs when the flow of blood to the brain is blocked
- 80% of strokes
aneurysm
weakened area in blood vessel wall that fills w blood and bulges
- due to high BP or trauma > rupture > uncontrollable bleed enter brain
arteriovenous malformation (AVM)
-genetic
- malformation of blood vessels that cause arterial walls to be weak and increase risk to hemorrhagic stroke
stroke & TIA s/s
- weakness
- trouble speaking
- confusion
- decrease LOR
- vision problems
- headache
- dizzy
FAST
F = face (drooping)
A = arms (drop one arm when elevate both)
S = speech (slurred speech)
T = time (how long symptoms? hospital?)
- require immediate medical care w/in 3 hrs
stroke & TIA treatment
- Keep patient at rest in a position found or position of comfort
- loosen tight clothing
- treat for shock
- GCS on worst side (side w effects)
- treat same as heart attack w/o meds
- oxygen via NRB
cardiac arrest
heart stop beating or beats irregularly or too weak to circulate blood
Due to:
- stroke, brain damage
- CVD
- respiratory failure
- poison, electrocution, drown, suffocate
- certain drugs
- chest trauma
- severe blood loss
clinical death
lack of heartbeat and respiration
compression fraction and off-chest time
% of total CPR time which patient is receiving compressions
- off chest time is the other time (AED analyze, breaths. etc)
-want CF to be the highest and reduce off-chest time
When can you stop CPR
- some one w equal or more training takes over
- too tired to continue
- scene is unsafe
- pulse comes back (assess ABCs)
CPR for pregnant women
put blanket/cushion under right hip to help blood flow return to heart
- Do not interrupt or delay CPR to find an object
automated external defibrillator
AED
- reads heart rythem and advises to deliver shock if needed
- success in more than 80% of time
- lose 10% success per minute delay
- right pad on chest and left pad on torso bones = cross over heart
- children get ant/post if adult sizes
- good CPR must precede &/or accompany use of AED
asystole
the absence of a electrical activity; heart is not pumping and there is no pulse
- no shock advised
ventricular fibrillation
v-fib
- chaotic discharge of electrical activity
- no pulse; deteriorate into asystole quickly
- AED will work; shock indicated
ventricular tachycardia
v-tach
- heart rate so fast it is not detectable
- may have pulse present
- AED will work; shock indicated
Pulseless Electrical Activity
aka electromechanical dissociation
- lack of palpable pulse but there is organized electrical activity
- no shock advised
AED considerations
- non-conductive surface
- dry and shave and expose chest
- scissors for bra
- remove jewelry and medicine patches within 1” of pads
- do not use in confined space
- move off and turn off O2 when analyzing and administering shocks
- Hypothermia, check pulse for 45s and deliver only 1 shock
- Drowning only get 1 shock
- wait 30-60 sec to shock if internal defib went off; place patches 1” away
