1. Chapter 5
Cardiac Emergencies

2. Heart Disease
Cardiovascular disease – an abnormal condition that affects the heart and blood vessels.
Coronary heart disease – occurs when the arteries that supply blood to the heart muscle harden and narrow.

3. Common Causes of Heart Disease
Age
Gender
Heredity
Stress
Diabetes
Smoking 
Alcohol Consumption
High blood pressure
High blood cholesterol
Being overweight or obese
Physical inactivity

4. Controlling Risk Factors
Changing One’s Lifestyle
Stop smoking/ Do not start smoking
Change diet
Avoid saturated fats and cholesterol
Exercise regularly

5. Heart Attack
Myocardial Infarction - Death of or damage to part of the heart muscle due to an insufficient blood supply.
The term "heart attack" refers to death of heart muscle tissue due to the loss of blood supply, not necessarily resulting in a cardiac arrest or the death of the heart attack victim.

6. Signs & Symptoms of a Heart Attack
Chest Pain
Chest, shoulder, arm, jaw
Last longer than 3 – 5 minutes or goes away and comes back
Difficulty breathing
Short of breath
Breathes faster than normal
Skin Appearance
Skin may be moist or sweating profusely
Skin may appear pale or ashen
Men vs. Women

7. When to call 9-1-1 Victims often deny signals are serious
Do not let this influence your decision to call 9-1-1
Most people who die of a heart attach die within 2 hours of the first signal

8. Giving Aspirin to Lessen Heart Attack Damage -
If the person is able to take medicine by mouth ask –
Are you allergic to aspirin
Do you have a stomach ulcer or stomach disease?
Are you taking any blood thinners, such as warfarin?
Have you ever been told by a doctor to avoid taking aspirin?

9. Giving Aspirin to Lessen Heart Attack Damage -
If the person answers NO to all of these questions, you may offer him or her two chewable (81 mg) baby aspirins or one 5 grain (325 mg)adult aspirin with a small amount of water.
You may offer these doses of aspirin if the person regains consciousness while you are giving care and is able to take the apirin by mouth.

10. Cardiac Arrest
Cardiac arrest is the sudden, abrupt loss of heart function.
Most cardiac arrests occur when the electrical impulses in the diseased heart become rapid (ventricular tachycardia) or chaotic (ventricular fibrillation) or both.
This irregular heart rhythm (arrhythmia) causes the heart to suddenly stop beating.
The term "massive heart attack" is often wrongly used in the media to describe sudden death from cardiac arrest.

11. Cardiac Chain of Survival For each minute CPR and defibrillation are delayed, the chance of survival is reduced by about 10 percent.
Early recognition and early access
Early CPR
Early defibrillation
Early advanced medical care

12. Cardiopulmonary Resuscitation
CPR is a method that combines chest compressions and rescue breathing for a victim who is not breathing and has no pulse.
This technique provides oxygenated blood to vital organs until advanced care arrives.
Given together, rescue breaths and compressions help to take over for the heart and lungs.

13. CPR Skill Component Adult Child Infant Hand Position
Two hands in center of chest
Two or three fingers in center of chest (just below nipple line)
Chest Compressions
Rescue Breaths
At least 2 inches
Until chest clearly rises (about 1 second)
About 1 ½ inches
Cycle
30 compressions
2 breaths
Rate
30 compressions in about 18 seconds
(at least 100 compressions per minutes)

15. If Two Responders Are Available
If the 1st responder is tired and needs help, they should tell the second responder to take over.
The 2nd responder should immediately resume CPR, starting with chest compressions.

16. When to stop CPR - The person shows signs of life
An AED becomes available and is ready to use
Another trained responder arrives and takes over
You are too exhausted to continue
The scene becomes unsafe

17. Continuous Chest Compressions (Hands Only CPR)
If you are unable or unwilling to perform full CPR give continuous chest compressions after calling

18. Advance Directives Instructions that describe a person’s wishes about medical treatment.
Adults who are admitted to a health care facility have the right to make fundamental choices about their own care.
Two examples of written directives are
Living Wills
Durable Powers of Attorney
Do Not Resuscitate or Do Not Attempt Resuscitation (DNR/DNAR)

19. Advance Directives