EMT: Cardiovascular

The one valve that lies between the left ventricle and the aorta that keeps blood from flowing back into the left ventricle after the left ventricle ejects its blood back into the aorta

An aortic aneurysm is a general term for any swelling (dilation or aneurysm) of the aorta, due to a weakness in the wall of the aorta that makes it susceptible to rupture

The main artery, which receives blood from the left ventricle and delivers it to all other arteries that carry blood to tissues of the body

The front of the body. the side facing you in anatomic position

Transient (short lived) chest discomfort caused by partial or temporary blockage of blood flow to the heart muscle (demand for oxygen exceeds supply) May be associated with shortness of breath, nausea or sweating.
Disappears with rest, supplemental oxygen or nitroglycerin.

Patients having chest pain should be treated as if they are having an AMI

Pain is usually felt in the mid portion of the chest, under the sternum. Pain can also radiate to the jaw, the arms (frequently the left arm), the mid portion of the back, or the epigastrium(the upper middle region of the abdomen).

Angina can either result from a spasm of an artery. But most commonly it is a symptom of atherosclerotic coronary artery disease.

A heart attack: death of heart muscle following obstruction of blood flow to it
Acute in this context means now or happening now.

30 minutes some cells begin to die, 2 hours half of cells die, 4-6 hours 90% of cells die.

A term used to describe a group of symptoms caused by myocardial ischemia.

Includes angina and myocardial infarction.

An irregular or abnormal heart rhthm

The complete absence of heart electrical activity

A disorder in which cholesterol and calcium build up inside the walls of blood vessels, eventually leading to partial or complete blockage of blood flow

One of two (right and left) upper chambers of the heart. The right atrium receives blood from the vena cava and delivers it to the right ventricle. The left atrium receives blood from pulmonary veins and delivers it to the left ventricle

The ability of cardiac muscle cells to contract without stimulation from the nervous system

The part of the nervous system that controls the involuntary activities of the body such as the heart rate, blood pressure and digestion of food

A slow heart rate, less than 60 beats/min.

Damage to the inferior portion of the heart presents as bradycardia

A state in which the heart fails to generate effective and detectable blood flow; pulses are not pulpable in cardiac arrest, even if muscular and electrical activity continues in the heart

A state in which not enough oxygen is delivered to the tissues of the body, caused by low output of blood from the heart. It can be a severe complication of a large acute myocardial infarction, as well as other conditions.

A measure of the volume of blood circulated by the heart in 1 minute calculated by multiplying the stroke volume by the heart rate

A disorder in which the heart loses part of its ability to effectively pump blood, usually as a result of damage to the heart muscle and usually resulting in a backup of fluid into the pulmonary veins. This increases pressure on the capillaries of the lungs. When the pressure exceeds a certain level fluid passes through the walls of the pulmonary vessels into the alveoli.

The blood vessels that carry blood and nutrients to the heart muscle.

To shock a fibrillating (chaotically beating) heart with specializd electrical current in an attempt to restore a normal rhythmic beat

Widening of a tubular structure such as a coronary artery

A condition in which the inner layers of an artery such as the aorta become separated, allowing the blood (at high pressures) to flow between the layers

Swelling in the part of the body closest to the ground, caused by collection of fluid in the tissues; a possible sign of congestive heart failure

Hypertensive Emergency occurs with a systolic blood pressure greater than 160.

An emergency situation caused by excessively high blood pressure, which can lead to serious complications such as stroke or aneurysm

Death of body tissue, usually caused by interruption of its blood supply.

The part of the body or any body part nearer to the feet

A lack of oxygen that deprives tissues of necessary nutrients, resulting from partial or complete blockage of blood flow; potentially reversible because permanent injury has not yet occured

The inside diameter of an artery or other hollow structure

The heart muscle -
increased oxygen demand of the heart muscle itself is met by the dilation of the coronary arteries

A blockage, usually of a tubular structure such as a blood vessel

The part of the autonomic nervous system that controls vegetative functions such as digestion of food and relaxation

The flow of blood through body tissues and vessels

The back surface of the body; the side away from you in the standard anatomic position.

The volume of blood ejected with each ventricular contraction

The part of the body or any body part nearer to the head

The part of the autonomic nervous system that controls active functions such as responding to fear (also known as the "fight-or-flight" system).

A fainting spell or transient loss of conciousness

A rapid heart rate, more than 100 beats/minute

A blood clot that has formed within a blood vessel and is floating within the blood stream

One of two (right and left) lower chambers of the heart. The left ventricle receives blood from the left atrium (upper chamber) and delivers blood to the aorta. The right ventricle receives blood from the right atrium and pumps it into the pulmonary artery

Disorganized, ineffective twitching of the ventricles, resulting in no blood flow and a state of cardiac arest

A rapid heart rhythm in whch the electrical impulse begins in the ventricle (instead of the atrium), which may result in inadequate blood flow and eventually deteriorate into cardiac arrest.

