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
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
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.
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.
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)
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
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
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