Cardiac AP & CPR
Name the two major components of
blood.
Plasma
Formed cells
What are the two major
components of plasma?
90% water
10% solutes
Name 3 proteins found in plasma.
Albumin
Globulin
Fribrinogen
Prothrombin
Cardiac AP & CPR
What is the purpose of Albumin?
Thickens blood
What is the purpose of fibrinogen &
prothrombin?
Necessary for clotting
Name three energy molecules
found in plasma
Glucose
Lipids
Amino acids
Cardiac AP & CPR
Name four electrolytes found in
plasma
Sodium
Chloride
Bicarbonate
Potassium
Calcium
Magnesium
Phosphate
Sulfates
Organic Acids
Give the normal range for Sodium
135-145 mEq/L
Give the normal range for Chloride
96-105 mEq/L
Cardiac AP & CPR
Give the normal range for
Bicarbonate
22-26 mEq/L
Give the normal range for
Potassium
3.5-5 mEq/L
Give the normal range for Calcium
4.25-5.25 mEq/L
Cardiac AP & CPR
Give the normal range for
Magnesium
1.4-2.2 mEq/L
What is the normal range for
hemoglobin?
Normally 12-18 gms Hb/100ml blood
How many RCB’s are there?
4.2-6.2 million per cubic mm
Cardiac AP & CPR
Name 3 leukocytes
Eosinophils
Basophils
Mononuclear Monocytes
Lymphocytes
Polymorphonuclear neutrophils
What is the function of
Eosinophils?
Protects body from parasites &
allergens
What is the function of Basophils?
Secrete heparin
Cardiac AP & CPR
What is the function of
Mononuclear Monocytes?
Phagocytes
What is the function of
Lymphocytes?
Function in the immune mechanism
What is the function of Platelets?
Play a role in clotting
Cardiac AP & CPR
What is the normal volume of
WBC’s?
5,000-10,000 white blood cells per
cubic mm
What are the three types of fluid
(where is it found) in the body?
Intravascular – in the vessels
Interstitial – between the cells
Intracellular – within the cells
What type of fluid does blood make
up?
Intravascular
Cardiac AP & CPR
Give four purposes of blood
Transport respiratory gases
Circulate defenses
Nutrients to cells
Remove wastes from cells
Clotting
Electrolytes
What is the normal number of red
blood cells in males?
4.6 – 6.2 Million
What is the normal number of red
blood cells in females?
4.2 – 5.4 Million
Cardiac AP & CPR
In the differential count, what
percentage of white blood cells are
Neutrophils?
40-75%
In the differential count, what
percentage of white blood cells are
Lymphocytes?
20-45%
In the differential count, what
percentage of white blood cells are
Basophils?
0 - 01%
Cardiac AP & CPR
In the differential count, what
percentage of white blood cells are
Eosinophils?
0 – 6%
Define hematocrit?
Percentage of packed cell volume
3 X Hb
40-50%
What is the normal range of
hematocrit for males?
40 – 54%
Cardiac AP & CPR
What is the normal range of
hematocrit for females?
38 – 47%
What is the normal hemoglobin for
males?
14 – 18 gm
What is the normal hemoglobin for
females?
12 – 14 gm
Cardiac AP & CPR
What is the SED Rate?
Determines rate of fall in 1 hour of
RBC’s
What is the normal time it takes for
blood to clot?
2 – 9 Minutes
Why is the finger pinch check
done?
To check for cardiovascular
integrity.
Cardiac AP & CPR
Where is the heart located?
Posterior to the sternum
Superior to the diaphragm
To the left side
Name the four layers of the heart.
Pericardium
Epicardium
Endocardium
Myocardium
What is the Pericardium?
Sac surrounding the heart
Cardiac AP & CPR
What is the Epicardium?
Exterior heart wall
What is the Endocardium?
Inner heart wall
What is the Myocardium?
Heart muscle
Cardiac AP & CPR
Name the Chambers of the heart.
Right atria
Right ventricle
Left atria
Left ventricle
The right atria and the right
ventricle are considered part of
which circulation?
Pulmonary
The Left atria and the Left ventricle
are considered part of which
circulation?
Systemic
Cardiac AP & CPR
Name the valves of the heart:
Tricuspid
Pulmonary
Bicuspid or Mitral
Aortic
Where is the tricuspid valve
located?
Between the RA and RV
Where is the pulmonary valve
located?
