Chapter 10
Cardiac Emergencies
The Heart –
Right atrium – receives blood from body
Left atrium – receives blood from lungs
Right ventricle – pumps blood to lungs
Left ventricle – pumps blood to body
Common Causes of Heart Attack:
 Cardiovascular disease
o Leading cause of death in U.S.
o 70 million Americans have some form of cardiovascular disease
o There are one million deaths from cardiovascular disease each year and
half are heart attacks and most are sudden deaths.
o Develops slowly.
 Cholesterol – fatty substance
 Atherosclerosis – when the cholesterol build up on inner walls of
arteries.
 Diseased arteries in brain can lead to a stroke.
Signs & Symptoms of a Heart Attack:
1)
Persistent chest pain or discomfort ◄
a. Not relieved by resting, changing position, or oral medication
b. Pain ranges from discomfort to unbearable crushing feeling.
c. Pain may radiate to shoulders, arms, neck, or back.
2)
Difficulty breathing
a. Victim’s breathing is noisy
b. Victim feels short of breath
c. Victim breathes faster than normal
3)
Change in pulse rate – may be faster or slower than normal, or may be
irregular.
4)
5)
Skin appearance
a. May be pale, ashen, or bluish
b. Face may be moist, or victim may sweat profusely.
Nausea or vomiting
- Most people who die from a heart attack, die within 1-2 hours after the first signs &
symptoms appear.
- A heart attack interrupts the heart’s electrical system – may cause an irregular heart beat
so that blood cannot be circulated effectively.
Angina Pectoris:
 Some people with cardiovascular disease may have chest pain that comes and
goes and is not generally caused by a heart attack.
 Develops when the heart needs more oxygen-rich blood, such a physical activity
or stress – the lack of oxygen causes chest pain.
 Pain usually last less than 10 min.
 Stop activity and take medication.
 Can progress to a heart attack is the pain is not relieved.
Care for a Heart Attack:
 Recognize the signals of a heart attack.
 Convince the victim to stop activity and rest.
 Help the victim rest comfortably (usually sitting is best).
 Try to obtain information about the victim’s condition.
o When did the pain start?
o What brought it on?
o Does anything lessen it?
o What does it feel like?
o Where does it hurt?
 Comfort the victim.
 Administer oxygen if available and you are trained to do so.
 Call for advanced medical personnel.
 Assist with medication, if prescribed.
 Monitor vital signs.
 Be prepared to give CPR if the victim’s heart stops beating.
Cardiac Arrest
- Occurs when heart stops beating or beats too irregularly or weakly to circulate blood
effectively.
- when heart stops, breathing soon stops – called clinical death.
Causes of cardiac arrest: cardiovascular disease (most common), drowning, suffocation,
certain drugs, severe injuries to the chest, severe loss of blood, electrocution, and stroke.
Signs of cardiac arrest: absence of a pulse**, not breathing, no signs of movement.
Care for cardiac arrest:
 Cardiopulmonary resuscitation (CPR
Cardio – heart
Pulmonary – lungs
 Without CPR, brain will begin to die within 4-6 minutes. (Irreversible brain
damage, brain cell death, = biological death
 Even at its best, CPR only gives the brain 1/3 of the normal blood supply. 5%
come home from hospital
 Advanced care is essential.
o AED – 40% come home from hospital
o For every minute an AED is delayed, the victim’s chance of survival is cut
by 10%.
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CPR for Adults
Victim should be flat on back on hard surface – level or head lower.
Hand location – over the lower half of the sternum
Rescuer – kneel close to victim, arms should be straight and elbows locked,
should push down STRAIGHT onto sternum.
Compress 1 ½ to 2”
Give compressions at the rate of 100/minute. (15 compressions in 10 sec.)
Compression/breathing cycles – 15-2
Always find proper hand placement.
Check for pulse after the first minute and every few minutes thereafter.
When to stop CPR:
 If another trainer person takes over.
 If advanced medical personnel arrive and take over.
 If the person’s heart starts beating (check breathing and give rescue breathing
if needed).
 If the scene suddenly becomes unsafe.
 If the defibrillator is available and someone is trained to use it.
 If you are presented with a valid DNR order.
 If you are too exhausted to continue.
Cardiac Emergencies in Infants & Children:
 Children do not usually have a cardiac emergency – it begins as a
respiratory problem.
o Other problems occur with injuries: car accidents, near-drowning,
firearms, falls, etc. or heart defects. In rare cases may be due to
disease or asthma
- Most cardiac emergencies are preventable
- Recognize early signs of a respiratory emergency
o Agitation
o Drowsiness
o Change in skin color
o Increased difficulty breathing
o Increased heart and breathing rates
CPR in Infants and Children:
(see pg. 203 for chart)
Children:
 Rescuer – kneel close to victim, arm should be straight and elbows locked, should
push down STRAIGHT onto sternum.
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Hand location – ONE hand on the lower half of the sternum – other hand on
forehead.
Compress 1” to 1 1/2”
Give compressions at the rate of about 100/minute. (5 compressions in 3 sec.)
Compression/breathing cycles – 5 to 1
You do not have to re-measure hand placement each time.
Check for pulse after each minute.
CPR for Infants:
o Keep one hand on infant’s forehead to keep airway open.
o Use two fingers – one finger width below the nipples.
o Compress 1/2” to 1”
o Compression/breathing cycles – 5 to 1
o Check circulation after 1st minute and every few minutes thereafter
Two-rescuer CPR
Infant – change hand placement. Use thumbs next to each other on the lower half of the
sternum
Adult – Rate of 5 – 1
When both arrive together – one begins CPR while other takes care of scene safety,
communications, equipment, etc. then helps with CPR
When CPR in Progress by One rescuer: First one finished 15 compressions and 2
breaths and then checks for breathing and circulation. Second rescuer assumes position
at chest. If no pulse, begin with compressions; 5-1.
Changing position: The rescuer at the head completes breath and then moves to chest.
The rescuer at chest moves to head and checks pulse for no more than 10 seconds. If no
pulse, continues CPR.
Controllable Risk factors for Cardiovascular Disease:
 Smoking
 Diet high in fat
 High blood pressure
 Obesity
 Lack of regular exercise