Cardiac Emergencies (emt b)

Created by jenava 

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What are two heart functions

Electrical Function & Mechanical

What are the types of blood vessels

Arteries
Arterioles
Capillaries
Venules
Veins

Trace a drop of blood

Right Ventricle
Pulmonary Artery
Pulmonary Arterioles
Pulmonary Capillaries
Pulmonary Venules
Pulmonary Vein
Left Atrium
Left Ventricle

Aorta
Systemic Arteries
Systemic Arterioles
Systemic Capillaries
Systemic Venules
Systemic Veins
Sup / Inf Vena Cava
Right Atrium

Composition of the blood

Red Blood Cells
White Blood Cells
Platelets
Plasma

what is Atherosclerosis

Narrowing of the arteries caused by build up of plaque/calcium/cholesterol

What is Arteriosclerosis

Narrowing of the arteries caused by hardening/thickening of arterial walls (loss of elasticity)

Electrical System of the Heart?

...

What is Agina Pectoris

Heart's blood supply temporarily cut off
Caused by ischemia to the heart muscle
Commonly following strenuous activity

Relieved by:
Rest
Nitroglycerin (NTG)
Increased oxygen intake

Myocardial Infarction

Insufficient oxygen to the heart that leads to cell infarction

Results from persistent ischemia

What is Congestive Heart Failure (CHF)

Inability of one or both sides of heart to pump blood out
Cardiogenic Shock (pump failure)
Commonly presents with pulmonary edema and/or edema in the ankles, hands, or feet

What are symptoms of Cardiac Compromise

Sudden onset of weakness, nausea, and sweating
Chest pain or discomfort
Pain in lower jaw, arms, or back
Sudden fainting
Anxious or irritable
Feeling of impending doom

What are types of pain

Somatic Pain
Can pinpoint
i.e. cut finger

Visceral Pain
Cannot be localized
Typical cardiac pain

What is a pacemaker

Pulse generator and wires to the heart.
Externally can be seen and felt under the skin

What is a AUTOMATED INTERNAL CARDIAC DEFIBRILLATOR (AICD)?

In patients with recurrent arrhythmias.
Wires attached directly to the heart.
Senses an "event" and delivers a shock.
Only requires 5-15 joules.

What is a Normal Sinus Rhythm?

NSR is a "happy" rhythm
If part of the heart becomes injured or dies (i.e. heart attack), the electrical conduction system can become damaged and it can compromise the mechanical function as well.

An "Irritated" Heart?

An irritated heart may show "funny little beats."
These are called Premature Ventricular Complexes.?

What are the 2 Shockable rhythms?

Pulseless Ventricular Tachycardia (VT) may be the initial rhythm for a patient in cardiac arrest.

Ventricular Fibrillation (VFib) is the most frequent rhythm present when a patient is found in cardiac arrest.

What is V Tach?

AEDs can also detect Ventricular Tachycardia (aka V-Tach).
It is similar to V-fib but (unlike V-fib) it has an organized rhythm can sometimes have a pulse

What is V Fib

V-Fib is an unorganized electrical rhythm which interferes with the heart's normal pumping activity.
V-Fib is a useless quivering of the heart that results in no blood flow, therefore no pulse.

What is absence of any electrical impulse?

Asystole

In cardiogenic shock, the _____ is pumping ineffectively.

Heart

Immediately after shocking with the AED, your next step is to __________.

Begin CPR. (Follow prompts of your AED)

Before delivering a shock, you must say, "________" while looking around the patient

I'm clear, you're clear, everybody clear!

The absence of electrical rhythm in the heart is called

Asystole

As an EMT, you are granted STANDING ORDERS to deliver ______ number of shocks with a LP 12 / 15.

3 total

As an EMT, you are granted STANDING ORDERS to deliver ______ number of shocks with a LP 1000.

3 total.

If you had a patient who is found pulseless and unresponsive at a pool. No CPR has been initiated prior to your arrival. Should you initiate CPR or connect an AED first?

CPR, then connect AED

When blood leaves the right ventricle, it enters the ______.

Pulmonary Arteries

The correct position on the adult patient for the electrodes with the AED is ___ and _____.

Apex - Sternum

One of three things must occur before you transport the patient connected to the AED. They are:

1.3 shocks are delivered
2.Three "No Shock Advised"
3.Patient regains a pulse

Describe the Chain of Survival.

Early Access - Early CPR - Early Defibrillation - Early ACLS

You are transporting a patient in the ambulance, when the patient collapses. What do you do FIRST?

Reassess Initial Assessment (LOC & ABCs)

What is the primary pacemaker site in the heart?

SA Node

You arrive to assist a patient in cardiac arrest with an AICD. What do you do?

Treat them the same, just try not to put the AED pads directly over the AICD

What is the most common reason for an AED failure?

Battery Failure

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