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Early Heart Attack Care

Early Heart Attack Care. Heart attacks have beginnings. For Questions, call Amy Fraulini, MSN, RN Director of Critical Care and Heart Services (740)356-8305 fraulina@somc.org. Heart Attack:. A community problem… with a community solution. Cardiovascular Disease Mortality Rates.

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Early Heart Attack Care

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  1. Early Heart Attack Care Heart attacks have beginnings For Questions, call Amy Fraulini, MSN, RN Director of Critical Care and Heart Services (740)356-8305 fraulina@somc.org

  2. Heart Attack: A community problem… with a community solution

  3. Cardiovascular Disease Mortality Rates BLUEindicates those counties which exceed the state of Ohio’s mortality rate Source: US CDC Mortality Database

  4. Course Outline • Anatomy and Physiology 101: Your Heart • Who’s at risk for heart disease? • 3. A Heart Attack in Progress • 4. Concepts of Early Heart Attack Care • 5. Recognition and Intervention • 6. Delay and Denial • 7. You: The Early Heart Attack Caregiver

  5. Part 1 Anatomy & Physiology 101:Your Heart

  6. The Human Heart • Location • Middle of the chest • Size • That of a fist • Purpose • Pumps blood throughout the body • Weight • 7 - 12 ounces • Capacity • Pumps 1,800 gallons of blood & beats over 100,000 times daily

  7. The Human Heart & Coronary Arteries SUPERIOR VENA CAVAL BRANCH (NODAL ARTERY) ANTERIOR R. ATRIAL BRANCH OF R. CORONARY ARTERY L. CORONARY ARTERY CIRCUMFLEX BRANCH OF L. CORONARY ARTERY RIGHT CORONARY ARTERY GREAT CARDIAC VEIN ANTERIOR INTERVENTRICULAR (ANTERIOR DESCENDING) BRANCH OF L. CORONARY ARTERY ANTERIOR CARDIAC VEINS SMALL CARDIAC VEIN

  8. The Human Heart & Coronary Arteries SUPERIOR VENA CAVAL BRANCH (NODAL ARTERY) OBLIQUE VEIN OF L. ATRIUM GREAT CARDIAC VEIN SINOATRIAL (S-A) NODE CIRCUMFLEX BRANCH OF L. CORONARY ARTERY SMALL CARDIAC VEIN CORONARY SINUS POSTERIOR VEIN OF L. VENTRICLE R. CORONARY ARTERY MIDDLE CARDIAC VEIN POSTERIOR INTERVENTRICULAR (POSTERIOR DESCENDING) BRANCH OF R. CORONARY ARTERY

  9. The Human Heart: Electric Pump

  10. Who’s at risk for Heart Disease? • Some persons are more likely than others to have a heart attack because of their “risk factors” • There are • Factors you can control • Factors you cannot control

  11. Risk factors we can control: • Smoking • High blood pressure • High blood cholesterol • Overweight and obesity • Physical inactivity • Diabetes

  12. Risk factors we cannot control: • Pre-existing coronary heart disease, including a heart attack, prior angioplasy, bypass surgery, or angina • Age • Family history of heart disease • A father or brother diagnosed before age 55 • A mother or sister diagnosed before age 65

  13. Part 3 A Heart Attack in Progress

  14. Heart Attack Facts • #1 Killer of Adults BOTH Men and Women • 1.1 million Americans suffer a heart attack each year • 460,000 of those heart attacks are fatal • Hundreds of thousands survive but are left with a damaged heart

  15. Some different presentations ofheart attack • Sudden, severe pain that stops you in your tracks. • Gradual increasing pain with damage occurring over a period of hours. • Very early presentation with mild symptoms over hours or days.

  16. Ischemia & Angina Pectoris Partial block producing chest pain Area of decreased blood supply

  17. Coronary Artery Disease

  18. Complete Obstruction: AMI Area of Infarct

  19. Part 4 Concepts of Early Heart Attack Care

  20. Are all heart attacks created equal?

  21. Progress: Heart Attack Treatment • Prehospital Cardiac Care • Thrombolytic Therapy (clot busters) • Angioplasty (preferred treatment with optimal outcomes) • Decrease in time to treatment saved heart muscle improvement in quality of life

  22. Too Little Progress: Heart Attack Recognition • Most heart attack patients do not benefit from optimal medical advances……………WHY?

  23. Delay • in recognizing and responding to the early warning signs of a heart attack

  24. Why Early Heart Attack Care? • Early Care: Recognize & Respond • often mild symptoms, usually normal activity • Late Care: Obvious Emergency & Respond • incapacitating pain, diminished activity • Too Late Care: Critical Emergency & Respond • unconscious, CPR, defibrillation, probable death • 85% of the heart damage takes place within the first two hours.

  25. Part 5 Recognition & Intervention

  26. Non-Specific Heart Attack Symptoms: weakness/fatigue clammy/sweating nausea/indigestion dizziness/nervousness shortness of breath neck/back/jaw pain feeling of doom elbow pain Specific Heart Attack Symptoms chest discomfort chest pressure chest ache chest burning chest fullness Early Symptoms of aHeart Attack

  27. Part 6 Delay & Denial

  28. Why do we delay? Denial and Procrastination = Our Heart’s Enemy!

  29. It’s nothing really serious “I’ll just rest a bit”

  30. I’m too busy right now “I don’t have time to be sick”

  31. I don’t want to be a problem “If it turns out to be nothing, I’ll be embarrassed by the fuss made.”

  32. Paramedics BEWARE! First responders can easily be swayed by patient rationalizations and denials

  33. It’s probably heartburn or indigestion “I’ll take something for it”

  34. I’m strong! “Just walk it off, grin and bear it”

  35. I’m healthy “I have no serious medical problems…I exercise.”

  36. I’ll just wait it out “Everything will be OK.”

  37. Part 7 YOU:The Early Heart Attack Caregiver

  38. Who is theCaregiver? • Spouse • Children • Parent • Co-worker • Friend • Exercise Partner • Anyone who cares about you!

  39. What to ask and look for • Do you have any chest discomfort? • Is it tightness, pressure, pain in the center of your chest? • Is the discomfort also in your arms or jaw or neck or throat or back? • Are you sick to your stomach? • Is the person sweaty or clammy? • What were you doing when the symptoms started? • Do the symptoms go away with rest? • Are you having any shortness of breath?

  40. Listen to yourHeartand be a Winner • Be aware of pressure, not necessarily pain, in your chest. • Be aware if it increases with activity and subsides with rest. • Don’t try to rationalize it away. Be honest with yourself and others. • Call 9-1-1 or have someone drive you to the nearest emergency room. • Don’t go to your doctors office or wait for an appointment. • Recognize the subtle danger signs and act on them before damage occurs.

  41. Remember to Call 9-1-1 WHY? • EMS can begin treatment immediately-even before arrival at the hospital • The heart may stop beating during a heart attack. EMS have the equipment needed to start the heart again • Heart attack patients have emergency needs that can be met by the EMS….such as oxygen, heart medications, and pain relief treatments • EMS are linked to the hospital and doctors to give them needed resources during this critical time

  42. Anyquestions? www.somc.org SafetyQuality Service RelationshipsPerformance

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