Cardiac Emergencies for Medical Students
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Cardiac Emergencies - Medical Students
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Cardiac Emergencies for Medical Students
- 1. Emergency Care CHAPTER Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe THIRTEENTH EDITION Cardiac Emergencies VIKRAM SINGH RAJAWAT M.Sc (M), M.Sc (N), MBA JNU HOSPITAL
- 2. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Multimedia Directory Slide 102 Ventricular Fibrillation and AED Video Slide 103 Cardiac Arrest Animation Slide 104 AED Video Slide 105 Coronary Heart Disease Video
- 3. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Topics • Cardiac Anatomy and Physiology • Acute Coronary Syndrome • Causes of Cardiac Conditions • Cardiac Arrest
- 4. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Cardiac Anatomy and Physiology
- 5. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Cardiac Anatomy and Physiology • Review of the cardiovascular system: Flow of blood through the chambers of the heart Cardiac conductive system Composition of the blood Flow of blood through arteries, veins, arterioles, venules, and capillaries continued on next slide
- 6. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Cardiac Anatomy and Physiology • Review of the cardiovascular system: Circulation of blood between heart and lungs, and between heart and the rest of body How heart function and circulation of blood relate to pulse and blood pressure Shock (hypoperfusion)
- 7. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Four Chambers of the Heart Cross-section of the heart showing chambers, layers, valves, and major associated blood vessels.
- 8. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Four Chambers of the Heart The path of blood flow through the heart.
- 9. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Think About It • How does the normal function of the heart and blood vessels relate to blood pressure and distal pulses? • How is shock related to the function of the heart and blood vessels?
- 10. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Acute Coronary Syndrome
- 11. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Acute Coronary Syndrome • Sometimes called cardiac compromise • Refers to any time the heart may not be getting enough oxygen • Many different kinds of problems under the ACS heading continued on next slide
- 12. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Acute Coronary Syndrome • Symptoms often mimic non-cardiac conditions. • Treat all patients with ACS-like signs and symptoms as though they are having a heart problem. continued on next slide
- 13. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Acute Coronary Syndrome • Chest pain is best-known symptom. Can be described as crushing, dull, heavy, or squeezing • Sometimes described only as pressure or discomfort • Radiates along arms, down to upper abdomen, or up to jaw continued on next slide
- 14. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Acute Coronary Syndrome • Dyspnea also found in ACS May be the only finding in some patients
- 15. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Acute Coronary Syndrome • Other symptoms Anxiety, feeling of impending doom Nausea and pain or discomfort in upper abdomen (epigastric pain) Sudden onset of sweating Abnormal pulse (tachycardia/bradycardia) Abnormal blood pressure
- 16. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Management of Acute Coronary Syndrome • Patient assessment Perform primary assessment. Obtain history and physical exam. Use OPQRST to get history of present illness. Obtain past medical history. Take baseline vital signs. continued on next slide
- 17. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Management of Acute Coronary Syndrome • Patient care Place patient in position of comfort (typically sitting up). Determine if oxygen should be administered. Transport.
- 18. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Treatment Provide high-concentration oxygen by nonrebreather mask if necessary to raise the oxygen saturation to 94 percent. Perform the history and physical exam for a medical patient. Document the findings.
- 19. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Management of Acute Coronary Syndrome • Patient care If trained, equipped, and authorized to do so, obtain a 12-lead electrocardiogram (ECG). Follow local protocol as to whether to transmit it to hospital for interpretation. continued on next slide
- 20. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Management of Acute Coronary Syndrome • Patient care Indications for administering nitroglycerin • Chest pain • History of cardiac problems and prescribed nitroglycerin • Physician has prescribed nitroglycerin to patient. • Patient has nitroglycerin with him.
