Chapter 2 Cardiac Emergencies and CPR

Heart Disease

Cardiovascular disease – an abnormal condition that affects the heart and blood vessels.

Coronary heart disease – an abnormal condition that affects the arteries that supply blood to person’s heart.

Heart DiseaseAtherosclerosis – condition in

which the arteries that supply blood to the heart harder and narrow due to plaque build up.

Plaque – cholesterol and fatty deposits

Common Causes of Heart Disease

AgeGenderHeredity StressDiabetesSmoking  Alcohol ConsumptionHigh blood pressure High blood cholesterol Being overweight or obese Physical inactivity

Controlling Risk Factors

Changing One’s Lifestyle◦Stop smoking/ Do not start

smoking◦Change diet

Avoid saturated fats and cholesterol

◦Exercise regularly

Heart AttackMyocardial Infarction - Death of or damage to

part of the heart muscle due to an insufficient blood supply.

The term "heart attack" refers to death of heart muscle tissue due to the loss of blood supply, not necessarily resulting in a cardiac arrest or the death of the heart attack victim.

Signs & Symptoms of a Heart Attack

Chest Pain◦ Chest, shoulder, arm, jaw◦ Last longer than 3 – 5 minutes or goes away and

comes backDifficulty Breathing

◦ Short of breath◦ Breathes faster than normal

Skin Appearance◦ Skin may be moist or sweating profusely ◦ Skin may appear pale or ashen

Signs in Women◦ Nausea and vomiting ◦ Back and jaw pain◦ Unexplained fatigue

Calling 9-1-1Victims often deny signals are

seriousDo not let this influence your

decision to call 9-1-1 Most people who die of a heart

attach die within 2 hours of the first signal

9-1-1

Care for a Heart AttackCall 9-1-1Have the person rest comfortablyLoosen any tight clothingMonitor the person’s conditionBe prepared to perform CPR or use

an AEDDo not try to drive the person to

the hospital yourself

Giving Aspirin to Lessen Heart Attack Damage -

If the person is able to take medicine by mouth ask – ◦Are you allergic to aspirin◦Do you have a stomach ulcer or

stomach disease?◦Are you taking any blood thinners,

such as warfarin?◦Have you ever been told by a doctor

to avoid taking aspirin?

Giving Aspirin to Lessen Heart Attack Damage -

If the person answers NO to all of these questions, you may offer him or her two chewable (81 mg) baby aspirins or one 5 grain (325 mg)adult aspirin with a small amount of water.

You may offer these doses of aspirin if the person regains consciousness while you are giving care and is able to take the aspirin by mouth.

Cardiac Arrest

Cardiac arrest is the sudden, abrupt loss of heart function.

Arrhythmias are abnormal, chaotic electrical activity of the heart.

This irregular heart rhythm (arrhythmia) causes the heart to suddenly stop beating.

Ventricular fibrillation (V-fib) is the most common life threatening abnormal arrhythmia.

Cardiac Chain of SurvivalFor each minute CPR and defibrillation are delayed,

the chance of survival is reduced by about 10 percent.

Early recognition and early access

Early CPR

Early defibrillation

Early advanced medical care

Cardiopulmonary ResuscitationCPR is a method that combines

chest compressions and rescue breathing for a victim who is not breathing and has no pulse.

This technique provides oxygenated blood to vital organs until advanced care arrives.

Given together, rescue breaths and compressions help to take over for the heart and lungs.

CPRSkill Component

Adult Child Infant

Hand Position Two hands in center of chest

Two hands in center of chest

Two or three fingers in center of chest (just below nipple line)

Chest Compressions

Rescue Breaths

At least 2 inches

Until chest clearly rises (about 1 second)

About 2 inches

Until chest clearly rises (about 1 second)

About 1 ½ inches

Until chest clearly rises (about 1 second)

Cycle 30 compressions2 breaths

30 compressions2 breaths

30 compressions2 breaths

Rate 30 compressions in about 18 seconds(at least 100 compressions per minutes)

30 compressions in about 18 seconds(at least 100 compressions per minutes)

30 compressions in about 18 seconds(at least 100 compressions per minutes)

If the Chest Does Not Rise with Rescue Breaths

You give a 1 rescue breath and notice the chest does not rise – ◦Re-tilt the head and before giving the

second breath.If the second breath does not go in the

person may be choking. Give 30 more chest compressions, look

for an object and, if seen, remove.Continue CPR.

If Two Responders Are Available

If the 1st responder is tired and needs help, they should tell the second responder to take over.

The 2nd responder should immediately resume CPR, starting with chest compressions.

When to stop CPR -

The person shows signs of lifeAn AED becomes available and is ready

to useAnother trained responder arrives and

takes overYou are too exhausted to continueThe scene becomes unsafe

Continuous Chest Compressions(Hands Only CPR)If you are unable or unwilling to

perform full CPR give continuous chest compressions after calling 9-1-1.