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EMT > Chapter 17 > Flashcards

Chapter 17 Flashcards

Cardiovascular Emergencies (58 cards)

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1
Q

Chambers of the heart

A

Upper chambers (atria) receive incoming blood
Lower chambers (ventricles) pump outgoing blood

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2
Q

Aorta

A

body’s main artery, receives blood ejected from left ventricle

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3
Q

Heart’s electrical system

A

Controls heart rate and coordinates atria and ventricles

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4
Q

ANS and its two parts

A

Autonomic nervous system (ANS) controls involuntary activities
The ANS has two parts:
-Sympathetic nervous system
-Parasympathetic nervous system

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5
Q

Arteries supply oxygen to different parts of the body:​

A

Right and left carotid ​
Right and left subclavian​
Brachial​
Radial and ulnar​
Right and left iliac​
Right and left femoral​
Anterior and posterior tibial and peroneal​

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6
Q

Arterioles and capillaries

A

Arterioles and capillaries are smaller vessels.​
-Capillaries connect arterioles to venules.​
Venules are the smallest branches of the veins.​
-Venae cavae return deoxygenated blood to the heart.​

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7
Q

Blood consists of

A

Red blood cells, which carry oxygen​
White blood cells, which fight infection​
Platelets, which help blood to clot​
Plasma, which is the fluid cells float in​

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8
Q

Pulse

A

A pulse is felt when blood passes through an artery during systole.​
-Peripheral pulses felt in the extremities​
-Central pulses felt near the body’s trunk​

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9
Q

Cardiac output and perfusion

A

Cardiac output is the volume of blood that passes through the heart in 1 minute.​
Perfusion is the constant flow of oxygenated blood to tissues.​
If perfusion fails, cellular and eventually patient death occur.​
​

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10
Q

Ischemia

A

Chest pain usually stems from ischemia, which is decreased blood flow.​
Ischemic heart disease involves a decreased blood flow to one or more portions of the heart.​
If blood flow is not restored, the tissue dies.​

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11
Q

thromboembolism

A

A thromboembolism is a blood clot floating through blood vessels.​
If a clot lodges in a coronary artery, acute myocardial infarction (AMI) results. ​

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12
Q

Coronary artery disease

A

Coronary artery disease is the leading cause of death in the United States.​

Controllable AMI risk factors:​
Cigarette smoking, high blood pressure, high cholesterol, diabetes, lack of exercise, and obesity​

Uncontrollable AMI risk factors:​
Older age, family history, atherosclerotic coronary artery disease, race, ethnicity, and being male​

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13
Q

Myocardial ischemia

A

a condition where the heart muscle does not receive adequate blood flow, leading to a lack of oxygen and nutrients.

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14
Q

Acute coronary syndrome (ACS)

A

Acute coronary syndrome (ACS) is caused by myocardial ischemia.​
-Angina pectoris​
-Acute myocardial infarction (AMI)​

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15
Q

Angina pectoris

A

Angina pectoris occurs when the heart’s need for oxygen exceeds supply.​
-Crushing or squeezing pain​
-Does not usually lead to death or permanent heart damage​
-Should be taken as a serious warning sign​

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16
Q

Unstable angina

A

Occurs in the absence of a significant increase in oxygen demand​
-treat angina patients like AMI patients

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17
Q

Stable angina​

A

Occurs in response to exercise or activity that increases demand on the heart muscle​
-treat angina patients like AMI patients

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18
Q
A
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18
Q

AMI patients

A

-people who have experienced a myocardial infarction, which is a sudden loss of blood to the heart muscle
-AMI pain signals actual death of cells in the heart muscle
-Once dead, cells cannot be revived.​
-“Clot-busting” (thrombolytic) drugs or angioplasty within the first few hours prevents damage.​
-Immediate transport is essential.​