- 21. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Treatment Nitroglycerin
- 22. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Management of Acute Coronary Syndrome • Patient care Indications for administering nitroglycerin • Systolic blood pressure meets protocol criteria. • Patient has not had Viagra or similar drug for erectile dysfunction within forty- eight to seventy-two hours. • Medical direction authorizes administration of the medication. continued on next slide
- 23. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Management of Acute Coronary Syndrome • Patient care After giving one dose of nitroglycerin, repeat dose in 5 minutes if: • Patient experiences no relief or only partial relief. • Systolic blood pressure remains greater than 90 to 100 systolic. • Medical direction authorizes another dose of medication. continued on next slide
- 24. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Management of Acute Coronary Syndrome • Patient care Indications for administering aspirin • Chest pain • Patient not allergic to aspirin • No history of asthma • Patient not taking medications to prevent clotting continued on next slide
- 25. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Management of Acute Coronary Syndrome • Patient care Indications for administering aspirin • No other contraindications to aspirin • Ability to safely swallow • Medical direction authorization
- 26. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Treatment Aspirin
- 27. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Causes of Cardiac Conditions
- 28. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Causes of Cardiac Conditions • Heart problems caused by a number of disorders affecting condition and function of blood vessels and heart
- 29. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Coronary Artery Disease • Conditions that narrow or block arteries of heart • Often result from fatty deposit buildup on inner walls of arteries • Buildup narrows inner vessel diameter, restricting flow of blood. continued on next slide
- 30. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Coronary Artery Disease • Thrombus Occlusion of blood flow caused by formation of a clot on rough inner surface of diseased artery Can break loose and form an embolism • Emboli can move to occlude flow of blood downstream in a smaller artery. continued on next slide
- 31. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Coronary Artery Disease • Reduced blood supply to myocardium causes emergency in majority of cardiac-related medical emergencies • Chest pain is most common symptom of reduced blood supply.
- 32. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Aneurysm • Weakened sections of arterial walls begin to dilate (balloon). • Bursting can cause rapid, life- threatening internal bleeding.
- 33. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Aneurysm A weakened area in the wall of an artery will tend to balloon out, forming a saclike aneurysm, which may eventually burst.
- 34. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Electrical Malfunction of the Heart • Malfunction of heart's electrical system generally results in dysrhythmia. • Dysrhythmias include bradycardia, tachycardia, and rhythms that may be present when there is no pulse.
- 35. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Mechanical Malfunctions of the Heart • Angina pectoris • Acute myocardial infarction (AMI) • Congestive Heart Failure (CHF)
- 36. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Angina Pectoris • Chest pain caused by insufficient blood flow to the myocardium • Typically due to narrowed arteries secondary to coronary artery disease • Pain usually during times of increased myocardial oxygen demand, such as exertion or stress
- 37. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Acute Myocardial Infarction (AMI) • Death of a portion of the myocardium due to lack of oxygen • Coronary artery disease is usually the underlying reason.
- 38. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Acute Myocardial Infarction (AMI) Cross-section of a myocardial infarction.
- 39. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Congestive Heart Failure • Inadequate pumping of the heart • Often leads to excessive fluid buildup in lungs and/or body • May be brought on by diseased heart valves, hypertension, obstructive pulmonary disease • Often a complication of AMI continued on next slide
- 40. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Congestive Heart Failure • Progression Patient sustains AMI • Myocardium of left ventricle dies Because of damage to left ventricle, blood backs up into pulmonary circulation and lungs If untreated, left heart failure commonly causes right heart failure continued on next slide
- 41. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Congestive Heart Failure • Signs and symptoms Tachycardia Dyspnea Cyanosis Normal or elevated blood pressure Diaphoresis Pulmonary edema continued on next slide
- 42. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Congestive Heart Failure • Signs and symptoms Anxiety or confusion due to hypoxia Pedal edema Engorged, pulsating neck veins (late sign) Enlarged liver and spleen with abdominal distention (late sign)
- 43. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Cardiac Arrest
- 44. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Chain of Survival • Five elements 1. Immediate recognition and activation 2. Early CPR 3. Rapid defibrillation 4. Effective advanced life support 5. Integrated post-cardiac arrest care • Teamwork • Coordination
- 45. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Immediate Recognition and Activation • Requires prompt notification of EMS system • Most likely a bystander responsibility
- 46. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Early CPR • Increases survival chances significantly • Three ways CPR can be delivered earlier Get CPR-trained professionals to patient faster. Train laypeople in CPR. Train dispatchers to instruct callers how to perform CPR. continued on next slide
- 47. Copyright © 2016, 2012, 2009 by Pearson Education, Inc. All Rights Reserved Emergency Care, 13e Daniel Limmer | Michael F. O'Keefe Early CPR • High-Performance CPR Changes implemented in resuscitation efforts Compressing the chest at least 2 inches in adults Allowing for full relaxation on the upstroke of compressions Spending half of each compression on the downstroke and half on the upstroke continued on next slide
Editor's Notes
- These videos appear later in the presentation; you may want to preview them prior to class to ensure they load and play properly. Click on the links above in slideshow view to go directly to the slides.
