Cardiac Emergencies

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Chapter 2

• Cardiac Emergencies

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Cardiac EmergenciesObjectives

1. Identify the common cause of a heart attack
2. List signs and symptoms of a heart attack
3. Identify the care for a heart attack
4. Recognize the primary signs of cardiac arrest
5. Describe the purpose of CPR
6. Be able to perform CPR
7. List conditions in which a rescuer may stop CPR

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Heart Attack

• Like all living tissue, the cells of the heart
  need a continuous supply of oxygen. The coronary
  arteries supply the heart muscle with oxygen-rich
  blood. If the heart is deprived of this blood, it
  dies.
• If enough of the muscle dies, the heart cannot
  circulate blood effectively, causing a heart
  attack.
• A heart attack interferes with the hearts
  electrical and mechanical systems. This
  interference may result in an irregular
  heartbeat, which may prevent blood from
  circulating effectively.

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Common Cause of a Heart attack

• A Heart attack is usually the result of
  cardiovascular disease (coronary heart disease).
• This is the leading cause of death for adults
  over 44 years of age in the U.S.
• 70 million Americans suffer from this.
• 1 million deaths annually/500,000 are due to
  heart attacks
• Cardiovascular disease develops slowly. Fatty
  deposits of cholesterol and other material may
  gradually build up on the inner walls of the
  arteries.

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Signs and Symptoms

• Persistent chest pain or discomfort, sometimes
  confused with indigestion, (a muscle spasms)
• Heart burn to unbearable crushing pain
• Breathes noisily, short of breath, faster than
  normal
• Skin ashen, pale, bluish - profuse sweating
• Nausea/vomit

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Care for a Heart attack

1. Recognize the signs and symptoms of a heart
   attack
2. Call EMS
3. Convince the victim to stop activity and rest
4. Help the victim rest comfortably
5. Comfort victim
6. Assist the victim with medication, if prescribed
   (Nitroglycerin - vasodilator)
7. Be prepared to give CPR if the victims heart
   stops beating.

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Cardiac Arrest/Common Causes

• Cardiac arrest occurs when the heart stops
  beating or beats too ineffectively to generate a
  pulse and blood cannot be circulated.
• Cardiovascular disease is the most common.
• Drowning, suffocation, and certain drugs can
  cause breathing to stop, which will soon lead to
  cardiac arrest.
• Severe injuries to the chest or severe blood loss
  can also cause the heart to stop.
• Electrocution disrupts the hearts electrical
  activity
• Stroke or other types of brain damage can also
  stop the heart

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Cardiac Chain of Survival

• The greatest chance of survival from cardiac
  arrest occurs when the following sequence of
  events happens
• Early Recognition
• Early CPR
• Early Defibrillation
• Early Advanced care

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Purpose of CPR

• A victim who is not breathing and has no pulse is
  said to be clinically dead. However, the cells
  of the brain and other vital organs will continue
  to live for a short period of time until oxygen
  is depleted. This victim needs cardiopulmonary
  resuscitation (CPR)
• Without CPR, the brain will begin to die within 4
  to 6 minutes. This irreversible damage caused by
  brain cell death is known as biological death.

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CPR

• If a person is in cardiac arrest, they are
  unconscious, not breathing and show no other
  signs of life.
• Cardiopulmonary resuscitation (CPR) can help
  circulate blood that contains oxygen to vital
  organs by combination of chest compressions and
  rescue breaths.

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CPR Adult

• Give cycles of 30 chest compressions with 2
  rescue breaths.
• Position hands in the center of the chest over
  the breastbone
• Position the shoulders over the hands
• Compress the chest smoothly to a depth of at
  least 2 inches 30 times in about 18 seconds
• Give 2 rescue breaths
• Continue CPR until
• Scene becomes unsafe
• You find signs of life
• An AED is ready
• You are too exhausted to continue
• Another trained responder arrives and takes over.
  

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CPR Child

• After checking for signs of life, give 2 initial
  rescue breath before starting compressions.
• Give cycles of 30 chest compressions with 2
  rescue breaths.
• Position hands in the center of the chest over
  the breastbone
• Position the shoulders over the hands
• Compress the chest smoothly to a depth of about 2
  inches 30 times in about 18 seconds
• Give 2 rescue breaths
• Continue CPR until
• Scene becomes unsafe
• You find signs of life
• An AED is ready
• You are too exhausted to continue
• Another trained responder arrives and takes over.
  

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CPR Infant

• After checking for signs of life, give 2 initial
  rescue breath before starting compressions.
• Give cycles of 30 chest compressions with 2
  rescue breaths.
• Position 2 or 3 fingers in center of the infants
  chest and the other hand on the forehead to
  maintain an open airway
• Compress the chest smoothly to a depth of about 1
  ½ inches 30 times in about 18 seconds
• Give 2 rescue breaths
• Continue CPR until
• Scene becomes unsafe
• You find signs of life
• An AED is ready
• You are too exhausted to continue
• Another trained responder arrives and takes over.
  

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Do Not Stop CPR unless

1. You see an obvious sign of life such as
   breathing.
2. An AED is ready to use.
3. Another trained responder or EMS personnel take
   over.
4. You are too exhausted to continue.
5. The scene becomes unsafe.

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AED Basics
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Automated External Defibrillator

• An AED is a portable electronic device than
  analyzes the hearts electrical rhythm and if
  necessary prompts you to deliver a shock to a
  person in sudden cardiac arrest.
• If a person is unconscious and not breathing, use
  an AED as soon as available in conjunction with
  CPR

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• AEDs can help the heart re-establish an effective
  rhythm by delivering a shock that disrupts the
  chaotic electrical activity of the heart long
  enough for the heart to establish an effective
  rhythm on its own.
• AEDs are simple and save to use when the
  manufacturers instructions are followed.
• The sooner an AED is used and CPR is performed,
  the more likely the person will survive.
• AEDs can be used on anyone in cardiac arrest,
  including children and infants.

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