qwerqwer Flashcards
qlkwjeh (59 cards)
PEA
Pulseless Electrical Activity
Two MOST common underlying and potentially reversible causes of PEA
- Hypovolemia
- Hypoxia—absence of enough )2j in the cells and
tissues to maintain homeostasis
ROSC
Return Of spontaneous Circulation
Hypovolemia produces WHAT classic physiologic response
Sinus Tachycardia—rapid, narrow complex
What does hypovolemia typically do to
1. Systolic BP
2. Diastolic BP
- Decreases SBP
- Increases DBP
Two major/common causes of hypovolemia
- Occult internal hemorrhage
- Dehydration
IHCA
In-house cardiac arrest
pVT
Pulseless Ventricular Tachycardia
ACS
Acute Coronary Syndrome
What ACS drugs are initially used to relieve ischemic discomfort, dissolve clots, and inhibit thrombin and platelets
- Oxygen
- Aspirin
- Nitroglycerin
- Opiates (e.g. morphine)
- Fibrinolytic therapy
- Heparin (unfractionated-low-molecular weight)
STEMI chain of command
- Recognize ACS symptoms
- Activating/Notifying EMS
- Providing CPR if needed, providing early defib with AED
- Providing coordinated system of care among EMS and
hospital
What disease is underlying reason for many clinical syndromes, resulting in varying degrees of artery occlusion
Coronary Atherosclerosis
What ECG interpretation indicates an MI (myocardial infarction)
ST elevation
2 examples of adjunct therapies
- Nitroglycerin
- Heparin
What are two of the most important points to be aware for STEMI need?
- The EG=CG is essential
- STEMI patients don’t need evidence of elevated cardiac markers to decide to administer fibrinolytic therapy, or perform coronary angiography with interventions (angioplasty, stenting).
For ACS response, hospital intervention should occur when
Less than 10 minutes
Major ischemia or infarction symptoms include:
- Chest pain
- Shoulder pain
- Dyspnea
- Nausea
What is the most common symptom of myocardial ischemia and infarction
Retrosternal chest discomfort….Patient may perceive discomfort as tightness or pressure
What should a person do before arrival of first responders with presentation of ACS symptoms
Chew aspirin (162-325 mg non-enteric coated) if no contraindications
During EMS assessment, what should be done IMMEDIATELY upon ECG determination of ST-elevation
- Notify hospital of results of ECG
- Note time of onset
- Note first medical contact
Assessing ABS’s includes:
- Monitoring vit signs and cardiac rhythms
- Being prepared to provide CPR
Using a defibrillator if needed
What are the parameters for administering nitroglycerin to reduce ischemic chest discomfort
- Give 1 s/l or translingual dose every 3 to 5 minutes for
a maximum of 3 doses - Give only if SPP > 90, or if SPB is no lower than 30
below baseline (if known) - HR is 50-100
Nitroglycerin, being a venous dilator, caution should be taken in patients with inadequate ventricular pre-load. What are these situations
- Inferior wall and RV infarct
- Hypotension, Bradycardia, Tachycardia
- Recent phosphodiesterase inhibitor use…..sildenafil,
vardenafil, tadalafil (all erectile dysfunctional drugs)
Is morphine a venodilator
YES