- Planning Your Time: Plan 180 minutes for this chapter. Cardiac Anatomy and Physiology (20 minutes) Acute Coronary Syndrome (20 minutes) Causes of Cardiac Conditions (70 minutes) Cardiac Arrest (70 minutes) Note: The total teaching time recommended is only a guideline. Core Concepts: Aspects of acute coronary syndrome (ACS) Conditions that may lead to a cardiac emergency Cardiac arrest and the chain of survival Management of a cardiac arrest patient Use of an automated external defibrillator (AED) Special considerations in AED use Use of mechanical cardiopulmonary resuscitation (CPR) devices
- Teaching Time: 20 minutes Teaching Tips: Students should review the cardiovascular section of Chapter 6 prior to beginning this chapter. This section lends itself well to video graphics. Excellent anatomy and physiology websites abound and may significantly enhance understanding of these concepts. Use anatomical models or even cow or pig hearts to add a "hands on" element to this discussion. Relate the heart to the concept of blood pressure. Discuss the importance of pressure within the cardiovascular system.
- Covers Objective: 18.2 Point to Emphasize: Adequate pumping of the heart is necessary to maintain pressure within the cardiovascular system. When the pump fails, shock occurs. Discussion Topics: Discuss how pressure within the cardiovascular system is maintained. Describe how a loss of pressure within the cardiovascular system might affect a patient. Describe the heart's electrical conduction system. Knowledge Applications: Have students label a blank diagram of the heart, either in class or as an online assignment. As this section is primarily a review, assign small groups of students specific topics and have them review anatomy and physiology concepts with the class. Class Activity: Use cell phone technology to create a model of the cardiac conduction system. Assign roles and have students text each other a specific message in a manner that models the depolarization of the heart.
- Covers Objective: 18.2 Knowledge Applications: Dissect a pig or cow heart. Obtain hearts from a local butcher and allow students to visualize the structures of the heart. Assign an online scavenger hunt. Ask students to research and present the best cardiac anatomy and physiology graphic that they can find. Remind students to give credit to the source. Critical Thinking: How does the presence of a radial pulse demonstrate a functioning heart? How does blood pressure relate to the function of the heart?
- Covers Objective: 18.2 Discussion Topics: Describe the flow of blood through the heart. Describe how deoxygenated blood becomes oxygenated and is distributed out to the body. Class Activity: Have the class act out the flow of blood through the heart. Assign roles and have students act out the various steps.
- Covers Objective: 18.2 Discussion Topics: Describe the flow of blood through the heart. Describe how deoxygenated blood becomes oxygenated and is distributed out to the body. Class Activity: Have the class act out the flow of blood through the heart. Assign roles and have students act out the various steps.
- Covers Objective: 18.2 Talking Points: The heart is the pump and the blood vessels are the container for blood and the cardiovascular system as a whole. The size of the container and the force of the pump create pressure within this system to circulate blood. This pressure is measurable when we use a sphygmomanometer and assess blood pressure and it is also palpable by feeling for distal pulses. Shock occurs when pressure within this system falls and blood fails to circulate properly.
- Teaching Time: 20 minutes Teaching Tips: Relate the signs and symptoms of acute coronary syndrome (ACS) to anatomy and physiology discussions. Describe how ACS interferes with normal function and how this dysfunction manifests as symptoms. Reinforce the need to "cast a wide net." In many cases it will not be possible to rule out ACS in the field. EMTs always should err on the side of caution and treat more aggressively, not less. Describe the mechanism of action of oxygen, nitroglycerine, and aspirin. Discuss why they are important to an ACS patient. Invite a member of a cardiac catheterization team to class to discuss definitive treatment of a blocked artery. Relate this treatment to the actions of prehospital providers.