Sudden onset of weakness, nausea and sweating without an obvious cause.

Chest pain, discomfort, or pressure that is crushing or squeezing and does not change with each breath.

Pain, discomfort or pressure in te lower jaw, arms, back, abdomen or neck

Irregular heartbeat and syncope

Shortness of breath or dyspnea

Pink froty sputum

Sudden death

Sudden death
Cardiogenic Shock
CHF

Appearance - Nausea, vomiting or cold seat. Skin can be pale or ashen gray. Occasionally there will be cyanosis.

Patient finds it easier to breath when sitting up (when the patient is lying down more blood is returned to the right ventricle and lungs)

Patient is mildly or severely agitated

Chest pain may or may not be present

The patient may have swollen ankles from dependent edema.

The patient will generally have high blood pressure, rapid heart rate and rapid respirations.

The patient will usally be using accessory muscles

The fluid surrounding the small airways may produce rales

CHF is treated but not cured. Half die within five years

**(CPAP) Continuous Positive Airway Pressure is the most effective way to assist a person with CHF to breathe effectively and prevent an invasive airway management technique.***

1. Take vitals and give oxygen by non-rebreather mask with an oxygen flow of 10 to 15 L/min

2. Patient should remain sitting in an upright position with legs down.

3. Be reassuring as patients with CHF can't breathe

4. Gather any medications and take to the hospital.

5. Nitroglycerin may be helpful if the patient's blood pressure is greater than 100mm hg.

heart lacks the power to force the proper volume of blood through the circulatory system

"air hunger" Patient says they can breathe (they can breathe because they can talk, however brain is sensing it isn't getting enough oxygen)

Body sends blood away from less important organs leading to pale, clammy skin.

Body compensates by increasing the amount of blood pumped. Pulse rate may increase

Rapid shallow and shallow breathing, nausea and vomiting and a decrease in body temperature.

Do not assume shock is not present because blood pressure is normal. Systolic blood pressure will be less than 90, but this is a late finding.

Position the patient comfortably. Most patients will be comfortable in a semi-Fowler's position (head and knees slightly elevated); Patients with low blood pressure may not tolerate this position and may be comfortable in a supine position

Administer high-flow oxygen

Assist ventilations as necessary

Cover the patient with sheets or blankets as indicated to preserve body heat. Be sure to cover the patients head in cold weather.

Prompt Transport

Obtain an order form medical control. Take the patient's blood pressure. Administer nitroglycerin only if the systolic blood pressure is greater than 100 mm HG

Check the medication and expiration date. Ask the patient the last does he or she took and its effects. Make sure that the patient understands the route of administration. Prepare to have the patient lie down to prevent fainting

Ask the patient ot lift his or her tongue. Place the tablet or spray the does under the tongue (while wearing gloves) or have the patient do so. Have the patient keep his or her mouth closed with the tablet or spray under the tongue until it is dissolved and absorbed. Caution the patient against chewing or swallowing the tablet.

Recheck the blood pressure within 5 minutes. Record each medication and the time of administration. Reevaluate the chest pain and blood pressure and repeat treatment if necessary.

If arrest happens during transport, stop the vehicle.

Stop CPR if it is in progress. Assess responsiveness. If patient is responsive, do not apply the AED

If the patient is unresponsive, open the airway and assess breathing. If the patient is not breathing or breathing agonally (slow, gasping breaths) give two ventilations (1 second each) using a bag mask device or pocket mask device and then check for a pulse.

If there is no pulse, perform five cycles (about 2 minutes) of CPR and prepare the AED for use.

Turn on the AED

Remove clothing from the patient's chest area. Apply the pads to the chest: one just to the right of the sternum just below the clavicle, the other on the left lower chest area with the top of the pad 2 to 3 inches below the armpit. Plug in the pads connector to the AED.

Stop CPR

State aloud, clear the patient, and ensure no one is touching the patient.

Push the Analyze button, if there is one, and wait for the AED to determine if a shockable rhythm is present

If a shock is not advised, perform five cycles (about 2 minutes) of CPR and then reassess the patients pulse and reanalyze the cardiac rhythm. If a shock is advised, reconfirm that no one is touching the patient and press the shock button.

After the shock is delivered, immediately resume CPR beginning with chest compressions.

After five cycles of CPR, reassess the patient's pulse and reanalyze the cardiac rhythm.

If the AED advises a shock, clear the patient, push the shock button and immediately resume CPR. If no shock is advised, immediately resume CPR.

Gather additional information about the arrest event

After five cycles (2 minutes) of CPR, reassess the patient's pulse and reanalyze the cardiac rhtym.

Repeat the cycle of 2 minutes of CPR, one shock, and 2 minutes of CPR

Transport, and contact medical control

A dual shaped valve that lies between the left atrium and the left ventricle.

SA Node (upper right atrium) -> (travel across both atria causing them to contract) -> AV Node -> Bundle of His -> Bundle Branches -> Purkinje fibers (spread through out both ventricles)