Between RV & Pulmonary artery
Cardiac AP & CPR
Where is the mitral valve located?
Between LA LV
Where is the aortic valve located?
Between LV and aorta
Where is the bicuspid valve
located?
Between LA and LV
Cardiac AP & CPR
What is the function of the arteries?
Carry blood away from the heart
What is the function of the Veins?
Carry blood to the heart
What vessels carry blood between
arteries and veins?
Capillaries
Cardiac AP & CPR
Where does blood go after leaving
the superior vena cava?
Right atria
Where does blood go after leaving
the right atrium?
Tricuspid valve
Where does blood go after leaving
the tricuspid valve?
Right ventricle
Cardiac AP & CPR
Where does blood go after leaving
the right ventricle?
Pulmonic valve
Where does blood go after leaving
the pulmonary valve?
Pulmonary artery
Where does blood go after leaving
the pulmonary artery?
Pulmonary capillaries
Lungs
Cardiac AP & CPR
Where does blood go after leaving
the pulmonary capillaries?
Pulmonary vein
Where does blood go after leaving
the pulmonary vein?
Left atria
Where does blood go after leaving
the left atria?
Mitral or bicuspid valve
Cardiac AP & CPR
Where does blood go after leaving
the Mitral valve?
Left ventricle
Where does blood go after leaving
the left ventricle?
Aortic valve
Where does blood go after leaving
the aortic valve?
Aorta
Cardiac AP & CPR
What does the pulse reflect?
Contraction of the left ventricle –
systole
What would you use to take a
pulse?
Use fingers, not thumb
Name six pulse sites.
Radial
Carotid
Femoral
Temporal
Ulnar
Brachial
Dorsalis Pedis
Cardiac AP & CPR
What equipment is needed get a
blood pressure?
Sphygmomanometer
Stethoscope
Describe how you would obtain a
blood pressure?
Stethoscope over brachial pulse point;
inflate cuff until blood flow stops (no pulse);
Slowly deflate cuff;
1st sound is systolic blood pressure;
Change of mufflinf sound is diastole.
What is normal diastolic pressure?
120 mmHg
Cardiac AP & CPR
What is normal systolic pressure?
80 mmHg
Describe the electrical conduction
pathway of the heart?
SA node to AV node to Bundle of
His to Left & Right Bundle
branches, to Purkinje Fibers
What is the rate initiated by the SA
node?
60-100 bpm
Cardiac AP & CPR
What is the rate initiated by the AV
node?
40-60 bpm
Define tachycardia.
Heart rate greater than 100
Define bradycardia.
Heart rate less than 60
Cardiac AP & CPR
Define Systole.
Cardiac contraction
Define Diastole.
Cardiac relaxation
Define Depolarization.
Change in intracellular charge from
negative to positive due to influx of
sodium ions into the interior of the
cell which results in muscle
contraction.
Cardiac AP & CPR
Define Repolarization.
Electrical imbalance is restored by
“pumping” sodium ions out of the
cell which results in muscle
relaxation.
Name the parts of an EKG.
P wave
QRS complex
T wave
What is the significance of the “P”
wave?
Atrial depolarization
Cardiac AP & CPR
What is the significance of the
“QRS” complex?
Ventricle depolarization
What is the significance of the “T”
wave?
Ventricular repolarization
What is a Sinus rhythm
Any rhythm that starts at the SA
node
Cardiac AP & CPR
What is an Atrial rhythm
Any atrial rhythm that does not
start at the SA node – abnormal “P”
wave – not life threatening
Define PAC
Premature atrial contraction – early
atrial beat caused by an ectopic
stimulus in the atria
Define Atrial flutter
Rapid atrial rate of 240-400 bpm –
characterized as having a saw tooth
pattern
Cardiac AP & CPR
Define Atrial fibrillation
Chaotic twitching of atrial tissue –
rate of 360-700 bpm – may cause
decrease in cardiac output because
of impaired ventricular filling
What is a Junctional or nodal
rhythm?
The stimulus originates near the AV
node – often inverted “P” wave
What do PVC’s look like?
Large, wide, bizarre QRS – early in
cycle – may not follow “P” wave
Cardiac AP & CPR
When can PVC’s be dangerous?
