1. Chapter 15: Cardiac Emergencies

2. Objectives
Describe structure and function of the cardiovascular system (heart, blood vessels, and blood)
Describe the emergency care of patient experiencing chest pain
Management protocol for OEC

3. Blood vessels Arteries, Veins, Capillaries
Which brings blood to the heart?
Which brings blood from the heart?
Which connects them?

4. Blood Red blood cells: White blood cells: Platelets:
Carries oxygen to tissues and cells
Removes CO2 and waste
White blood cells:
Fight infection
Platelets:
Helps blood clot

5. Blood Flow Through the Heart

7.
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8. Key Terms Angina pectoris Ischemia Myocardial Infarction Pericarditis
Atherosclerosis
Hypertension
Congestive heart failure
Pulmonary edema
Aortic aneurysm
Ischemic heart disease- dec blood flow due to anaerobic metabolism produces lactic acid and CO2 accumulation in myocardium, causing pain
Infarction- death of tissue
Pericarditis: inflammation of pericardium – changes breathing andn motion
Angina- chest pain
Pulmonary edema: fluid in lungs reduces gas echange in alveoli. From fluid back up in veins bc left ventricle cant pump blood effectively
Aortic a: severe chest pain or upper back discomfort – shooting pain
Tampon- filling up of pericardial sac with blood

9. Atherosclerosis- materials built in blood vessels

10. Pericarditis vs. Pericardial tamponade
TIME
Excess fluid build up in pericardial sac
applies external pressure to the heart preventing adequate filling of the heart with blood
restricts hearts ability to pump effectively
Biggest symptom?

11. Angina Pectoris
Chest pain or discomfort caused by ischemia of myocardium Two common causes: narrowing of heart muscle spasm of coronary artery

12. Name that Arrhythmia A bradycardia B ventricular tachycardia
c. Asystole – compelte absence of heart beat due to lack of electrical activity

13. Which is Which?
A. chaotic and ineffective contraction of the ventricles that leads to cardiac arrest
B. rapid contraction of ventricles that lead to ineffective blood flow to body tissues that leads to cardiac arrest
Ventricular fibrillation
Ventricular tachycardia

14. What is the difference?
Aortic aneurysm
thromboembolism

15. Signs and Symptoms Shortness of breath Signs of inadequate perfusion
Chest pain, pressure, or discomfort (with or without radiation to back, neck, jaw, arm, wrists)
Nausea
Weakness/syncope
Dysrhythmias
Chest pain/discomfort
Often crushing or squeezing
Does not change with each breath

16. What to look out for Diaphoresis (78%) Shortness of Breath (47%)
Pain/discomfort (64%)
Nausea/vomiting (52%)
No signs or symptoms (25%)
N Eng Journal Med 1984;311:

17. Cardiogenic Shock Hypoperfusion
Caused by disorders of heart muscle, valves, conduction system
Infarction= muscle doesn’t contract
Hypoxia
Altered LOC
Rapid, shallow breathing
Restlessness and anxiousness
Pale, cool skin= cyanotic
Tachycardia/dysrhythmia
Hypotension

18. Nitroglycerin
Instruct patient to put tablet under tongue and let dissolve
May administer total of three doses at five min intervals
when cant you use:
Expiration date
Systolic lower than 100mg
Taking Viagra
Patient has already taken three doses
Patient took cocaine
Chest pain is due to trauma
BSI scene safety
ABC
Secondary- sample pay close attention to medications including nitroglycerin or aspirin
Treatment
30 Chest compressions at a rate of 100/minute
Body position
skin signs and color
respiratory rate and effort
mental status
pulse rate and character

19. Management OPQRST: What questions are we asking? BSI scene safety ABC
Secondary- sample pay close attention to medications including nitroglycerin or aspirin
Look for:
Body position
skin signs and color
respiratory rate and effort
mental status
pulse rate and character
OPQRST: What questions are we asking?
Onset –
“When and at what time did it start”
Provocation –
“Does anything make it better or worse?”
“Does it change with position, palpitation, inspiration?”
Quality –
“Describe the pain/discomfort in your own words”
Region/Radiation –
“Where does it start?”
“Does it radiate anywhere?”
Severity –
“On a scale of 1 to 10, what was the pain/discomfort at onset?”
“What is the pain/discomfort at now?’
Time –
“When did this episode start?”
“How long has it been going on?”

20. https://quizlet.com/97897026/chapter-fifteen-flash-cards/