cardiac emergency ppt

1. SEMINAR
ON
CARDIAC EMERGENCY
NAMRALATA SINGH
MSC (N) FINAL YEAR

2. DEFINITION
As cardiology emergency situations are potentially life-
threatening, receiving immediate medical attention is
crucial. A sudden cardiac death is different from a
myocardial infarction or a heart attack, which can occur
when there is a blockage in one or more cardiac arteries.

3. CARDIAC EMERGENCIES.
Cardiac compromise refers to any kind of
heart problem. Patients may complain of
chest pain, flu-like symptoms, or dyspnea
(difficulty breathing). The most common
complaint is chest pain. The pain may
radiate down an arm with the left arm
more commonly involved.

4. CARDIAC EMERGRNCY CONDITION –
Heart emergencies include:
 A heart attack.
 A sudden cardiac arrest
 An angina attack or unstable angina.
 Congestive cardiac failure
 Cardiac tamponade
 Cardiogenic shock

5. HEART ATTACK (MYOCARDIAL
INFARCTION )
Heart attack also called myocardial
infarction it occur when the flow of blood
to the heart is blocked the interrupted
blood flow can damage or destroy part of
the heart muscles .

6. EMERGENCY MANAGEMENT OF MYOCARDIAL
INFARCTION –
 Ensure patent airway
 Administer oxygen be nasal cannula or non rebreather mask
 Obtain 12 lead ECG
 Insert two IV catheter
 Assess pain using PQRST mnernomic
 Medicate for pain as ordered ( morphine, nitroglycerine)
 Initiate continuous ECG monitoring and identify underlying
rhythm

7.  Obtain baseline blood work ( cardiac marker)
 Obtain portable chest x rays
 Assess for antiplatelets , anticoagulant , or fibrinolytic therapy
or PCI as appropriate.
 Administer aspirin and B adrenergic blocker for cardiacrelated
chest pain unless contraindicated
 Administer antidysarrythmic drug as indicated .
 Provide proper position.

8. ONGOING MONITORING –
 Monitoring vital sign , level of consciousness, cardiac
rhythm and oxygen saturation.
 Monitor responces to medication ( e.g. decrease in chest
pain) and remedicate or titrate mediation (e.g. as
nitroglycerine) as needed.
 Provide reassurance and emotional; support to patient
and family .

9.  Explain all intervention / procedure to patient in simple terms.
 Anticipate need for intubation if respiratory distress is evident.
 Prepare for CPR , defibrillation, transcutaneous pacing or
cardioversion.

10. CARDIAC ARREST –
It is define as the cessation of effective
pumping action of heart . which commonly
occurs when the muscles fibre of ventricles
start to beat rapidly without pumping any blood
( ventricular fibrillation) or when the heart
stops beating completely ( asystole ) .

13. EMERGENCY MANAGEMENT –
CPR – ( cardiopulmonary resuscitation ) is only emergency
management for these cases.
CPR an emergency procedure for life support ,consisting of
artificial respiration and manual external cardiac massage . it is
used in cases of cardiac arrest or apparent sudden death
resulting from electrical shock , drowning, respiratory arrest.

14.  Apply a cardiac monitor
 Immediate administration of defibrillation
 Quickly attend to the client airway and oxygenation.
 Insert an oral airway to maintain the tongue in a forward
position
 Administer 100 percent oxygen
 Starts IV lines for administration of resuscitation medication .
 Catheterization should be maintain.

15. ANGINA PECTORIS –
Angina is a term used for chest pain caused by decrease blood flow
to the heart muscles . angina is a symptoms of CAD . it is described
as pressure , heaviness , squeezing , tightness or pain in chest.
DEFINITION –
It is chest pain due to ischemia of heart muscles generally due to
obstruction or spam in coronary artery.

16. SAME AS MYOCARDIAL INFRACTION

17. CARDIOGENIC SHOCK
 It is the failure of the heart to pump blood adequately to
meet the oxygenation needs of the body .it occurs when
the heart muscles loses its contractile power .
 Cardiogenic shock occur because of impaired muscle
action or mechanical obstruction .