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18
Q

Signs and symptoms of AMI

A

-Weakness, nausea, sweating​
-Chest pain, discomfort, or pressure ​
-Lower jaw, arm, back, abdomen, or neck pain​
-Irregular heartbeat and syncope (fainting)​
-Shortness of breath (dyspnea)​
-Nausea/vomiting​
-Pink, frothy sputum​
-Sudden death​

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19
Q

AMI pain

A

-not always due to exertion
-lasts 30 minutes to several hours
-not always relieved by rest or nitroglycerin
-AMI patients may not realize they are experiencing a heart attack

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20
Q

AMI and cardiac compromise physical findings

A

-Fear, nausea, poor circulation​
-Faster, irregular, or bradycardic pulse​
-Decreased, normal, or elevated blood pressure​
-Normal or rapid and labored respirations​
-Patients express feelings of impending doom.​
​

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21
Q

Serious complications of AMI

A

-Sudden death​
-Cardiogenic shock​
-Congestive heart failure (CHF)​

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22
Q

Dysrhythmia

Study These Flashcards
A

heart rhythm abnormalities

23
Examples of dysrhythmia
-Premature ventricular contractions​ -Tachycardia​ -Bradycardia​ -Ventricular tachycardia​ -Ventricular fibrillation​
24
Asystole
-Absence of all heart electrical activity -reflects a long period of ischemia -nearly all patients will die
25
Cardiogenic shock
-often caused by heart attack -Heart lacks power to force enough blood through circulatory system -Inadequate oxygen to body tissues causes organs to malfunction
26
Congestive heart failure
-Often occurs a few days following heart attack -Increased hear rate and enlargement of left ventricle no longer make up for decreased heart function -Lungs become congested with fluid -May cause dependent edema
27
Dependent edema
a condition where fluid accumulates in the lower extremities such as the feet, ankles, and legs
28
Hypertensive emergencies
-Systolic pressure greater than 180 mm Hg -Common symptoms: Sudden and severe headache strong and bounding pulse ringing in the ears Nausea and vomiting Dizziness Warm skin (dry or moist) Nosebleed Altered mental status Sudden pulmonary edema
29
Hypertensive emergencies treatment
-if untreated, can lead to stroke or dissecting aortic aneurysm -Transport patients quickly and safely -Consider ALS assistance
30
Aortic aneurysm
-Weakness in the wall of the aorta -Susceptible to rupture -Dissecting aneurysm occurs when inner layers of aorta become separated -May be difficult to tell the difference between a dissecting aneurysm and AMI
31
Aortic aneurysm cause and symptoms and treatment
-Primary cause: uncontrolled hypertension -signs and symptoms: Very sudden chest pain Comes on full force Different blood pressures -Transport patients quickly and safely
32
AMI vs Dissecting aneurysm
AMI Onset of pain: Gradual, with additional symptoms Quality of pain: Tightness or pressure Severity of pain: Increases with time Timing of pain: May wax and wane Region/radiation: Substernal; back is rarely involved Clinical signs: Peripheral pulses equal Dissecting Aneurysm Onset of pain: Abrupt, without additional symptoms Quality of pain: Sharp or tearing Severity of pain: Maximal from onset Timing of pain: Does not abate once it has started Region/radiation: Back possibly involved, between the shoulder blades Clinical signs: Blood pressure discrepancy between arms or decrease in a femoral or carotid pulse
33
Oxygen equipment for pulmonary edema
bag-mask device (BVM) or CPAP
34
Emergency medical care for chest pain or discomfort
-Ensure a proper position of comfort -Give oxygen if indicated -Depending on protocol, prepare to administer low-dose aspirin and assist with prescribed nitroglycerin
35
Aspirin
-Prevents blood clots from forming or getting bigger -81 mg chewable tablets -Recommended dose: 162 mg (two tablets) to 324 mg (four tablets)
36
Nitroglycerin available forms
-sublingual pill -sublingual spray -skin patch applied to chest
37
Nitroglycerin mechanism of action
-relaxes blood vessel walls -Increases blood flow and oxygen supply to the heart -Decreases workload of heart -Dilates blood vessels
