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35 Cards in this Set
- Front
- Back
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CPR |
- Used to establish artificial circulation and ventilation in a patient who is not breathing and has no pulse. - Steps: 1. Open airway 2. Look for signs of breathing and circulation 3. Chest compressions (circulate blood) 4. Artificial respirations by rescue breathing. (mouth2mouth, mouth2nose - infant, mechanical devices) |
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AHA's chain of survival |
- Early access - Early CPR - Early defibrillation - Early advanced care |
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Cardiac rhythms EMT-B should recognize |
- Normal sinus rhythm - Ventricular fibrillation (V-fib) - Ventricular Tachycardia (V-tach) - pulseless electrical activity (PEA) - asystole - artifact |
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Ventricular Fibrillation |
- lethal dysrhythmia originating from many sites in ventricles --> ineffective quivering of the ventricular muscle - no pulse or cardiac output |
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Ventricular Tachycardia |
- very rapid heart rhythm; organized and originating in ventricles - inadequate cardiac output, decreased b.p., decreased perfusion OR no pulse or cardiac output |
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Pulseless electrical activity |
- electrical activity normal but heart muscle has failed or patient is hypovolemic - no pulse or cardiac output * AED will not shock |
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Asystole |
- no electrical impulses exist (flatline) - no pulse or cardiac output - can result from untreated ventricular fibrillation, a sick heart, vagal stimulation, a terminal illness or severe blood loss * Doesn't mean not savable! |
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Artifact |
- electrical energy created by something besides heart muscle (loose leads, agonal respirations, or patient movement) - no effect on pulse or cardiac output, but may interfere with interpretation of ECG reading |
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Shockable vs. Non-shockable rhythms |
- Shockable = ventricular fibrillation, ventricular tachycardia - Non-shockable = normal sinus, pulseless electrical activity, asystole |
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AED indications |
- Adults and Children: unresponsive, pulseless, non-breathing
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AED contraindications |
- Any patient who is awake, has a pulse or is breathing - Traumatic full arrest --> caused by severe hypovolemia or injury to major organs, these patients generally not in a rhythm that requires defibrillation. If an arrest appears to have a medical cause, AED should be used and applied. - DNR - obvious signs of death |
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When not to start BLS? |
- obvious signs of death: rigor mortis, dependent lividity, putrefaction, decomposition, decapitation, dismemberment, burned beyond recognition - DNR orders |
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When to stop BLS? (acronym) |
- S (patient) Starts breathing and has a pulse - T (patient) transferred to another trained responder - O (you are) out of strength - physically unable - P Physician directs to discontinue |
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Foreign body airway obstruction in unconscious adults |
When victim found unconscious: - normal assessment - determine unresponsiveness - open airway - look at breathing, check pulse - attempt to give breaths, reposition airway if needed, attempt breaths - perform 30 chest compressions, open airway and look in mouth - attempt to carefully remove any visible object
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Common causes of chest pain? |
- myocardial - vascular - pulmonary - gastro-intestinal - musculoskeletal |
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Cardiac output = ? |
stroke volume x heart rate |
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Blood pressure = ? |
cardiac output x peripheral vascular resistance |
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Def: Hypoperfusion |
widespread inadequate blood flow |
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Acute Coronary Syndromes - Risk Factors |
- Unmodifiable: age, sex, race, family history - Modifiable: hypertension, high lipids, obesity, smoking, personality, stress, high blood sugar, physical inactivity, oral contraceptive |
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Location and types of chest pain |
- midsternal chest pain (most common) - pain radiating from the chest to the scapula, neck, jaw, or the left or right arm - "heartburn, indigestion" - left arm pain - pressure, squeezing, or crushing pain
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Before administering medication (acronym) |
D.I.C.E.
- Drug/dosage/dexterity - Integrity - Color/clarity/concentration - Expiration date |
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Nitroglycerin contraindications |
- b.p. <100 - recently taken - hypersensitivity |
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ASA (aspirin) |
- Contraindications: stroke, GI bleed, hyposensitivity - Dose: 162 - 324 mg - Side-effects: not typical, sometimes upset stomach *Can assist them with own aspirin |
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Specific cardiovascular emergencies |
- angina pectoris - myocardial infarction - acute dissecting aortic aneurysm - CHF
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Angina Pectoris |
- temporary inadequate oxygen supply to the heart muscle
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Angina - signs and symptoms |
- Provoke: exercise, stress, or emotional upset - Palliation: NTG, rest, oxygen - Quality: pressure, squeezing, crushing pain which is constant - Region: substernal - Radiation: upper thorax - Reoccurence: possible, especially if prescribed NTG - Severity: mild to moderate - Time: should last less than 30 mins |
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Myocardial infarction |
sudden blockage of the coronary artery and prolonged ischemia |
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Myocardial infarction - signs and symptoms |
- Provoke: can be increased heart rate, but can still happen at rest - Palliation: nothing by EMT-B - Quality: pressure, squeezing or crushing pain which is constant - Region: substernal - Radiation: upper thorax - Reoccurence: possible, especially if prescribed NTG - Severity: moderate to severe - Time: longer than 30 mins |
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Cardiac disease - assoc. signs and symptoms |
- nausea / vomiting - diaphoresis - dyspnea - irregular pulse - weakness - hypotension / hypertension |
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Angina/Myocardial infarction - treatment |
- high flow O2 if no pulse ox (nasal cannula) - if pulse ox, no O2 if Spo2 >95% - focused history and physical - OPQRST - SOB? JVD? Edema? - obtain baseline vitals - SAMPLE - assist with NTG if appropriate - Consider ASA local protocol - transport code 2 & reassess |
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Acute dissection Aortic Aneurysm - signs and symptoms |
- Provoke: heavy lifting and straining - Palliation: nothing in prehospital setting - Quality: tearing, ripping, hot, knifelike - Region: substernal - Radiation: anterior to posterior - Reoccurence: usually not - Severity: severe, maximal at onset - Time: minutes to hours |
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Acute dissection Aortic Aneurysm - associated signs and symptoms |
- unequal radial or femoral pulses - unequal blood pressure - pulsating mass if abdominal - shock (hypoperfusion) |
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Acute Dissecting Aortic Aneurysm - treatment |
- airway - reassure patient - high flow oxygen(NR mask; ventilations prn) - supine position - treat for shock - rapid transport and reassess |
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Hypertensive emergency |
any systolic blood pressure greater than 160 mm Hg or a rapid increase in the systolic pressure |
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Hypertensive emergency - signs and symptoms |
- sud |
