EMS Circulation

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EMS Circulation
2012-01-24 11:39:03
EMS Circulation

EMS Cardiac, Blood, Circulatory Related Emergency
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  1. Palpitation (pal-pih-TA-shuns)
    Generally harmless, it condition is the self-awarness of one's beating heart. Can be described as:

    Skipped heartbeats, fluttering heartbeats, heartbeats that are too fast, and/or heartbeats that are pumping harder than usual.

    If found alongside other symptoms such as: sweating, faintness, frequent headaches, fainting, chest pain or dizziness, indicate irregular or poor heart function and should be investigated.
  2. Tachycardia
    Condition where the heart beats abnormally faster in the upper chambers and/or lower chambers of the heart. Can cause a change in normal heart function, increase the risk of stroke, or cause sudden cardiac arrest or death.

    Due to the increased rate, blood may not be pumped effectively to the body, which may manifest symptoms such as:

    Dizziness, shortness of breath, lightheadedness, rapid pulse rate, palpitations, chest pain, vasovagal syncope (fainting)
  3. Bradycardia
    Slower than normal heart rate, below 60 beats per minute. Symptoms may include:

    Near-fainting or fainting (syncope), dizziness, weakness, fatigue, shortness of breath, chest pains, disturbed sleep, confusion or memory impairment, and/or easily tiring during physical activity.
  4. Hypertension
    High blood pressure. Primary generally has no cause. Secondary can be brought upon by:

    - Chronic kidney disease, disorders of adrenal glands, pregnancy, medications (birt control, diet, some cold, and migraine pills), renal artery stenosis (narrowed artey to the kidney), or hyperparathyroidism.
  5. Hypotension
    Low blood pressure, can result in vital organs being deprived of oxygen. Symptoms may include:

    Dizziness or lightheadedness; fainting (syncope); lack of concentration; blurred vision; nausea; cold, clammy, pale skin; rapid, shallow breathing; fatigue; depression; thirst
  6. Ventricular Tachycardia
    Rapid heartbeats that starts in the ventricles, has a pulse more than 100 beats per minute, and with at least three irregular heartbeats in a row. Symptoms:

    Angina (chest discomfort), syncope, light-headedness/dizziness, palpitations, shortness of breath.

    Signs are: absent pulse, loss of consciousness, normal or low blood pressure, rapid pulse.
  7. Ventricular Fibrillation
    Occurs when the heart beats rapid, erratic electrical impulses which causes the ventricles (the pumping chambers) in the heart to quiver rather than pump blood.

    Symptoms: Chest pain, dizziness, nausea, rapid heartbeat, shortness of breath.
  8. Arrhythmia
    Disorder in which the heart rate (pulse) or rhythm beats improperly such as too fast (tachycardia) or too slow (bradycardia) or irregularly.

    Symptoms: Chest pain, fainting, palpitations, light-headedness, dizziness, paleness, shortness of breath, skipping beats, sweating.
  9. Ectopic Beat
    Small variations in an otherwise normal heartbeat that causes an irregular pulse. May be caused or made worse by excessive smoking, alocohol, caffeine, certain medical stimulants, and some illicit drugs.

    Symptoms if any: palpitations, feeling your heart stopped or skipped a beat, felling of occasional forceful beats.
  10. Sinoatrial Node (SA Node, Sinus Node)
    Impulse-generating cells located in the wall of the right atrium near the entrance of the superior vena cava. These modified cardiac myocytes generate electrical impulses (action potentials) to initiate contraction of the heart.
  11. In a healthy adult, the heart typically beats ________ times per minute.
  12. Myocardial infarction
    Interruption of blood supply to a part of the heart long enough to cause heart cells to be damaged or die. Most common reason for this is an occlusion (blockage) of a coronary artery.

