Chapter 20: Cardiac Emergencies

Overview

• Objective: Explore the 'C' in ABC (Airway, Breathing, Circulation) and understand how to address cardiac emergencies.
• Focus Areas: Cardiac anatomy, physiology, and processes to handle cardiac emergencies.

Basic Cardiac Anatomy & Physiology

• Heart's Function: Pump blood through the body
  • No hormonal/digestive roles.
• Blood Circulation:
  • Heart Chambers: Right atrium, right ventricle, left atrium, left ventricle
  • Blood Flows: Between heart & lungs, and the rest of the body
  • Key Structures: Arteries, veins, arterials, granules, capillaries

Main Arteries

• Aorta: First artery sending blood from the heart to the body
• Right Coronary Artery: Supplies blood to the heart's right side.
• Left Coronary Artery: With branches for the left & back of the heart
  • Left Ascending, Descending, Circumflex

Acute Coronary Syndrome (Cardiac Compromise)

• Definition: Blocked blood supply to coronary arteries
  • Causes: Clots, cholesterol, other potential issues
  • Result: Cellular death, ischemia (muscle death) due to lack of oxygen

Symptoms

• Chest Pain: Pressure, squeezing, aching, various individual descriptions
• Radiating Pain: Jaw, arm, neck, upper abdomen
• Other Symptoms: Dyspnea, nausea, vomiting, syncope, sweating, abnormal pulse, impending doom feeling

Patient Assessment

1. Primary Assessment: ABCs, chief complaint.
2. History: OPQRST for current illness, sample history.
3. Vitals: Baseline vital signs, early symptoms review.
4. Describe Symptoms: Chest pain, palpitations, sweating, nausea, syncope, anxiety, abnormal pulse, blood pressure anomalies, appearance (sweating, pale/gray skin, restlessness)

Diagnostic & Initial Treatment

• EKG Application: Place electrodes, secure contact, follow local protocol for sending data.
• Oxygen Administration: As needed, avoid high flow unless necessary.
• Medications: Aspirin and possibly nitroglycerin (under specific conditions and medical control).

Cardiovascular Disorders

• Coronary Artery Disease:
  • Issues: Cholesterol buildup, restricted arteries, insufficient blood flow, chest discomfort.
  • Risk Factors: Age, heredity, hypertension, obesity, lack of exercise, smoking, high cholesterol
  • Treatment: Rest, nitroglycerin for symptom relief
  • Angina Pectoris: Rest-induced symptom relief, differentiate from myocardial infarction

Myocardial Infarction (Heart Attack)

• Blockages: Plaque or thrombus blocking blood flow
• Symptoms: Similar to acute coronary syndrome but persistent
• Treatment:
  • Immediate: ABCs, early transportation, medication (aspirin, nitro under control)
  • At Hospital: Balloon angioplasty, fibrinolytics

Other Considerations

• Heart Failure:
  • Symptoms: Fluid buildup, pulmonary & Pitting edema, jugular vein distension
  • Assessment: History, multiple vital sets, possible ALS assistance
  • Pulmonary Edema: ALS treatments, CPAP consideration

Emergency Conditions

• Aneurysms:
  • Types: Aortic, abdominal aortic aneurysm (AAA)
  • Assessment: Pulsating masses, rapid transport, minimal handling to prevent burst

Summary

• Key Points: Identify cardiac symptoms early, understand protocols for treatment, use diagnostic tools effectively, provide immediate and efficient care to improve outcomes.
• Practice: EKG setup, medication administration, recognizing symptoms.

Questions: Feel free to ask during class.

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