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Chapter 6

Chapter 6. Cardiac Emergencies. Cardiovascular Disease. Abnormal conditions that affect the heart and blood vessels Leading cause of death in US (male/female) 61 million suffer; 950,000 die each year (2005) Principle components :

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Chapter 6

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  1. Chapter 6 Cardiac Emergencies

  2. Cardiovascular Disease • Abnormal conditions that affect the heart and blood vessels • Leading cause of death in US (male/female) • 61 million suffer; 950,000 die each year (2005) • Principle components: • Coronary heart disease: arteries that carry oxygen-rich blood to heart harden or narrow from build up of fatty deposits • Stroke: disruption of blood flow to part of brain which causes permanent damage to brain tissue (cerebrovascular accident or CVA)

  3. Cardiovascular Emergencies • 2 common emergencies: • A) heart attack- (myocardial infarction) blood flow to some part of heart muscle is comprised and heart begins to die; if enough of heart dies, heart cannot circulate blood effectively -B) cardiac arrest – heart stops beating

  4. Cardiovascular Emergencies • Clinically dead = no signs of life (no pulse or breathing) • Cells of brain and other vital organs continue to live until oxygen is depleted • CPR: cardiopulmonary resuscitation is needed; combination of chest compressions and rescue breathing • Together take over functions of heart/lungs until advanced medical care given • Only generates 1/3 of normal blood flow to brain

  5. Cardiovascular Emergencies • Cardiac Chain of Survival: give victim of cardiac arrest the best chance of survival 1. Early recognition and early access: sooner 9-1-1 called; sooner early advanced medical care arrives 2. Early CPR: helps circulate oxygen-rich blood to vital organs until AED is ready to be used or advanced medical help arrives

  6. Cardiovascular Emergencies • Early Defibrillation: electric shock called defibrillation that can restore an effective heart rhythm to cardiac arrest victim; each minute delayed reduces chance of survival by 10% • Early Advanced Medical Care: given by trained medical personnel, who provide further care and transport to hospital

  7. Signals of Heart Attack • Chest pain spreading * shortness of breath shoulders/neck/jaw/arms * sweating • Nausea or vomiting * denial • Dizziness, light headed *pale, ashen (gray) or bluish or fainting skin Additional Signs felt by Women • Shortness of breath • Nausea or vomiting • Back or jaw pain • Nearly ½ of all deaths from heart attacks are Women

  8. Heart Attack • Most important first aid measure is to be able to recognize signals of heart attack and take action. • Most victim’s will deny the seriousness of the signals he/she is experiencing. • Many delay seeking care – usually 2 hours or more before going to hospital • Some mistake signals for indigestion

  9. Care for Heart Attack • Check, Call, Care • Recognize signals of heart attack • Call 9-1-1 • Help victim rest comfortably • Loosen any restrictive clothing • Assist the victim w/any prescribed medication • Monitor breathing and other signs of life • Be prepared to perform CPR or use an AED if victim’s heart stops beating

  10. Heart Attack • Angina Pectoris: chest pain or pressure that comes and goes at different times • Heart needs more oxygen than it gets • Lack of oxygen causes constricting chest pain that spreads to neck, jaw, and arms • Seldom lasts longer than 3 to 5 minutes • Nitroglycerin – medication that dilates blood vessels to make it easier for blood to reach heart; relieves pain • If does not go away after 10 min; call 9-1-1

  11. Cardiac Arrest • Heart stops beating or beats to ineffectively to generate a pulse and blood is not circulated to brain and other vital organs • Causes • Cardiovascular disease • Drowning *certain drugs • Severe injuries to chest *suffocation • Severe blood loss *electrocution • Stroke or other brain damage • Sudden Death- no warning signals at all • Signals: no signs of life

  12. CPR for Adult • Check the scene and victim • If victim is unconscious, send someone to call 9-1-1 • Check for breathing for no more than 10 seconds (Look, listen, and feel) • Check for bleeding • 30 chest compressions • Head tilt/chin lift • 2 slow breaths • Repeat