38
Nitroglycerin side effects
-Decreased blood pressure -Severe headache
39
Nitroglycerin contraindications
-Systolic blood pressure less than 100 mm Hg -Head injury -Use of erectile dysfunction drugs within 24 hours -Maximum prescribed dose has been given
40
Guiding principles for placing ECG electrodes
-may need to shave body hair -Rub electrode site with alcohol swab before application -Attach electrodes to ECG cables before placement -Confirm electrode placement -Once the electrodes are in place, switch on the monitor -Print a sample rhythm strip -If strip shows artifact, confirm electrodes are firmly applied and cable is plugged in
41
Coronary artery bypass graft
Chest or leg blood vessel is sewn from the aorta to a coronary artery beyond the point of obstruction
42
Percutaneous transluminal coronary angioplasty
a tiny balloon is inflated inside a narrowed coronary artery
43
Patients who had heart surgeries and cardiac assistive devices
-patients who have had open-heart procedures may or may not have long chest scars -Treat chest pain in a patient who has had any of these procedures the same as a patient who has never had heart surgery -some patients have implanted cardiac pacemakers to maintain a regular cardiac rhythm and rate
44
Cardiac pacemakers
-maintain regular cardiac rhythm and rate -deliver electrical impulse through wires in direct contact with the myocardium -Implanted under a heavy muscle or fold of skin in the upper left portion of the chest
45
Cardiac pacemaker malfunction
-Can cause syncope, dizziness, or weakness due to an excessively slow heart rate -transport patients promptly
46
Automatic implantable cardiac defibrillators
-used by some patients who have survived cardiac arrest due to ventricular fibrillation -Monitor heart rhythm and shock as needed -Treat chest pain patients with these devices like other patients having an AMI -Electricity is low so it will not affect rescuers
47
External defibrillator vest
-a vest with built-in monitoring electrodes and defibrillation pads worn by the patient -attached to a monitor -Uses high-energy shocks -do not touch the patient if devices warns it is about to deliver a shock -Vest should remain in place while CPR is being performed unless it interferes with compressions
48
Left ventricular assist devices (LVADs)
-used to enhance the pumping of the left ventricle -most common ones have an internal pump and external battery pack -most patients will not have a palpable pulse -transport all supplies and battery packs with the patient
49
Cardiac arrest
-the complete cessation of cardiac activity -absence of a carotid pulse
50
Considerations of AED in cardiac arrest
-not all patients in cardiac arrest require shock -all patients in cardiac arrest should be analyzed with an AED -Asystole indicates no electrical activity -pulseless electrical activity refers to a state of cardiac arrest that exists despite an organized electrical complex
51
AED preparation caution
-make sure the electricity injures no one -do not defibrillate patients in pooled water -do not defibrillate patients touching metal -carefully remove nitroglycerin patch and wipe with dry towel before shocking -Shave hairy chest to increase conductivity -determine the NOI and/or MOI -call ALS assistance
52
After AED, one of the following is likely:
-pulse regained -no pulse regained and no shock advised -no pulse regained and shock advised
53
If ALS is not responding:
-begin transport when: The patient regains a pulse 6 to 9 shocks are delivered AED gives three consecutive messages (every 2 min of CPR) advising no shock
54
Cardiac arrest during transport:
-stop the vehicle -Begin CPR is AED is not immediately available -Call for ALS support -Analyze rhythm -deliver shock, if indicated, and resume CPR -Continue resuscitation per local protocol
55
Management of return of spontaneous circulation
-monitor for respirations -provide oxygen via BVM at 10 breaths/min -maintain SpO2 between 95% and 99% -Assess blood pressure -See if patient can follow simple commands -Immediately begin transport if ALS is not en route per local protocol
56

EMT (4 decks)

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