    Symptoms include: Feeling a tight band around the chest, bad indigestion, something heavy sitting on your chest, squeezing or heavy pressure; anxiety; cough; fainting; light-headedness; dizziness; nausea or vomiting; palpitations; shortness of breath; sweating, which may be very heavy.
  13. Unstable Angina
    Type of chest pain where the heart doesn't recieve enough blood flow through the coronary vessels of the myocardium. Symptoms will appear randomly. This condition increases the chances of heart attack and may lead to one.
  14. Stable Angina
    Type of chest pain where the heart doesn't recieve enough blood flow through the coronary vessels of the myocardium. Chest pain or discomfort brought upon by activity or stress at predictable intervals.
  15. Angina
    Angina Pectoris
    Type of chest pain due to ischemia, where the heart doesn't recieve enough blood flow through the coronary vessels of the myocardium

    Symptoms: Chest pain that you may also feel in the shoulder, arm, jaw, neck, back, or other area; discomfort that feels like tightness, squeezing, crushing, burning, choking, or aching; discomfort that occurs at rest and does not easily go away with medicine; shortness of breath; sweating.Described as squeezing, pressure, heaviness, tightness or pain in your chest.
  16. Atherosclerosis
    Occurs when fat, cholesterol, and other substances build up in the walls of arteries and form hard structures called plaques. Over time, these plaques can block the arteries and cause symptoms and problems throughout the body.
  17. Systolic Blood Pressure
    Contraction of the left ventricle.
  18. Diastolic Blood Pressure
    Is the period of time when the heart fills with blood after systole (contraction).Ventricular diastole is the period during which the ventricles are relaxing, while atrial diastole is the period during which the atria are relaxing.
  19. Asystole
    Known also as flateline, it is the state in which there is no cardiac electrical activity.
  20. Pulseless Electrical Activity
    Cardiact arrest situation noted for unresponsivenesswith a lack of palpable pulse in the presence of organized cardiac electrical activity as seen on an ECG (electrocardiogram) and should be producing a palpable pulse, but does not.
  21. Hypoxia
    Condition for the lack of oxygen via the whole body or parts of the body.
  22. Hypovolemia
    Decrease in the volume of blood in the body, which can be due to blood loss or loss of body fluids. Blood loss can result from external injuries, internal bleeding, or certain obstetric emergencies.

    Causes: Diarrhea and vomiting (common); large burns; excessive perspiration; diuretics.

  23. Thrombus
    A blood clot in a blood vessel or within the heart
  24. Air Embolism
    Obstruction in the blood vessles caused by air.
  25. Pericardial Tamponade
    (Tamponade; Pericardial tamponade )
    Cardiac tamponade is compression of the heart that occurs when blood or fluid builds up in the space between the myocardium (heart muscle) and the pericardium (outer covering sac of the heart).

    Symptoms: anxiety; restlessness; chest pain: radiating to the neck, shoulder, back, or abdomen. Sharp, stabbing pain, worsened by deep breathing or coughing; difficulty breathing; discomfort: sometimes relieved by sitting upright or leaning forward; fainting, light-headedness; pale, gray, or blue skin; palpitations; rapid breathing; swelling of the abdomen or other areas; dizziness; drowsiness; low blood pressure; weak or absent pulse
  26. Systolic Heart Failure
    Your heart muscle cannot pump (eject) the blood out of the heart very well.
  27. Diastolic Heart Failure.
    Your heart muscles are stiff and do not fill up with blood easily.
  28. Congestive Heart Failure (CHF)
    Heart failure is a condition in which the heart can no longer pump enough blood to the rest of the body.
  29. Difference between Pericardial Effusion and Tamponade?
    A tamponade is anything that compresses, an effusion is the leaking of fluids into an area(s) not intended.
  30. Pericardial Effusion
    Abnormal accumulation of fluid in the pericardial cavity. Because of the limited amount of space in the pericardial cavity, fluid accumulation will lead to an increased intrapericardial pressure and this can negatively affect heart function, causing a tamponade.
  31. Circumferential Burn
    Burns encircle the body part, they constrict the skin and can interrupt circulation to the distal tissues of the extremity, just like a tourniquet.
  32. Partial Thickness Burn
    Burn that damages the epidermis and dermis, but not the underlying tissues. It causes pain, reddening, blisters, and mottled appearance to the skin.
  33. Hypoperfusion (Shock)
    Decreased blood flow to vital organs, causing organ failure.
  34. Decompensated Shock
    When the body can no longer compensate for low blood volume or lack of perfusion. Late signs, such as decreasing blood pressure, become evident.