18. EMERGENCY MANAGEMENT IN CARDIOGENIC
SHOCK-
 Establish and maintain patent airway
 Administer high flow oxygen (100%) by non breather
mask or bag valve mask .
 Anticipate need for intubation and mechanical
ventilation
 Stabilize cervical spine and appropriate.

19.  Establish IV access with two large bore catheter ( 14-16) and
begin fluid resustitation(replacement of body fluids) with
crystalloids ( e.g. blood culture lactate, WBC)
 Control any external bleeding with direct pressure or pressure
dressing.
 Assess for life threatening injuries (e.g.) pericardial tamponade
, liver laceration , tension pneumotyhorax)

20.  Consider vasopressor therapy only after hypovolemia has been
corrected(Norepinephrine, Epinephrine ,Vasopressin
(Vasostrict)Dopamine)
 Insert an indwelling bladder catheter and nasogastric tube.
 Antibiotic therapy if sepsis is suspected
 Treat dysarythmias.(amiodarone)

21. Ongoing monitoring –
 Level of consciousness
 Vital signs, including pulse oximetry , peripheral pulses ,
capillary refill .
 Respiratory status
 Cardiac rhythm
 Urine output.2

22. Emergency cardiac surgery –
 Bypass graft
 Heart transplantation

23. CONGESTIVE CARDIAC FAILURE
DEFINITION –
 It is a physiological state in which heart is incapable to pump
blood according to metabolic need. Heart failure is not a
disease but group of manifestation in which inadequate pump
performance of heart that leads to pulmonary and systemic
congestion .

25. MEDICAL MANAGEMENT
 Diuretics – decrease preload ( furosemide , thiazide)
 Positive intropic agent – increase effectively heart ability
 Example – digoxin –only effective in severe case of failure
 Dopamine – also improve renal blood flow
 Vasodilators – nitrates
 ACE inhibitors – reduce after load ( captopril 15-25mg tds )

26. The following steps must be following in
providing emergency care of patients with
cardiac compromise:
1. Place patient in comfortable position (usually sitting).
2. Apply high concentration oxygen through a
nonrebreather mask.

27. 3. Transport immediately if the patient exhibits any of
the following:
 No history of cardiac problems
 History of cardiac problems but, has no
nitroglycerin
 Systolic blood pressure less than 100

28. 4. Give the patient (or help administer) nitroglycerin
(sublingually) if all the following conditions are met:
 Chest pain
 History of cardiac problems
 Patient prescribed nitroglycerin
 Patient has nitroglycerin with them
 Systolic blood pressure is greater than 100
 Medical direction authorizes administration

29. 5. Repeat dose in five minutes if all of the
following conditions are met:
 Patient experiences no relief
 Systolic blood pressure remains greater than
100
 Medical direction authorizes another dose

31. RESEARCH ARTICLE-
A New Face of Cardiac Emergencies
The human immunodeficiency virus epidemic is a major health challenge
of the twenty-first century as the transition from infectious complications to
noncommunicable disease becomes more evident. These patients may
present to the emergency department with a variety of cardiovascular
diseases, such as acute coronary syndromes, heart failure, pericardial
disease, infective endocarditis, venothromboembolism, and other
conditions. Increased awareness is needed among health care professionals
to enhance adequate identification and promote prompt management of
these patients.

32.  The human immunodeficiency virus (HIV) epidemic is a
major health challenge of the twenty-first century with an
estimated 36.7 million people living with HIV globally and
more than 1.2 million HIV-positive patients living in the
United States. 12 The improved access to combination
antiretroviral therapy (cART) has not only increased life
expectancy, but has also changed the spectrum of disease.
Thus HIV-positive patients present a unique challenge to
emergency physicians, as they may present with a variety of
cardiovascular diseases related to the HIV infection .

33.  Summary –
 Conclusion –
Emergency happen everyday at every
time it is not safe for any person , if the patient is in
emergency room there may have possibility to cure the
patient with the help of proper emergency treatment.

34. THANK YOU