PREVIEW OF

EMT/EMR CARDIOVASCULAR EMERGENCIES

POWERPOINT TRAINING PRESENTATION

DESCRIPTION

Reviews of the cardiovascular system, an introduction to the signs and symptoms ofCardiovascular disease, administration of aspirin and a patient's prescribed nitroglycerin, and use of the automated external defibrillator. Meets current US DOT NHTSA EMT training requirements. Presentation is over 120 slides in length. Recommended classroom time is 4 hours and 4 hours lab time.

HEART

ValvesBlood supply to myocardiumMyocardial muscle cellsSpecialized electrical cellsAutonomic system control

Sympathetic – “fight or flight”Parasympathetic

HEART ELECTRICAL SYSTEM

PLASMA

Pale yellow component of the blood that holds blood cells in suspension

Serves as the protein reserve of the bodyMakes up about 55% of blood volume

CARDIAC CYCLE

A complete heartbeat from its generation to the beginning of the next beat, and so includes the diastole, the systole, and the

intervening pauseSystoleDiastole

SYSTOLE

Phase of contraction

in the cardiac cycle

DIASTOLE

The phase of relaxation in which the

heart fill with blood

BLOOD PRESSURE

SystolicPressure in the arteries created when the

left ventricle contracts forcing blood into circulation

DiastolicPressure in the arteries when the left

ventricle is relaxed and is refilling

CARDIAC OUTPUT (CO)

Describes the volume of blood being pumped by the heart, in particular by the left or right ventricle per unit time

Heart rate “X” blood volume ejected/beatInfections are correlated with high CO and heart

failure with low CO

HEART ATTACK

Death of the heart muscle (infarction)1) Blockage2) Infracted area

ANGINA PECTORIS

Severe chest pain due to ischemia of the heart muscle, generally due to obstruction or spasm of the coronary artery

Worsening ("crescendo") angina attacks, sudden-onset angina at rest, and angina lasting more than 15 minutes are symptoms of unstable angina

ANGINA PECTORIS

Normal Artery

Artery Wall

Narrowing of Artery

Plaque

Plaque

Normal Blood Flow

Abnormal Blood Flow

Narrowed Artery

SHORTNESS OF BREATH MAY OCCUR

Does it happen?During activity/exerciseAt restDoe it get worse when lying flat

ACUTE CORONARY SYNDROMES (ACS) HEART FAILURE

A group of conditions due to decreased blood flow in the coronary arteries such that part of the heart is unable to function

CARDIOGENIC SHOCK

Signs & Symptoms includeLow blood pressure often 80 systolic or lessSlow or fast pulse often sinus tachycardiaEdema in feet or anklesAltered level of consciousnessRestlessness, confusion, comaCool & clammy skinTachypnea

CONGESTIVE HEART FAILURE (CHF)

The inability of the heart to pump blood out as fast as it enters the heart

CONGESTIVE HEART FAILURE

Signs & symptoms (con’t)Distended neck veinsRespiratory cracklesShortness of breathPale, cool, clammy skinAbdominal distensionPetal or lower extremity edema

Photo by James Heilman

PACEMAKER FAILURE

The inability of the pacemaker to function in controlling the beats of the heart

Has multiple causesBattery or lead failureExposure to high voltages or

microwavesUnit malfunction

SINUS RHYTHM

Normal electrical pattern of the heart

VENTICULAR FIBRILLATION

Pulseless electrical activityHappens in 90% of adult cardiac arrests

Normally leading arrhythmia in cardiac arrest

EARLY CPR

CPR started by bystanders shows the best survival rate in cardiac arrest situationsRemember

Brain death starts in 4-6 minutes after the heart stops

The chances of reviving the heart are reduced by 10% for every minute of delay

START CPR

Follow local protocol using the 30 to 2 or continuous compressionsTurn on AED and follow audio prompts on AED

(some AED’s turn on when case is opened)Bare chest Attach AED Pads and plug them into AED

(some AED’s are stored with pads plugged in)

THE SEQUENCERecognize

Cardiac Arrest

Start CPR

Turn on & attach

AED

Listen to AED

Prompts

Push analyze

when told

Push Shock

when told

Listen for Directions

Monitor Patient

Restart CPR for2 minutes

PAD PLUGS

There are about 15-20 different

manufacturer of AED’s each use different plugs Some times you can purchase adapters to go from one brand to another

POST RESUSCIATATION

Monitor ABC’sTransportInitiate ALS interceptLeave AED attached & do NOT turn it offPatient may rearrestPerform focused assessment

LIABILITY

There is little chance of being sued in the U S & Canada due to numerous “Good

Samaritan” Laws and other limits of liability in other statutes

NITROGLYCERIN

Used to dilate blood vessels when patient has chest pains

Comes in many ways Tablet IV solutionSpray PastePatch (continually worn)

Generic names includeNitrostat, Tridill, Nitro-Dur, Nitro-Bid

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