- Covers Objective: 18.3 Point to Emphasize: Acute coronary syndrome (ACS) is a blanket term that refers to any time that the heart may not be getting enough oxygen. Discussion Topic: Define acute coronary syndrome.
- Covers Objective: 18.3 Point to Emphasize: An EMT should treat all patients with ACS-like signs and symptoms as though they are having a heart problem. Knowledge Application: Have each student plot out a definitive care strategy for an ACS patient in his area. Have students describe transport decisions and what the most effective treatment would be based upon their local geography and care options.
- Covers Objective: 18.3 Knowledge Application: Invite ACS patients to class, or visit a cardiac rehab center. Have students interview patients and discuss the symptoms of ACS. Critical Thinking: Why is "casting a wide net" so important with regard to ACS patients? Why is it so important to err on the side of a cardiac problem?
- Covers Objective: 18.3
- Covers Objective: 18.3 Point to Emphasize: Chest discomfort, dyspnea, nausea, and anxiety are common symptoms of ACS, but not all ACS patients present with common symptoms. Discussion Topic: Describe the common symptoms of acute coronary syndrome. Discuss specific populations in which "common symptoms" are not so common.
- Covers Objective: 18.3
- Covers Objective: 18.4 Points to Emphasize: In the past everyone with chest pain or discomfort was given oxygen by nonrebreather mask. You may hear people talk about this or even see protocols that still mention high-concentration oxygen. Laboratory and animal studies suggest that administering more oxygen than necessary may lead to the production of certain chemical entities that can be harmful. The current recommendation is to administer only enough oxygen to bring that patient's oxygen saturation level up to 94 percent.
- Covers Objective: 18.4 Points to Emphasize: In the past everyone with chest pain or discomfort was given oxygen by nonrebreather mask. You may hear people talk about this or even see protocols that still mention high-concentration oxygen. Laboratory and animal studies suggest that administering more oxygen than necessary may lead to the production of certain chemical entities that can be harmful. The current recommendation is to administer only enough oxygen to bring that patient's oxygen saturation level up to 94 percent.
- Covers Objective: 18.4 Knowledge Application: Use programmed patients to present ACS scenarios. Have students work in small groups to practice decision-making and treatment strategies.
- Covers Objective: 18.5
- Covers Objective: 18.5
- Covers Objective: 18.5
- Covers Objective: 18.6 Discussion Topic: Describe the treatment of ACS. Discuss definitive care and prehospital care. Class Activity: Have each student plot out a definitive care strategy for an ACS patient in his area. Have students describe transport decisions and what the most effective treatment would be based upon their local geography and care options.
- Covers Objective: 18.6 Discussion Topic: Describe the treatment of ACS. Discuss definitive care and prehospital care. Class Activity: Have each student plot out a definitive care strategy for an ACS patient in his area. Have students describe transport decisions and what the most effective treatment would be based upon their local geography and care options.
- Teaching Time: 70 minutes Teaching Tips: This section lends itself well to video graphics to better illustrate pathophysiology. Describe how cardiac conditions interfere with normal physiology. Relate this discussion to your lesson on anatomy and physiology. Relate pathophysiology to physical findings and symptoms. Discuss how these disorders impact patients. The American Heart Association is a useful resource for this section. Its website and classes can provide beneficial enhancements and teaching tools to improve your lesson.
- Covers Objective: 18.7 Class Activity: Have the class work in small groups. Assign each group a cause of a specific cardiac condition. Have that group research and present the pathophysiology of its disorder to the class.
- Covers Objective: 18.7a Point to Emphasize: The majority of cardiovascular emergencies are caused, directly or indirectly, by changes in the inner walls of arteries. Conditions that narrow or block the arteries of the heart are commonly called coronary artery disease (CAD). Knowledge Application: Use programmed patients to present cardiac scenarios. Have students practice assessment and discuss symptom patterns associated with cardiac conditions.
- Covers Objective: 18.7a
- Covers Objective: 18.7a Discussion Topic: Describe how artery disease leads to heart problems. Discuss the role of coronary artery disease in ACS.
