CARDIOVASCULASR EMERGENCIES Cardiac Structure and Function: a.

Blood Circulation/Flow in the body Deoxygenated blood from the superior part of the body will go to the RIGHT ATRIUM passing thru the SUPERIOR VENA CAVA Deoxygenated blood from the inferior part of the body will go to the RIGHT ATRIUM passing thru the INFERIOR VENA CAVA Deoxygenated blood from the right atrium will go to the RIGHT VENTRICLES passing thru the TRICUSPID VALVE Deoxygenated blood from the right ventricle will go to the LUNGS for oxygenation passing thru the PULMONARY ARTERY Oxygenated blood from the lungs will go to the LEFT ATRIUM passing thru the PULMONARY VEIN Oxygenated blood from the left atrium will go to the LEFT VENTRICLE passing thru the MITRAL or BICUSPID VALVE Oxygenated blood will then be pumped by the left ventricle to the whole body where exchange of oxygen and nutrients will happen. b. Conduction System in the Heart Electric conductivity (EC) of the heart will start at the SINOATRIAL NODE will then proceeds ATRIOVENTRICULAR NODE. EC will then spread to the BUNDLE of HIS and will later spread to the left and right PURKINJE FIBERS

Diseases of the Heart Disease ATHEROSCLER OSIS materials (calcium, fatty material, cholesterol) build up in the blood vessels Assessment (Signs & Symptoms) Refer to notes s/s are commonly the same with that of the cardiac emergencies Consideration Risk Factors: Cant be change: H hereditary I - increasing Age S Sex (common on males) Can be change: I increase BP & Blood Cholesterol T - Tobacco P Physical Activity O Obesity & overweight D - Diabetes Chest pain do not last for 15 minutes The person should exert action prior to the perception of chest pain Can assisst in giving Nitroglycerin but need to take consider the following before giving; 1. Systolic blood pressure of less than 100 mm Hg 2. Head injury 3. Maximum dose taken in past hour Refer to notes s/s are commonly the When you have a hard time distinguishing for the possible cause of the chest pain, you can use this.

ANGINA PECTORIS chest pain when the heart is not getting enough oxygen Note: when the heart does not receive enough oxygen this may result to ISCHEMIA CARDIAC COMPROMISE

Refer to notes s/s are commonly the same with that of the cardiac emergencies

- chest pain resulting from ischemia HEART ATTACK / ACUTE MYOCARDIAL INFARCTION - pain resulting from necrosis (death tissue/cells in the heart) -

same with that of the cardiac emergencies Sudden onset of weakness, nausea, sweating without obvious cause Chest pain/discomfort Often crushing or squeezing Pain in lower jaw, arms, back, abdomen, or neck SOB/ dyspnea Sudden death

Immediate transport is essential. Pain Characteristics: 1. May or may not be caused by exertion 2. Does not resolve in a few minutes 3. Can last from 30 minutes to several hours 4. May not be relieved by rest or nitroglycerin

CARDIOGENIC SHOCK Heart lacks power to force blood through the circulatory system. Congestive Heart Failure - occurs when ventricles are damaged. - edema may happen to lungs or body as heart fails to pump.

If right sided heart failure = edema will be manifested on the organs and body system If left sided, usually jugular vein will distended upon inspected of the neck and JVD If left sided heart failure = fluids will be push in the lungs resulting to pulmonary edema

TAKING CARE OF A PERSON WITH CARDIAC EMERGENCIES Scene Size Up Initial Assessment General Impression Airway Breathing Circulation Focus Assessment consider BSI, safety, NOI, ALS? Responsive? Unresponsive?

Sufficient? DOB? SOB? Give Oxygen 100% 10-15 lpm via NRB Baseline Vital signs BP, PR, RR and capillary Refill SAMPLE History OPQRST Onset Provocation Quality of Pain Radiation Severity Timing Angina Pectoris sudden Exerted and effort Elephant on my chest Use pain scale Can be relieve for 15 mins Heart attack/AMI Sudden May or may not exerted effort crushing or squeezing Pain in lower jaw, arms, back, abdomen, or neck Cannot be relieve even after 30 mins

Transport Immediately Detailed Physical Assessment Medication commonly associated: may or may not be perfomed!

1. Aspirin Acetylsalicylate Acid prevents clot formation and for maintenance, 162 324 mg/day, P =
2. 80mg/day Nitroglycerin (NTG) relaxes the blood vessels and dilates arteries a. Take first the BP, do not give if BP is less than 100 systolic b. Do not give if pxn has head injury c. If the pxn has take 3 dosages, always ask for the medication d. Check for the expiration for potency of the medication