cardiovascular emergencies, cpr
TRANSCRIPT
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CIRCULATIONCIRCULATION
EMERGENCIES &EMERGENCIES &
CardiopulmonaryCardiopulmonary
Resuscitation- C.P.R.Resuscitation- C.P.R.
TERMINOLOGYTERMINOLOGY CAUSES OF CARDIAC ARRESTCAUSES OF CARDIAC ARREST C.P.R. FOR THE ADULT, CHILD & BABYC.P.R. FOR THE ADULT, CHILD & BABY
STROKE & STROKE MANAGEMENTSTROKE & STROKE MANAGEMENT
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CARDIOVASCULARCARDIOVASCULAR
EMERGENCIESEMERGENCIES
Occur when circulation of blood to various partsof the body is impaired. Remember the mainfunction of blood is to TRANSPORT OXYGENthrough the body. Without Oxygen- cells die=
tissue hypoxia
Common causes- Heart Attack, Angina, Stroke,Shock, Deadly Bleeding
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CARDIOPULMONARYCARDIOPULMONARY
RESUSCITATIONRESUSCITATION
CPR is an emergency procedure used toCPR is an emergency procedure used to
maintain life in a victim who is breathless andmaintain life in a victim who is breathless and
has no signs of circulation until they recover orhas no signs of circulation until they recover or
until advanced life support is available.until advanced life support is available.
CPR combines ventilations and chestCPR combines ventilations and chest
compressions for a casualty who is V.S.A.compressions for a casualty who is V.S.A.
Definitions: Angina (Pectoris), CardiovascularDefinitions: Angina (Pectoris), Cardiovascular(Heart) disease, Myocardial Infarct, Heart(Heart) disease, Myocardial Infarct, Heart
Attack, Cardiac Arrest.Attack, Cardiac Arrest.
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COMMON CAUSES OF CARDIACCOMMON CAUSES OF CARDIAC
ARRESTARREST
Cardiovascular DiseaseCardiovascular Disease
Drowning and near drowningDrowning and near drowning
SuffocationSuffocation ElectrocutionElectrocution
PoisoningPoisoning
Respiratory ArrestRespiratory Arrest Severe Blood loss (Hypovolemic Shock)Severe Blood loss (Hypovolemic Shock)
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CARDIOVASCULAR DISEASECARDIOVASCULAR DISEASE
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RISK FACTORS FORRISK FACTORS FOR
CARDIOVASCULAR DISEASECARDIOVASCULAR DISEASE
Factors that you cannot changeFactors that you cannot change HeredityHeredity SexSex AgeAge MenopauseMenopause
Risk factors you can control/changeRisk factors you can control/change SmokingSmoking High Blood Pressure/CholesterolHigh Blood Pressure/Cholesterol StressStress
DiabetesDiabetes Obesity/Physical ActivityObesity/Physical Activity
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CARDIOPULMONARYCARDIOPULMONARY
RESUSCITATIONRESUSCITATION
RELUCTANCY IN PERFORMING CPRRELUCTANCY IN PERFORMING CPR LiabilityLiability
DiseaseDisease
Fear in general and fear of making a mistakeFear in general and fear of making a mistake
Good Samaritan Laws Laws that protectGood Samaritan Laws Laws that protectbystanders acting in good faith when givingbystanders acting in good faith when giving
first aid to ill or injured casualties of anfirst aid to ill or injured casualties of anemergency.emergency.
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DISEASE TRANSMISSIONDISEASE TRANSMISSION
Some people hesitate to act because theySome people hesitate to act because theyfear the risk of disease transmission.fear the risk of disease transmission.
