CardiovasculCardiovascular ar EmergenciesEmergencies

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CH

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Cardiac emergencies are the Cardiac emergencies are the

most common medical most common medical

emergencies in the U.S., with emergencies in the U.S., with

over over 600,000600,000 deathsdeaths each each

year...year...

……more than more than halfhalf of of

them occur outside of them occur outside of

hospitals.hospitals.

Review of the Review of the Circulatory SystemCirculatory SystemReview of the Review of the Circulatory SystemCirculatory System

AnatomyAnatomy

External View of HeartAortaAorta

Coronary Coronary arteriesarteries

SuperioSuperiorr

vena vena cavacava Left Left pulmonary pulmonary

arteryartery

C4-22

Internal View of Heart

VentriclesVentricles

AtriaAtria

Pulmonary Pulmonary valvevalve

Aortic valveAortic valve

Blood flowthrough thecirculatorysystem.

Arterial System

Carotid Carotid arteryartery

Brachial Brachial arteryartery

Radial Radial arteryartery

Femoral Femoral arteryartery

Venous System

External External jugular veinjugular vein

Femoral Femoral veinvein

Inferior Inferior vena cavavena cava

Great Great saphenous veinsaphenous vein

Blood Composition Blood Composition Red blood cellsRed blood cells

HemoglobinHemoglobin

White blood cellsWhite blood cells

PlateletsPlatelets

PlasmaPlasma Fluid that carries cells and plateletsFluid that carries cells and platelets

Blood Composition Blood Composition Functions Functions

Blood Component

Function

Red blood cellsGive blood its color, carry O2 to organs, carry C 02 away

White blood cells Part of immune system

Plasma

Platelets

Carries blood cells, nutrients

Essential for clotting

PhysiologyPhysiologyPhysiologyPhysiology

Key Pulse Points

CarotidCarotid

RadialRadial

BrachialBrachial

FemoralFemoral

PosteriorPosteriorTibialTibial

DorsalisDorsalisPedisPedis

Assessing the Pulse Assessing the Pulse RateRate

Averages 60 - 80 beats per minuteAverages 60 - 80 beats per minutein adultsin adults

QualityQuality Strength?Strength? (strong or weak)(strong or weak) Regularity?Regularity? (regular or irregular)(regular or irregular)

Perfusion:Perfusion:

The process of delivering blood The process of delivering blood to the organs, delivering to the organs, delivering oxygen, and removing wastes.oxygen, and removing wastes.

The skin condition is a good indicator of perfusion.

Shock:Shock:

A state or condition of A state or condition of inadequate perfusion to the inadequate perfusion to the organs and tissue.organs and tissue.

Signs and Symptoms of Shock Signs and Symptoms of Shock

Rapid and weak pulseRapid and weak pulse

Pale or cyanotic skin colorPale or cyanotic skin color

Cool, clammy skinCool, clammy skin

Rapid and shallow breathingRapid and shallow breathing

Restlessness and anxietyRestlessness and anxiety

Mental dullness, confusionMental dullness, confusion

Nausea, vomiting, and thirstNausea, vomiting, and thirst

Low or decreasing blood pressureLow or decreasing blood pressure

Subnormal temperatureSubnormal temperature

Signs & Symptoms of Shock continued Signs & Symptoms of Shock continued

Low blood pressure is a Low blood pressure is a LATELATE

sign of shock sign of shock

(hypoperfusion).(hypoperfusion).

NEVER rely solely on BP to

determine the presence of

shock.

Cardiac CompromiseCardiac CompromiseCardiac CompromiseCardiac Compromise

Ischemia:Ischemia:

A condition of reduced oxygen to A condition of reduced oxygen to body tissues and cells.body tissues and cells.

Atherosclerosis:Atherosclerosis:

A condition in which cholesterol A condition in which cholesterol and cellular debris form a plaque and cellular debris form a plaque on the insides of arteries, on the insides of arteries, narrowing the area that the blood narrowing the area that the blood flows through.flows through.

Normal Artery

ArteryCloggedwith plaque

Angina:Angina:

Chest pain caused by reduced Chest pain caused by reduced oxygen to the heart due to oxygen to the heart due to inadequate blood supply inadequate blood supply through the coronary arteries.through the coronary arteries.

Acute myocardial infarction:Acute myocardial infarction:

A condition in which a part of the A condition in which a part of the heart muscle dies as a result of no heart muscle dies as a result of no blood supply and prolonged lack of blood supply and prolonged lack of oxygen.oxygen.

Acute Myocardial Infarction (AMI)

Area of Area of ischemiaischemia

EmbolusEmbolus(or spasm)(or spasm)

Chest pain is often a symptom of an acute MI.

Congestive heart failure (CHF):Congestive heart failure (CHF):

A condition in which the heart A condition in which the heart fails to pump efficiently, causing fails to pump efficiently, causing fluid to back up into the lungs fluid to back up into the lungs and venous system.and venous system.

Signs & Symptoms of CHF DyspneaDyspnea

JVDJVD

Pulmonary Pulmonary edemaedema

Pedal (peripheral) Pedal (peripheral) edemaedema

AssessmentAssessmentAssessmentAssessment

SSigns and symptomsigns and symptoms

AAllergiesllergies

MMedicationsedications

PPertinent past medical historyertinent past medical history

LLast oral intake (solid or liquid)ast oral intake (solid or liquid)

EEvents leading to injury or illnessvents leading to injury or illness

OOnsetnset

PProvocationrovocation

QQualityuality

RRadiationadiation

SSeverityeverity

TTimeime

Cardiac Compromise Cardiac Compromise Squeezing, dull pressure or pain in the chest Squeezing, dull pressure or pain in the chest (may radiate to arms, neck, jaw or upper back)(may radiate to arms, neck, jaw or upper back)

Sudden onset of sweatingSudden onset of sweating

Difficulty breathingDifficulty breathing

Anxiety or irritabilityAnxiety or irritability

Feeling of impending doomFeeling of impending doom

Nausea or vomitingNausea or vomiting

Cardiac Compromise continued Cardiac Compromise continued

Epigastric pain or abdominal discomfortEpigastric pain or abdominal discomfort

Abnormal and sometimes irregular pulseAbnormal and sometimes irregular pulse

Sometimes abnormal blood pressureSometimes abnormal blood pressure