Cardiovascular emergencies

Question 1

what are the ACS signs and symptoms

Answer 1

Site, onset, character, radiates, associated symptoms, time intervals, reeving factors, severity

Question 2

what are cardiac indicators

Answer 2

chest pain, dizziness, nausea, oedema, TLoC

Question 3

Physical assessment for cardiovascular conditions

Answer 3

IPPA + ECG + VITALS

Question 4

what does the term ‘ACS’ mean

Answer 4

term acs means a range of conditions including:
1. ST- segment- elevation myocardial infarction (STEMI)
2. non-ST- segment- elevation myocardial infarction (NSTEMI) and
3. unstable angina

happens due to a sudden reduction of blood flow to the heart (blood clot)

Question 5

3 types of HF

Answer 5

chronic hf, acute chronic hf, acute hf

Question 6

what medication is used for acs

Answer 6

analgesia, oxygen less than 94%, aspirin, anti-emetic, nitrate and repeat ecg-12 had

Question 7

what is ischaemia

Answer 7

Reduction of blood - shortage of oxygen

Question 8

what is infarction

Answer 8

tissue death due to lack of blood supply.

Question 9

what is a aortic aneurysm

Answer 9

A aneurysm is a known as a localised dilatation and weakening of the arterial wall - found usually in abdominal or thoracic aorta.

Question 10

what are some signs and symptoms of a aortic aneurysm

Answer 10

patient presents with non-discript back or abdominal pain, sever pain, shock, pale and sweaty, tachycardia, hypotension, loss of palpable pulses and reduction in consciousness.

Question 11

what is the correct treatment for aortic aneurysm treatment and management.

Answer 11

oxgen if hypoxic
Anagesia
permissive hypotension
90mmHg with 250ml fluid

Question 12

what is acute limb ischaemia (ALI)

Answer 12

Sudden decrease in limb perfusion risk of limb viability
ischemia considered acute is symptoms have developed over 2 weeks or less.

Question 13

what causes ALI

Answer 13

Emboli from the heart (e.g. AF)
* Proximal arterial disease (aneurisms or stenoses (narrowing of vessels)) and atherosclerosis
* Virchow’s Triad of risk of Thrombosis

Question 14

who is at risk

Answer 14

Older age (most common in >60YO)
* Peripheral artery disease
* Atherosclerosis
* Cardiac arrythmias (AF)
* Recent MI
* Valve replacement
* Recent Vascular surgery
* Hypertension and cholesterol
* Malignancy
* Smoking
* Diabetes

Question 15

Limb Ischaemia Signs & Symptoms:

Answer 15

Six Ps of Limb Ischaemia :
1. Pain — constantly present and persistent.
2. Pallor (or cyanosis or mottling).
3. Pulselessness — ankle pulses are always absent.
4. Perishing cold
5. Paraesthesia or reduced sensation or numbness.
6. Paralysis or power loss

Question 16

what are the ALI Differentials:

Answer 16

Deep Vein Thrombosis (DVT)
Presents with swollen, painful, and warm limb, typically without pallor or pulselessness. Confirmed by venous Doppler ultrasound.

Stroke or Transient Ischemic Attack (TIA)
Can cause weakness or numbness in a limb.
Lack of vascular features differentiates it from ALI.

Raynaud’s
Episodic pallor and pain triggered by cold or stress.
Usually bilateral and resolves spontaneously.

Question 17

ALI: Treatment & Management

Answer 17

If any of the following TIME-CRITICAL features are present:
* major <C>ABCDE problems (refer to Medical Emergencies in Adults – Overview).
* Start correcting any <C>ABCDE problems; see blood pressure targets below.
* Pain relief (Paracetamol, Morphine, Entonox)
* Undertake a TIME-CRITICAL transfer to the nearest appropriate receiving arterial centre.
* Continue patient management en-route.
* Provide an ATMIST information call.</C></C>

Question 18

what is AV Fistula

Answer 18

A surgical connection between an artery and a vein, usually in the arm.
The artery’s higher pressure and blood flow enlarge and strengthen the vein over time. This process, called maturation, allows the vein to handle repeated needle insertions and higher blood flow needed for dialysis.

Question 19

what is a AV Graft

Answer 19

A synthetic tube or material used to connect an artery to a vein, serving as a bridge.

Blood flows through the graft during dialysis. The graft provides immediate access without the need for vein maturation.

Question 20

causes and risk factors to AVF/GH

Answer 20

. Weakness
. Infection
. Trauma
. Appearing altered
. Non - healing wound
. Prolonged bleeding
. Growing aneurysms
. Thin skin over the site
. Other skin integrity tissue

Question 21

VFh Treamtent & Management:

Answer 21

Apply direct pressure (plastic bottle top or Olaes dressing with gauze removed placed over the bleeding site)

• Tourniquets not recommended as poor application can increase bleeding
• Don’t use absorbent dressings as they wont apply enough pressure
• If bleeding stopped on your arrival, do not remove
• All patients with a spontaneous bleed from their AV fistula/graft must be conveyed to hospital.