This risk (although small) encompasses aThis risk (although small) encompasses awide range of infectious diseaseswide range of infectious diseases Different routes of transmission includeDifferent routes of transmission include
Direct ContactDirect Contact
Indirect ContactIndirect Contact Airborne TransmissionAirborne Transmission Vector TransmissionVector Transmission
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WARNING SIGNS OF A HEARTWARNING SIGNS OF A HEART
ATTACKATTACK
There are a number ofThere are a number ofdifferent warning signs ofdifferent warning signs ofa possible heart attacka possible heart attackincluding;including; DenialDenial Chest PainChest Pain Profuse sweatingProfuse sweating A feeling of indigestionA feeling of indigestion Soft signs are minor andSoft signs are minor and
frequently overlooked.frequently overlooked.Signs and symptoms of anSigns and symptoms of an
Angina attack are oftenAngina attack are oftensimilar but are resolvedsimilar but are resolvedwith rest and medicationwith rest and medication
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HEART ATTACKHEART ATTACKKehrs Sign Referred Pain
Phrenic Nerve irritation
Pressure on Pericardium From theDia hra m.
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Heart AttackHeart Attack
A complete blockage of one or moreA complete blockage of one or more
of the coronary arteriesof the coronary arteries
Prevents a part of the cardiac musclePrevents a part of the cardiac musclefrom receiving blood- heart can notfrom receiving blood- heart can not
contract and relax properlycontract and relax properly
Causes heart to go into fibrillationCauses heart to go into fibrillation Victim needs advanced medical helpVictim needs advanced medical help
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ANGINAANGINAA medical condition theA medical condition the
victim is diagnosed withvictim is diagnosed with-often has medication to-often has medication to
help in an acute attack:help in an acute attack:nitroglycerine or ASAnitroglycerine or ASA
-unless it is the first attack-unless it is the first attack
victim knows they havevictim knows they havethe conditionthe condition
-S/S similar to heart attack,-S/S similar to heart attack,except that they improveexcept that they improvewith rest and Medicationwith rest and Medication
-if not improving- treat as a-if not improving- treat as aHeart AttackHeart Attack
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Aspirin or Nitroglycerine?Aspirin or Nitroglycerine?
How to decideHow to decide
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CARDIOPULMONARYCARDIOPULMONARY
RESUSCITATIONRESUSCITATION
Once the patients vital signs have been taken and itOnce the patients vital signs have been taken and ithas been determined that they are breathless (10has been determined that they are breathless (10second evaluation and two breaths given), and theresecond evaluation and two breaths given), and there
are no signs of circulation, CPR can then be initiated.are no signs of circulation, CPR can then be initiated. Steps;Steps;
Landmarking for Compressions- on the mid to lower 1/3Landmarking for Compressions- on the mid to lower 1/3rdrd ofofthe sternumthe sternum
30 Compressions pushing hard and pushing fast30 Compressions pushing hard and pushing fast
Ventilations 2 breaths (puff for a baby)Ventilations 2 breaths (puff for a baby) Repeat cycle 5 times- then re-assess breathing andRepeat cycle 5 times- then re-assess breathing and
CirculationCirculation Apply and follow steps for AED if available after the first 2Apply and follow steps for AED if available after the first 2
minutes of careminutes of care
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LANDMARKINGLANDMARKING
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THE HEARTTHE HEART
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COMPRESSIONSCOMPRESSIONS
Compressions areCompressions areperformed with two handsperformed with two hands(adult) one hand (child) or(adult) one hand (child) ortwo fingers (infant).two fingers (infant).
The depth of compressionThe depth of compressionwill differ according to thewill differ according to thevictim- Adult- 4-5 cm; Childvictim- Adult- 4-5 cm; Childand Baby- to 1/3and Baby- to 1/3rdrd depthdepthof chestof chest
Compressions should beCompressions should beperformed in a straight upperformed in a straight upand down movement takingand down movement takingcare that the up and downcare that the up and downstrokes are equal.strokes are equal.
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VENTILATIONSVENTILATIONS
Ventilations are doneVentilations are doneby mouth to mouthby mouth to mouthor by using a mask.or by using a mask.