    A child’s body can compensate for up to a 30 percent blood loss. After this point the child will often suddenly fall into this state.
  35. Compensated Shock
    When the patient is developingi shock, but the body is still able to maintain perfusion.
  36. Anaphylactic Shock
    Caused by an overreaction of the immune system when exposed to an allergen. Causes the blood vessels to dilate, resulting in a decrease in blood pressure and a corresponding decrease in perfusion.
  37. Hypovolemic Shock
    Occurs when a fifth of the blood volume is lost.
  38. Cardiogeneic Shock
    Type of shock when the heart can no longer pump blood adequately resulting in a decrease in cardiac output and thus a decrease in perfusion.
  39. Hemmorrhagic Shock
    Type of shock caused by loss of blood.
  40. Neurogenic Shock
    Caused by the vessels dilating abnormally in response to injury to the spinal cord. The dilation of the blood vessels results in a decrease in blood pressure and a corresponding decrease in perfusion.
  41. Septic Shock
    Caused by severe infections that abnormally dilate the blood vessels. The dilation of the blood vessels results in a decrease in blood pressure and a corresponding decrease in perfusion.
  42. Psychogenic Shock
    Caused by a sudden and temporary dilation of the blood vessels from psychological causes. The dilation of the blood vessels results in a decrease in blood pressure and a corresponding decrease in perfusion.
  43. Signs and Symptoms of Shock
    • Anxiety
    • Altered mental status
    • Cold, clammy skin, paleness
    • Decreased or absent urine output
    • Decreasing blood pressure (late sign)
    • Tachycardia (increased pulse rate)
    • Tachypnea (increased respiratory rate)
    • Increased capillary refill time
    • Nausea and/or vomiting
    • Pale, cool, and clammy skin
    • ThirstSluggish and dilated pupils
    • Weak peripheral pulses
    • Weakness
  44. Hematoma
    Collection of blood outside of a blood vessel. It occurs because the wall of a blood vessel wall, artery, vein or capillary, has been damaged and blood has leaked into tissues.

    Symptoms are mostly mild and superficial, generally causing redness, swelling, and irritation.
  45. Atrial Fibrillation
    Most common cardiac arrhythmia, and involves the two upper chambers (atria) of the heart. The fibrillating (quivering) of the heart muscles of the atria, instead of a coordinated contraction.
  46. Ischemia
    Restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue.
  47. Acute Coronary Syndrome
    Term used for any condition brought on by sudden, reduced blood flow to the heart. Can describe chest pain felt during a heart attack, or chest pain felt while at rest or doing light physical activity (unstable angina). Most cases do not occur during physical exertion.

    Between 10 and 20 percent of patients having heart attacks have no chest discomfort. Chest pain may be confused with upper abdominal pain. Dyspnea, or shortness of breath, is a common symptom of cardiac compromise. Denial is common.
  48. Blood Loss From Fractures:
    • Tibia-fibula fracture typically causes a 1-pint (500 cc)
    • Femur typically cause a 2-pint (1,000 cc)
    • Pelvic fractures cause a 3- to 4-pint (1,500–2,000 cc)
  49. Aneurysm
    An aneurysm is an abnormal widening or ballooning of a portion of an artery due to weakness in the wall of the blood vessel.

    The symptoms depend on the location. If it occurs near the body's surface, pain and swelling with a throbbing mass is often seen. Within the body or brain often cause no symptoms. If it ruptures, pain, low blood pressure, a rapid heart rate, and lightheadedness may occur. The risk of death after a rupture is high.
  50. Automaticity
    The ability of the heart muscle to generate and doncut electrical impulses on its own.
  51. Hyperglycemia
    (High Blood Surgar)
    Condition in which an excessive amount of glucose circulates in the blood plasma. Usually occurs in the diabetic patient when he/she has not taken enough insulin, has forgotten to take his/her insulin, has overeaten, or has an infection that has upset his/her glucose/insulin balance.

    • Three main ranges:
    • Fasting: 70 to 100 mg/dl
    • After Meal: 135 to 140 mg/dl
    • Normal: 100 to 150 mg/dl
  52. Normal resting heart rates:
    • Adult: 60-100
    • 11-14: 60-105
    • 6-10: 70-110
    • 3-5: 80-120
    • 1-3: 80-130
    • 6-12m: 80-140
    • 0-5m: 90-140
    • Newborn: 120-160
  53. Normal Blood Pressures:
    • Patient; Systolic; Diastolic (mmHg)
    • Adult male; 100+ (over 40); 60-90
    • Adult female; 90+ (over 40); 60-90
    • Adolescent (13-19); 90; 2/3 of systolic
    • 1-10 years; 90+ (2x age); 2/3 of systolic
    • 1-13 months; 70mmHg; 2/3 of systolic