Multiple configuration
More than 1 in 10 beats
Landing near a “T” wave
Describe Ventricular Tachycardia
Rapid rate 140-300 bpm
Appear like a continuous series of
PVC’s
If untreated may cause ventricular
fibrillation
Describe Ventricular Fibrillation
Sometimes called the “bag of
worms” effect
Life ending
Physiologically the same as cardiac
standstil
Cardiac AP & CPR
Describe Defibrillation & when it is
performed
Performed during ventricular
fibrillation
Electrical shock totally depolarize
heart to allow synchronization of
repolarization
Define Asystole
Straight line, no electrical activity,
cardiac standstill
Define EMD
Electrical mechanical
disassociation (dissonance).
Electrical activity with no pulse.
Cardiac AP & CPR
What is hypertension caused by?
Driving pressure of heart
Resistance of vascular system
Describe a myocardial infarction?
Coronary arteries become blocked
Tissue become ischemic
Tissue become necrotic
Muscle is weakened
Describe Cor Pulmonale?
Right-sided heart failure
Usually due to pulmonary Dx
Right-sided hypertrophy
Can cause left sided failure
Venous distension may be noted in
neck veins
Cardiac AP & CPR
What is an Aneurysm?
Ballooning out of the vessels
Weakening of vessel
Can rupture and cause death
What is Arteriosclerosis?
Hardening of the arteries by
calcium
What is Atherosclerosis?
Narrowing of the arteries due to fat
deposits
Cardiac AP & CPR
What can cause Ischemia?
Blood clots
Low BP
Define Hemorrhage & what could
cause it?
Uncontrolled bleeding – usually
caused by a ruptured or torn vessel
Define Shock:
Acute peripheral circulatory failure
due to:
Derangement of circulatory control
Loss of circulating fluid
Cardiac AP & CPR
Give 4 signs of Shock:
Pallor
Clamminess of the skin
Decreased blood pressure
Feeble, rapid pulse
Decreased respiration
Restlessness
Anxiety
Sometimes unconscious
What is Phlebitis?
Inflammation of veins
What is a Thrombus?
A stationary clot
Cardiac AP & CPR
Name 3 types of Cardiac
Inflammation:
Endocarditis – inflamed
endocardium
Myocarditis – inflamed heart
muscle
Pericarditis – inflamed pericardium
What is Angina Pectoris?
Pain located over heart, left
shoulder or in jaw due to decreased
blood supply (ischemia) to heart by
the coronary arteries
What is CHF & name 2 conditions
that could cause it:
Congestive Heart Failure – caused
by Myocardial infarction, Ischemic
heart disease, Cardiomyopathy
Cardiac AP & CPR
CPR:
At what age is adult CPR provided
for the victim?
8 years of age
CPR:
What is the most common cause of
childhood death?
Preventible injury
CPR:
List three risk factors for a heart
attack that cannot be changed:
Heredity
Gender
Age
Cardiac AP & CPR
CPR:
List four risk factors for a heart
attack than can be changed:
Cigarette smoke
Hypertension
Cholesterol levels
Physical inactivity
CPR:
After how many minutes of full
cardiac arrest, is brain death
certain?
10 min
CPR:
The victim whose circulation and
breathing has stopped will probably
have brain damage within how
many minutes?
4-6 minutes
Cardiac AP & CPR
CPR:
What is the most common cause of
airway obstruction in the
unconscious victim?
The tongue
CPR:
To determine pulselessness in the
unconscious adult, where should
be pulse be checked?
Carotid
CPR:
The third leading cause of death in
the U.S. is what?
Stroke
Cardiac AP & CPR
CPR:
More than 90% of deaths from
foreign-body aspiration in the
pediatric age group occur in
children younger than what?
5 years of age
CPR:
What is the proper method for
establishing an airway?
Head-tilt – Chin lift
Where on the sternum, should the
hands be placed, for performing
chest compressions?
Middle of the sternum
Cardiac AP & CPR
CPR
How do you verify the effectiveness
of compressions?
Check the Pulse
What is the ratio of ventilations to
compressions during one person
CPR?
2 breaths to 30 compressions
CPR:
What is the difference between call
fast and call first?
Call fast for children
Call first for adults
Cardiac AP & CPR
When should the AED be applied?
As soon as possible
How should you adjust the tidal
volume when bagging the patient
with O2?
Use lower VT’s - less volume (don’t
squeeze the bag as hard)
What are the signs of cardiac arrest
in the adult?
Unresponsiveness
Breathlessness