They should last 1They should last 1second in lengthsecond in length
Should not be tooShould not be tooforceful as this canforceful as this can
cause gastriccause gastricdistention- watchdistention- watchchest and stomachchest and stomach
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CPR TECHNIQUECPR TECHNIQUE
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SPECIAL SITUATIONSSPECIAL SITUATIONS
PREGNANCY AND CARDIAC ARREST
When cardiac arrest occurs in a pregnant woman, activate EMS/911, then start CPR as soon
as possible.
Put a pillow or some other wedge-shaped object under the right side of the
womans abdomen to shift the uterus to the left side. This will help blood return to the
heart.
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SPECIAL SITUATIONSSPECIAL SITUATIONS
Mouth-To-Stoma Breathing
AUTOMATED EXTERNAL
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AUTOMATED EXTERNALAUTOMATED EXTERNAL
DEVICEDEVICE
(A.E.D.)(A.E.D.) When someone collapses from sudden cardiac arrest, often the heartWhen someone collapses from sudden cardiac arrest, often the heart
does not completely stop but goes into ventricular fibrillation.does not completely stop but goes into ventricular fibrillation. A pulse may not be felt and a shock from an AED can reverse thisA pulse may not be felt and a shock from an AED can reverse this
condition if delivered within the first few minutes after a collapse.condition if delivered within the first few minutes after a collapse. An AED is safe to use on adults and childrenAn AED is safe to use on adults and children It should only be used on unconscious victimsIt should only be used on unconscious victims Slight variations between makes/models may exist, but they device isSlight variations between makes/models may exist, but they device is
quite self-explanatory and increases chances of survival significantlyquite self-explanatory and increases chances of survival significantly Look for medical patches, pace-maker scars, amount of water person isLook for medical patches, pace-maker scars, amount of water person is
lying inlying in If indicated by machine prompt, willIf indicated by machine prompt, will
alternate between delivering shock toalternate between delivering shock to
person and performing regular CPR forperson and performing regular CPR for
2 minutes.2 minutes.
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AUTOMATED EXTERNALAUTOMATED EXTERNAL
DEVICEDEVICE
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STROKESTROKE(CEREROVASCULAR ACCIDENT)(CEREROVASCULAR ACCIDENT)
A stroke is any disease process that impairs circulation to the brain.A stroke is any disease process that impairs circulation to the brain. A stroke can be caused by a blood clot lodging in the arteries of theA stroke can be caused by a blood clot lodging in the arteries of the
brain, an artery which ruptures (aneurysm), a head injury or a tumor.brain, an artery which ruptures (aneurysm), a head injury or a tumor.
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STROKE/TIASTROKE/TIA
A victim mayA victim mayexperience a T.I.A.experience a T.I.A.(Transient Ischemic(Transient IschemicAttack) or mini stroke.Attack) or mini stroke.
Like a stroke, a T.I.A.Like a stroke, a T.I.A.can reduce blood flow tocan reduce blood flow tothe brain but is usuallythe brain but is usuallyreversible.reversible.
A stroke will howeverA stroke will however
cause bleeding in thecause bleeding in thebrain.brain.
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SIGNS AND SYMPTOMSSIGNS AND SYMPTOMS
The signs and symptoms will vary depending onThe signs and symptoms will vary depending onwhat section(s) of the brain are effected.what section(s) of the brain are effected.
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MANAGEMENTMANAGEMENT
As with any situation, think Check, Call Care.As with any situation, think Check, Call Care. If there are no A, B, C complications:If there are no A, B, C complications:
Place the victim in recovery position with the effected sidePlace the victim in recovery position with the effected side
up.up. Do Secondary Survey and treat for ShockDo Secondary Survey and treat for Shock
Think F. A. S. T.Think F. A. S. T.F acial numbness/weaknessF acial numbness/weakness
A rm numbness/weaknessA rm numbness/weakness
S peech problems.slurringS peech problems.slurringT ime is essential due to the Anticlotting medication whichT ime is essential due to the Anticlotting medication which
is most effective if used immediately- person needsis most effective if used immediately- person needsadvanced madical careadvanced madical care