Cardiovascular Emergencies
Review cardiac anatomy (page 402-404)
Common cardiac Problems:
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Cardiac Compromise-Chest pain or discomfort that is related to the heart usually comes from
ischemia- lack of oxygen due to partial or complete blockage of the artery
Ischemic heart disease- disease involving insufficient blood flow to one or multiple parts of the
heart
Arteriosclerosis- build up of calcium and fatty tissue (plaque) inside the walls of the artery: this
buildup can eventually cause an occlusion- blockage of blood flow
Lumen- inside diameter of the artery
Acute Myocardial Infarction (AMI)- a heart attack: dead cardiac tissue as a result of an ischemic
episode in which blood flow was not restored in time for tissue to repair itself
Cardiac arrest- the hearts inability to pump
Angina pectoris- pain that is caused when the heart muscle does not get enough blood for a
brief period of time, this can also be caused by a spasm of the artery
Signs and symptoms of a heart attack: page 408-409
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Weakness
Nausea
Sweating
Chest pain/discomfort/pressure
Pain or discomfort in the jaw/arms/back/abdomen/neck
Sudden arrhythmia (abnormal heart beat)
Syncope- fainting
Shortness of breath or dyspnia
Pulmonary edema
Sudden death
The pain of a heart attack: page 409
1. May or may not be caused by exertion
2. Does not resolve in a few minutes (last for 30 minutes to several hours)
3. May or may not be relieved by rest or nitro
Physical findings of a heart attack (page 409):
1. Pulse
a. Increase rate
b. Irregular rhythm
2. Blood pressure may or may not be effected by heart attack
3. Respiration
a. Usually normal
b. CHF may cause them to become rapid and labored
4. General appearance
a. Frightened
b. Nausea/vomiting
c. Cold sweat/ clammy
d. Gray/ashing or bluish skin
5. Mental status
a. Overwhelming feeling of impending doom
Heart rhythms and rates: page 410
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Tachycardia-
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Bradycardia-
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Ventricular tachycardia (VT) – sometimes referred to as SVT (super ventricular tachycardia)-
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Ventricular fibrillation (V-Fib)-
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Asystole-
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Cardiogenic shock (page 410-411)
CHF(Page 412):
Congestive heart failure- when the heart muscle can no longer keep up with the return flow of blood
Dependent edema- collection of waist fluid in the body (usually in the feet, legs, or chest)
Administration of nitroglycerine page 416-417:
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Obtain order from medical control (on or off line)
Ensure the patient’s blood pressure is greater than 100 systolic
Question the patient about the last time they took this medication
Ensure the patient has not taken any sexual enhancements medications
Ensure the patient is sitting down incase fainting occurs
Check the 4 rights
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Have the patient open their mouth and lift his or her tongue
Your or the patient place the prescribed dose under their tongue
Tell the patient not to chew or swallow (if medication is in tablet form)
Alert the patient of the possible side effects
Wait 5 minutes (take them to the truck)
Recheck vitals and QRS
Document the time dose and effects of the medication
Transport immediately
Heart surgeries and pacemakers: page 418-420
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Bypass-
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Stint-
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Catherization-
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Pacemaker-
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Internal defibrillator-
Review protocol for cardiac arrest and use of an AED 423-430