  13. CPR • Chest compressions- victim needs to be on a hard surface to be effective • Hand position: 2 hands in center of chest • kneel down beside victim • Place heel of hand on the center of victim’s sternum (breastbone) • Place other hand directly on top of first • Use heel of hand to apply pressure • Keep fingers off chest • Shoulders directly over hands • Arms straight and elbows locked

  14. CPR • Compressions: push sternum down 2 inches • Each movement should be smooth not jerky • Do not pause between compressions • Hands never leave chest during compressions • 100 per minute (30 compressions – 18 seconds) • Count: one and two and three and four and five ….. Up to 30 • Push down saying #, up say “and”

  15. CPR • Cycles of 30 compressions and 2 rescue breaths • Use head tilt/chin lift technique to open airway after compressions • Breath until see the chest rise (1 second); pinch nose during breath and release • If two responders, send one to call 9-1-1 and get an AED

  16. When to stop CPR • Scene becomes unsafe • Victim shows signs of life • An AED becomes available and is ready to use • Another trained rescuer arrives and takes over • You are too exhausted to continue

  17. Child and Infant CPR • Children do not often initially suffer a cardiac emergency • Generally, they suffer a respiratory emergency that can develop into a cardiac emergency • Infant in need of CPR: no breathing and no signs of life • Causes:car crashes, drowning, smoke inhalation, poisoning, choking, firearm injury, falls, and also from acute respiratory conditions such as asthma attack

  18. Child CPR • Same as for the adult except for • Give 2 minutes of CPR then call 9-1-1 if you are alone otherwise ask someone to call for you • Use heel of only two hands for compressions Shoulders over hands • Compress chest 2 inches smoothly • 30 compressions in 18 seconds (100 per min) • 2 slow rescue breaths (until see chest rise); pinch nose and release after breath • Repeat cycle (30 compressions and 2 breaths)

  19. Infant CPR • Same as for the adult except for • Use only pads of 2 fingers for compressions and the other on the infant’s forehead to maintain open airway • Shoulders over hands • Compress chest 11/2 inches smoothly • 30 compressions in 18 seconds (100 per min) • 2 slow rescue breaths (until see chest rise); cover infant’s nose and mouth with your mouth • Repeat cycle (30 compressions and 2 breaths)

  20. Automated ExternalDefibrillator (AED) • Abnormal rhythms of the heart • Ventricular Fibrillation (V-fib): totally disorganized electrical activity in the heart • Results in fibrillation or quivering of the ventricles • Heart cannot pump blood and no signs of life (including no pulse) • Ventricular Tachycardia (V-tach): very rapid contraction of ventricles • Regular rhythm, rate is so fast heart unable to pump blood properly • No signs of life including no pulse • Fibrillation can be corrected by early defibrillation (85% of people) • If not corrected, all electrical activity will cease – asystole (flatline)…cannot be corrected or reversed

  21. AED Precautions • Do not touch victim while AED is analyzing (disrupts analysis) • Do not touch victim during defibrillation (you could be injured) • Do not use alcohol to wipe victim’s chest (flammable) • Do not use AED in a moving vehicle • Do not use AED on victim in contact with water • Use proper pads for adults and children (under 8 yrs and less than 55 lbs) • Do not use AED on victim with a nitroglycerin patch • Do not use cell phones or radio transmissions w/in 6 ft of AED- interrupts analysis

  22. AED • How to use an AED: • As soon as it is available and safe to do so, CPR is stopped • Turn on AED • Open victim’s shirt and wipe chest dry • Attach AED pads (upper right chest, lower left side) • Plug in connector to AED • AED analyze heart rhythm • Say: “everyone stand clear” (do not touch victim) • Deliver shock by pushing button when told to do so • Say: “everyone stand clear, shocking” • AED analyze again • Recheck for pulse, provide additional shock if advised to do so • No shock advised, continue CPR, leave AED attached

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