EMT-Chapter 17 - Cardiovascular Emergencies

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Author:
rolliespring
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225808
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EMT-Chapter 17 - Cardiovascular Emergencies
Updated:
2013-07-15 08:28:02
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EMT cardiovascular emergency
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Ch17
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  1. Circulatory System
    • System composed of the heart, blood vessels, and the blood
    • Also known as the cardiovascular system
  2. Cardiac Conduction System
    Contractile and conductive tissue of the heart that generates electrical impulses and causes the hearts to beat
  3. Automaticity
    • The ability of conductive cells within the cardiac conduction system to generate a cardiac pulse on its own
    • Independent of the autonomic nervous system of the body
  4. Sinoatrial(SA) Node
    Pace maker site in the upper portion of the right atrium
  5. Atrioventricular(AV) Node
    Pace maker site at the crux, where the walls separate the upper and lower chambers of the left and right side of the heart all crosses
  6. Purkinje Fibers/Network
    Pace maker site widely distributed in the conduction system of the ventricles
  7. Right-sided/Right Ventricular Heart Failure
    • Also known as cor pulmonale
    • High pressure built-up in the pulmonary vessels that lead to weakening of the right ventricle (more difficult for it to pump)
  8. Tricuspid Valve
    Valve separating right ventricle and right atrium
  9. Pulmonic Semilunar Valve
    Valve separating right ventricle and pulmonary artery
  10. Bicuspid Valve
    • Also known as mitral valve
    • Valve separates left atrium and left ventricle
  11. Aortic Semilunar Valve
    Valve separating left ventricle and aorta
  12. Pulminary Edema
    Condition beacause of fluids forced out of the capillaries and causing gas exchange problems leading to hypoxia and shortness of breath
  13. Serum
    Transport medium of the blood
  14. Thrombus
    • Clot formed in blood vessels
    • Consists of platelets, thrombin (protein responsible for activating the formation of the clot), fibrin (strands making the clot stronger)
  15. Dysrhythmias
    Heart rhythm abnormailities
  16. Electrocardiogram(ECG/EKG)
    • Graphic representation of the heart's electricla activity
    • Each heartbeat consists of depolarization, the electrical charges of the heart muscle change from positive to negative and cause heart muscle contraction, and repolarization, electrical charges go from negative to positive and cause heart relaxation
  17. P Wave
    First wave form of ECG and represents depolarization(contraction) of the atria
  18. QRS Complex
    Second wave form of ECG and represents depolarization(contraction) of the ventricles
  19. T Wave
    Third wave form of ECG and represents the repolarization(relaxation) of the ventricles
  20. PR Interval(PRI)
    Time between the P wave and QRS complex
  21. Perfusion
    Delivery of O2 and other nutrients to the cell resulting from constant adequate circulation of blood through the capillaries
  22. Cardiac Compromise
    reduced heart function caused by any condition, disease, or injury affecting the heart
  23. Atherosclerosis
    • A condition that causes the smallest or arterial structures to become stiff and less elastic is called Arteriosclerosis. This is one form and is a systematic disease.
    • Buildup of fatty deposits that are porridge-like
    • If this happens in the coronary arteries, it's called Coronary Artery Disease(CAD)
  24. Acute Coronary Syndrome(ACS)
    Signs and symptoms resulting from conditions in which the coronary arteries are narrowed or occluded
  25. Angina Pectoris
    • "Pain in the chest"
    • Unstable angina is the inadequate supply of O2 to the heart
    • May radiate
    • Crushing, heavy, achy
    • Cool, clammy, skin
    • Anxiety
    • Dyspnea(short of breath)
    • Diaphoresis(excessive sweating)
    • Nausea and/or vomiting
    • Usually 2 to 15 minutes
    • Nonrebreather mask 15lpm
    • If systolic blood pressure >90mm and has prescribed nitroglycerin, administer
    • 165-325mg of aspirin
  26. Acute Myocardial Infarcation(ACS)
    • Heart attack
    • Portion of the heart muscle dies due to lack of adequate O2
    • Pain that radiates
    • Dyspnea
    • Anxiety
    • Diaphoreosis
    • Nausea/Vomiting
    • Lasts longer than 10 minutes
    • Nitroglycerin may give incomplete or no relief
    • Nonrebreather mask 15lpm
    • Administer Nitro if prescribed
    • AED
    • 165-325mg of aspirin
  27. Aortic Aneurysm or Dissection
    • Aneurysm occurs when a weakened section of the aortic walls explodes
    • Dissection occurs when there is a tear in the inner lining of the aorta and blood blood enters ¬†and causes the separation of the aortic wall
    • Administer Nitro if prescribed
    • If dissection is suspected, do not administer aspirin
    • Administer O2
  28. Heart Failure
    • When the heart no longer has the ability to adequately eject blood out of the ventricle
    • Left/Right ventricle failure
  29. Congestive Heart Failure
    • Medical diagnosis that refers to the condition where there is a buildup of fluid(congestion) in the body resulting from the pump failure of the heart
    • Usually leads to edema(swelling)
    • Dyspnea
    • Tachycardia
    • Suddenly waking at night with dyspnea
    • Anxiety
    • Tachypnea
    • Diaphoresis
    • Cool, clammy, pale skin
    • Cyanosis
    • Decreased SpO2 reading
    • Crackles and wheezes
    • PPV if not breathing adequately
    • 15lpm O2
    • Nitro if prescribed
  30. Hypertensive Emerngencies
    • Systolic pressure > 160 mmHg or diastolic pressure > 94 mmHg
    • String, bounding pulse
    • Severe Headache
    • Ringing in the ears
    • Nausea/Vomiting
    • Respiratory distress
    • Chest pain
    • Administer O2
    • PPV if not breathing adequately
    • Semi-Fowler position
  31. Nitroglycerin
    • Medication that dilates the blood vessels, increasing blood flow and decreasing the workload of the heart
    • Cannot be given if systolic pressure is less than 90mmHg or 30mmHg below the baseline
    • Cannot be given with extreme bradycardia(<50bpm) or tachycardia(>100bpm)
    • Do not give if taken any blood thinners such as tadafil(Cialis), vardenfil(Levitra), sildenafil(Viagra)
    • Do not give if head injury suspected
    • Do not give if patient has already taken 3 doses or is a child
    • Administer 3 doses with 3-5 min in between¬†
    • Record time and B.P. in between
  32. Apply O2 if
    • Signs of respiratory distress or dyspnea
    • Signs of hypoxia
    • Signs or symptoms of heart failure
    • Signs or symptoms of shock
    • Altered mental status
    • SpO2 <94%
  33. OPQRST
    • Onset-When? What triggered it?
    • Provocation-What makes it worse/better?
    • Quality-What kind of discomfort would you describe it?
    • Radiation-Does it spread?
    • Severity-On a 1 to 10 scale w/10 being the worse
    • Time-When did it start? How long did it last?

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