Defibrillation
Delivery of an electricl shock to stop the fibrillation of heart muscles and restore a normal heart rythym
Cardiopulmonary Resuscitation (CPR)
Actions taken to revive a person by keeping the person's heart and lungs working
Cardiovascular System
The heart and blood vessels
Acute Coronary Syndrome (ACS)
A blanket term used to represent any symptoms related to lack of oxygen (ischemia) in the hear muscle; also called cardiac compromise
Oxygen
The most important drug in the treatment of heart problems
Cardiac arrest
The absence of a heartbeat and circulation of blood
Dyspnea
Shortness of breath; labored or difficult breathing
Bradycardia
When the heart rate is slow, usually less than 60 beats per minute
Tachycardia
When the heart rate is fast, more than 100 beats per minute
Palpatations
Irregular or rapid heartbeats; fluttering sensation in the chest
Coronary Artery Disease (CAD)
Diseases that affect the arteries of the heart
Thrombus
A clot formed of blood and plaque attached to the inner wall of an artery or vein
Occlusion
Blockage; as of an artery, by fatty deposits
Embolism
Blockage of a vessel by a clot or foreign material brought to the site by the blood current
Myocardium
Heart muscle
Angina Pectoris
Pain in the chest occurring when blood supply to the heart is reduced and a portion of the heart muscle is not receiving enough oxygen
Aneurysm
The dilation , or ballooning, of a weekend section of the wall of an artery
Dysrhythmia
A disturbance in heart rate and rhythm
Nitroglycerin
A medication that dilates the blood vessels; this results in more blood stay in in the veins of the body, so there is less blood coming back to the heart and the heart doesn't have to work as hard
Acute Myocardial Infarction (AMI)
The condition in which a portion of the myocardium dies as a result of oxygen starvation; also called a heart attack
Sudden Death
A cardiac arrest that occurs within 2 hours of the onset of symptoms; the patient may have no prior symptoms of coronary artery disease
Fibrinolytics
Medication that dissolves the clot that is blocking the coronary artery
Beta Blocker
Medication that slows the heart and makes it beat less strongly (decreases the work the heart has to do)
Congestive Heart Failure (CHF)
The failure of the heart to pump efficiently, leading to excessive blood or fluids in the lungs, the body, or both
Edema
Swelling resulting from a buildup of fluid in the tissues
Pulmonary Edema
Accumulation of fluid in the lungs
Pedal Edema
Accumulation of fluid in the feet or ankles
Diuretic
Medication that helps remove fluid from the circulatory system
Who has summarized the most important factors that affect survival of cardiac arrest patients?
American Heart Association
5 Elements of the Chain of Survival Concept for Cardiac Arrest Patients
1) Recognition and activation of the emergency response system
2) Immediate high-quality CPR
3) Rapid defibrillation
4) Basic and advanced EMS
5) ALS and post-arrest care
Underlying Theme of the Chain of Survival
Teamwork
AED
Automated External Defibrillator; only attach to pulseless, non-breathing, and unresponsive patients
Ventricular Fibrillation
A condition in which the heart's electrical impulses are disorganized, preventing the heart muscle from contracting normally
Ventricular Tachycardia
A condition in which the heartbeat is quite rapid; if rapid enough, ventricular tachycardia will not allow the heart's chambers to fill with enough blood between beats to produce blood flow sufficient to meet the body's needs
Pulseless Electrical Activity (PEA)
A condition in which the heart's electrical rhythm remains relatively normal, yet the mechanical pumping activity fails to follow the electrical activity, causing cardiac arrest
Asystole
A condition in which the heart has ceased generating electrical impulses; commonly called flatline
Apneic
Not breathing
3 Main Coronary Arteries That Feed the Heart:
Right coronary artery
Left Anterior Descending
Circumflex (wraps around back of heart)
What's the main pacemaker of the heart?
Sinoatrial (SA) Node; normally fires at 60-100 bpm
What holds true of arteries?
All arteries carry blood away from the heart (AAA)
Shock
Inadequate tissue perfusion (hypoperfusion)
Blood Flow Through the Heart:
Oxygenated Blood: Superior Vena Cava, Right Atrium, Tricuspid Valve, Right Ventricle, Pulmonary Artery (leading out to the lungs)
Deoxygenated Blood: In from the Pulmonary Veins, Left Atrium, Bicuspid (Mitral) Valve, Left Ventricle, Aorta, Aortic Artery (
Ischemia
Inadequate blood supply to an organ or part of the body, especially in the heart (that area will not receive enough oxygen)
These patients may not experience chest pain, only difficulty breathing, in Acute Coronary Syndrome (ACS); this is also called a silent MI:
The elderly, diabetics, and women
What is the best known symptom of Acute Coronary Syndrome?
Chest pain
What nervous system is activated during chest pain?
Sympathetic Nervous System
What does the sympathetic nervous system do during chest pain?
Release epinephrine
Diaphoresis
Excessive sweating
What is the order of primary assessment of an unconscious patient? (According to the American Heart Association)
Check for pulse first; CAB not ABC
How many chest compressions do you administer per minute?
100-120 per minute; hard, fast compressions
OPQRST
Onset, Provocation, Quality, Region/Radiation, Severity, Timing
When will you administer oxygen to a patient?
When their O2 saturation is less than 94%
If a patient has a nitroglycerin patch and shows low blood pressure, what do you do next?
Take off the patch
When do the coronary arteries receive their blood supply?
Diastole (When the heart is relaxed/isn't pumping)
The number one cause of heart attacks:
Atherosclerosis; condition in which fatty deposits called plaque build up on the inner walls of the arteries
Unstable Angina
Chest pain that occurs at rest and is not relieved by nitro
What is the most common symptom of reduced blood supply?
Chest pain
What is a classic sign of abdominal aortic aneurysm (AAA)?
Pulsating mass
What percentage of a failing heart is considered Cardiogenic Shock?
40%>
What percentage of a failing heart is considered Congestive Heart Failure?
25-40%
Starling's Law
The more the heart is filled during diastole the more forcefully it contracts
What are some of the signs of left sided congestive heart failure?
Pulmonary edema (rails in the lungs)
What are some of the signs of right sided congestive heart failure?
JVD, Ascites (fluid in the abdominal cavity), Pedal Edema (ankle swelling)
Cor Pulmonale
Isolated right sided heart failure; the number 1 cause is long-standing pulmonary disease
What is the most common cause of right sided heart failure?
Left sided heart failure
Signs and Symptoms of Congestive Heart Failure
Tachycardia
Dyspnea
Cyanosis
Normal or elevated blood pressure
Diaphoresis
Pulmonary Edema
Anxiety/Confusion
Pedal Edema
JVD
Abdominal Distention (enlarged liver and spleen)
5 Elements of the Chain of Survival
1) Immediate recognition and activation
2) Early CPR
3) Rapid defibrillation
4) Effective advanced life support
5) Integrated post-cardiac arrest care
What do you do immediately after administering a shock during CPR?
Resume chest compressions (do not check pulse)
Time between defibrillation
2 minutes of CPR
When will an AED advise shock?
V-Tach or V-Fib