Lecture 7: Circulatory Emergencies

Question 1

What regions should you auscultate when an iGel is in place?

Answer 1

Upper lung sounds: below the clavicles, midway
Lower lung sounds: below nipple line on the axillary line
You do NOT want to hear sounds over the stomach

Question 2

What is commotio cordis?

Answer 2

Hit over the heart at a specific time during the heart beat causing cardiac arrest

Question 3

What may be a trigger for ventricular arrhythmias in athletes with underlying heart disease?

Answer 3

Vigorous exercise

Question 4

What does the FAST acronym stand for?

Answer 4

Face
Arms
Speech
Time

Question 5

How can you prevent CVDs?

Answer 5

healthy diet/ choices
exercise
no smoking
genetics play a big role in this

Question 6

When does CVD begin?

Answer 6

when fatty material builds up on the inside walls of the arteries.

Question 7

What is atherosclerotic plaque?

Answer 7

Atherosclerotic plaque is a sticky, yellow substance made up of fatty substances like cholesterol and cellular debris

Question 8

Atherosclerosis can progress into what?

Answer 8

if it blocks the flow of blood through the coronary arteries, it is known as coronary artery disease (CAD)

Question 9

If atherosclerosis blocks arteries in the brain, what can it lead to?

Answer 9

Transient Ischemic attack
or a stroke

Question 10

What is a transient ischemic attack (TIA)?

Answer 10

temporary mini-stroke. caused by temporary interruption of blood flow to the brain, symptoms go away in less than 24hours

Question 11

What is a stroke?

Answer 11

sudden loss of brain function. caused by interruption of blood flow to brain (ischemic stroke 80%) or the rupture of blood vessels in the brain (hemorrhagic stroke 20%)

Question 12

The effects of a stroke depends on what factors?

Answer 12

depends on where the brain was injured as well as how much damage occurred

Question 13

What are the two types of ischemic strokes and define them?

Answer 13

Thrombotic: caused by a blood clot that forms in an artery going to the brain

embolic: occurs when a brain artery is blocked by a clot that formed somewhere else and was carried through the blood stream to the brain

Question 13

Atherosclerosis in the rest of the body can lead to what?

Answer 13

angina or heart attack

Question 13

When is the angina chest discomfort usually felt?

Answer 13

when someone is
active
stressed
has eaten alot
very cold or very hot

Question 14

What is angina pectoralis?

Answer 14

discomfort in the chest caused when the heart does not receive enough O2
pain should go away when they rest
no cardiac tissue damage
if pain remains after 5 min of rest and after taking 1 nitro, it may not be just angina.

Question 15

How does a heart attack occur?

Answer 15

it occurs when there is a blockage in one or more of the coronary arteries and blood stops flowing to part of the heart muscles

Question 16

What is an early sign of a heart attack?

Answer 16

a fist or clenched hand to the chest. Not a flat hand

Question 17

What are the S/S of a heart attack?

Answer 17

pain
discomfort or pain that does not go away with rest
pain that may be in chest, neck, jaw, shoulder, arms or back
pain that feels like burning, squeezing, heaviness, tightness, or pressure
In women, pain may be more vague
SOB
Difficulty breathing
nausea
indigestion
vomiting
sweating
cool, clammy skin
fear
anxiety
denial

Question 18

What are the 6 Rights of Medication?

Answer 18

Right person
Right medication
Right dosage
Right time
Right route
Right documentation

Question 19

What are the actions to take Nitro/ASA?

Answer 19

Ask fully conscious person if he/she carries ASA
Ask if he/she is allergic to ASA
if the fully conscious person does not carry nitroglycerin or if the pain is not relieved by the first dose of nitro suggest the person chew 2 children’s ASA or 1 regular adult dose

Question 20

What is nitro contraindicated with?

Answer 20

It is contraindicated with erectile dysfunction medication such as viagra, levitra, cialis as well as revatio, sildenafil (pulmonary hypertension) due to a risk of fatal BP drop.

Question 21

What are the steps of Nitro admin?

Answer 21

Do not shake container, hold upright, close to mouth
Spray under/on tongue, do not inhale
Prime container prior to first use or if not used in over 2 weeks
Prime by pointing away from face/people, spray 1-3 time prior

Question 22

How often can a nitro dose be repeated?

Answer 22

may be repeated every 5 minutes until pain is relieved or until a max 3 doses have been given.

Question 23

What is the max amount of time for drop-to-shock reaction time?

Answer 23

less than 3 minutes

Question 24

When should you activate a high performance BLS versus regular CPR?

Answer 24

High performance BLS if it is a witnessed cardiac arrest
30:2 BLS if unwitnessed or pediatric

Question 25

What are the only things more important than defibrillation?

Answer 25

patient/rescuer safety
airway emergency
Emergent bleed control

Question 26

What is the AED protocol on two 2 minute cycles?

Answer 26

200 compressions or 5 cycles of CPR 30:2
Repeated as needed until transfer to EMS
Change compressors every 2 minutes
Apply AED as soon as available, keep compression until second electrode ready to be placed

Question 27

What are the AED Considerations?

Answer 27

remove victim from wet environment
expose chest umbilicus to larynx
remove free-flowing O2 before shock (1m away)
Do not apply electrodes over metal implants/piercings
ensure good adherence/placement of electrodes
Shave if adherence will be affected, dry area before application
remove medication patches
avoid pacers/implantable defib (at least 1in away)
ensure at least 1in between electrodes
visualize patient before pushing shock button