1. Emergency Nursing Assessment Cardiac Exam

2. OLDCART Onset Location Duration Characteristics Aggravating factors
Relieving factors
Treatments

3. Emergent conditions
Cardiac
Pulmonary
GI/GU
Neuro
Trauma
Sepsis

4. Cardiac Assessment

5. Peripheral Vascular Exam

6. Peripheral Vascular Exam

7. Chest pain Arrhythmia Cardiac STEMI NSTEMI CHF Unstable angina
Aneurysm PE
PNA
Arrhythmia VF VT
Torsades
SVT
A-Fib/flutter
Bradycardia
Cardiac output = stroke volume x heart rate

8. Normal Sinus Rhythm

9. Bradycardia – SA node infarct

11. Localization of MI – S.A.L.I. (septal/anterior/lateral/inferior)

12. Septal MI (V1 and V2)

13. Anterior wall MI (V3 and V4)

14. Lateral wall MI (I, aVL, V5 and V6)

15. Inferior wall MI (II, III, aVF)

17. ST depression and T-Wave changes

18. T-Wave changes

19. Life Threatening Arrhythmias

20. Congestive Heart Failure
Systolic dysfunction, in which there is impaired cardiac contractile function.
Diastolic dysfunction, in which there is abnormal cardiac relaxation, stiffness or filling.
Systolic HF (SHF) is characterized by abnormalities in systolic function (ie, reduced left ventricular ejection fraction [LVEF]) usually with progressive chamber dilation and eccentric remodeling. Because the dominant abnormality is in systolic function, this syndrome is called SHF. This syndrome is also called HF with a reduced LVEF (HFrEF). SHF has been defined by a variety of LVEF partition values ranging from less than 35 to 50 percent. Our preference is to define SHF by an LVEF <50 percent.
Diastolic HF (DHF) is characterized by a normal LVEF, normal LV end-diastolic volume, and abnormal diastolic function, usually with concentric remodeling or hypertrophy [2,4-8]. The dominant abnormality resides in diastole. However, in clinical practice, the diagnosis of DHF is often one of exclusion based on the finding of a normal or near normal (or “preserved”) LVEF. As a result, this syndrome is also called “HF with preserved EF” (HFpEF). As discussed below, DHF may be best defined as HF with LVEF >50 percent and evidence of diastolic dysfunction (UptoDate2013)

23. GI Assessment

24. GU Assessment