- Covers Objective: 18.7b Point to Emphasize: An aneurysm occurs when weakened sections in the arterial walls dilate and occasionally burst. Discussion Topic: Define aneurysm. Discuss how an aneurysm occurs. Critical Thinking: How might the symptoms of an aneurysm present like the symptoms of ACS? Can an EMT differentiate in the field, and if so, how?
- Covers Objective: 18.7b Point to Emphasize: An aneurysm occurs when weakened sections in the arterial walls dilate and occasionally burst. Discussion Topic: Define aneurysm. Discuss how an aneurysm occurs. Critical Thinking: How might the symptoms of an aneurysm present like the symptoms of ACS? Can an EMT differentiate in the field, and if so, how?
- Covers Objective: 18.7c Point to Emphasize: Both electrical and mechanical problems can cause the heart to fail. Discussion Topic: Describe how an electrical problem might cause the heart to fail. Knowledge Application: Have students work in small groups. Assign each group a symptom commonly associated with ACS and have group members research and present how their symptom might be related to a cardiac cause discussed in this section.
- Covers Objective: 18.7d
- Covers Objective: 18.7e Point to Emphasize: Angina pectoris and acute myocardial infarction result from an interruption of the necessary blood flow to heart muscle. The chest pain associated with angina pectoris will often diminish when the patient stops the exertion.
- Covers Objective: 18.7f Discussion Topic: Define angina pectoris and acute myocardial infarction. How are they related, and how do they differ?
- Covers Objective: 18.7f Discussion Topic: Define angina pectoris and acute myocardial infarction. How are they related, and how do they differ?
- Covers Objective: 18.7g Point to Emphasize: Congestive heart failure occurs when the heart cannot pump properly due to damage or a disorder. Pulmonary edema is a common symptom of CHF. Discussion Topic: Define congestive heart failure (CHF). How is CHF related to acute pulmonary edema? Knowledge Application: Split the class into thirds. Assign one group the topic of stroke, one group the topic of ACS, and one group the topic of peripheral vascular disease. Have each group research pathophysiology and present its findings. Compare and contrast.
- Covers Objective: 18.7g
- Covers Objective: 18.7g
- Covers Objective: 18.7g
- Teaching Time: 70 minutes Teaching Tips: A great deal of research on cardiac arrest has been conducted. Relate current data to your discussion. Consider reviewing the Ontario Prehospital Advanced Life Support (OPALS) Study as it specifically underscores the importance of basic life support providers. Utilize CPR instructors to assist you with this lesson. They will have insight on both the topic and the teaching of the topic. This section is heavily weighted in skills. Be sure that you have enough assistance to ensure proper technique and orderly practice. Invite local ALS providers to class or join with an ALS class to practice integrating BLS and ALS in a cardiac arrest scenario. Invite your medical director to discuss post-arrest care and options available in your region.
- Covers Objective: 18.8 Points to Emphasize: The American Heart Association has summarized the most important factors that affect survival of cardiac arrest patients in its chain of survival. The elements are: (1) immediate recognition and activation, (2) early CPR, (3) rapid defibrillation, (4) effective advanced life support and (5) integrated post-cardiac arrest care. To maximize outcomes of cardiac arrest, EMTs must use teamwork to coordinate high-quality CPR with the use of early defibrillation. Talking Points: An underlying theme of the chain of survival is teamwork. There must be coordination for combined activities to work in the patient's favor. An EMS system where each of these links is strong is much more likely to bring back a patient from cardiac arrest than a system with weaknesses anywhere along the chain.
- Covers Objective: 18.8a Knowledge Application: Assign the Ontario Prehospital Advanced Life Support (OPALS) Study as a reading assignment. Have students write a summary paper on the study's conclusions. Discuss.
- Covers Objective: 18.8b Point to Emphasize: The most important element of cardiac arrest care is the administration of high-quality chest compressions. Knowledge Application: Have groups of students team with local CPR instructors to assist with the teaching of a basic life support class.
- Covers Objective: 18.8b Point to Emphasize: The most important element of cardiac arrest care is the administration of high-quality chest compressions. Knowledge Application: Have groups of students team with local CPR instructors to assist with the teaching of a basic life support class.