Chapter 2Chapter 2

Cardiac Cardiac EmergenciesEmergencies

Cardiac EmergenciesCardiac EmergenciesObjectivesObjectives

1.1. Identify the common cause of a heart Identify the common cause of a heart attackattack

2.2. List signs and symptoms of a heart attackList signs and symptoms of a heart attack3.3. Identify the care for a heart attackIdentify the care for a heart attack4.4. Recognize the primary signs of cardiac Recognize the primary signs of cardiac

arrestarrest5.5. Describe the purpose of CPRDescribe the purpose of CPR6.6. Be able to perform CPRBe able to perform CPR7.7. List conditions in which a rescuer may List conditions in which a rescuer may

stop CPRstop CPR

Heart AttackHeart Attack

Like all living tissue, the cells of the heart need a Like all living tissue, the cells of the heart need a continuous supply of oxygen. The coronary continuous supply of oxygen. The coronary arteries supply the heart muscle with oxygen-arteries supply the heart muscle with oxygen-rich blood. If the heart is deprived of this blood, rich blood. If the heart is deprived of this blood, it dies.it dies.

If enough of the muscle dies, the heart cannot If enough of the muscle dies, the heart cannot circulate blood effectively, causing a circulate blood effectively, causing a heart heart attackattack..

A heart attack interferes with the heartA heart attack interferes with the heart’’s s electrical and mechanical systems. This electrical and mechanical systems. This interference may result in an irregular interference may result in an irregular heartbeat, which may prevent blood from heartbeat, which may prevent blood from circulating effectively. circulating effectively. http://www.instructorscorner.org/media/videos/

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Common Cause of a Common Cause of a Heart attackHeart attack

A Heart attack is usually the result of A Heart attack is usually the result of cardiovascular disease (coronary heart cardiovascular disease (coronary heart disease).disease). This is the leading cause of death for adults This is the leading cause of death for adults

over 44 years of age in the U.S. over 44 years of age in the U.S. 70 million Americans suffer from this.70 million Americans suffer from this. 1 million deaths annually/500,000 are due to 1 million deaths annually/500,000 are due to

heart attacksheart attacks Cardiovascular disease develops slowly. Cardiovascular disease develops slowly.

Fatty deposits of cholesterol and other Fatty deposits of cholesterol and other material may gradually build up on the inner material may gradually build up on the inner walls of the arteries. walls of the arteries.

Signs and SymptomsSigns and Symptoms

1.1. Persistent chest pain or discomfort, Persistent chest pain or discomfort, sometimes confused with indigestion, (a sometimes confused with indigestion, (a muscle spasms)muscle spasms)

2.2. Heart burn to unbearable crushing painHeart burn to unbearable crushing pain

3.3. Breathes noisily, short of breath, faster Breathes noisily, short of breath, faster than normalthan normal

4.4. Skin = ashen, pale, bluish - profuse Skin = ashen, pale, bluish - profuse sweatingsweating

5.5. Nausea/vomitNausea/vomithttp://www.instructorscorner.org/media/videos/b1.html

Care for a Heart attackCare for a Heart attack

1.1. Recognize the signs and symptoms of a Recognize the signs and symptoms of a heart attackheart attack

2.2. Call EMSCall EMS

3.3. Convince the victim to stop activity and restConvince the victim to stop activity and rest

4.4. Help the victim rest comfortablyHelp the victim rest comfortably

5.5. Comfort victimComfort victim

6.6. Assist the victim with medication, if Assist the victim with medication, if prescribed prescribed (Nitroglycerin - vasodilator)(Nitroglycerin - vasodilator)

7.7. Be prepared to give CPR if the victimBe prepared to give CPR if the victim’’s heart s heart stops beating. stops beating.

Cardiac Arrest/Common Cardiac Arrest/Common CausesCauses

Cardiac arrest occurs when the heart stops beating Cardiac arrest occurs when the heart stops beating or beats too ineffectively to generate a pulse and or beats too ineffectively to generate a pulse and blood cannot be circulated.blood cannot be circulated.

Cardiovascular disease is the most common.Cardiovascular disease is the most common. Drowning, suffocation, and certain drugs can Drowning, suffocation, and certain drugs can

cause breathing to stop, which will soon lead to cause breathing to stop, which will soon lead to cardiac arrest.cardiac arrest.

Severe injuries to the chest or severe blood loss Severe injuries to the chest or severe blood loss can also cause the heart to stop.can also cause the heart to stop.

Electrocution disrupts the heartElectrocution disrupts the heart’’s electrical s electrical activityactivity

Stroke or other types of brain damage can also Stroke or other types of brain damage can also stop the heart stop the heart

Cardiac Chain of SurvivalCardiac Chain of Survival

The greatest chance of survival The greatest chance of survival from cardiac arrest occurs when from cardiac arrest occurs when the following sequence of events the following sequence of events happens:happens:

1.1. Early RecognitionEarly Recognition

2.2. Early CPREarly CPR

3.3. Early DefibrillationEarly Defibrillation

4.4. Early Advanced careEarly Advanced carehttp://www.instructorscorner.org/media/videos/j10.html

Purpose of CPRPurpose of CPR

A victim who is not breathing and has no A victim who is not breathing and has no pulse is said to be clinically dead. pulse is said to be clinically dead. However, the cells of the brain and other However, the cells of the brain and other vital organs will continue to live for a vital organs will continue to live for a short period of time until oxygen is short period of time until oxygen is depleted. This victim needs depleted. This victim needs cardiopulmonary resuscitation (CPR)cardiopulmonary resuscitation (CPR)

Without CPR, the brain will begin to die Without CPR, the brain will begin to die within 4 to 6 minutes. This irreversible within 4 to 6 minutes. This irreversible damage caused by brain cell death is damage caused by brain cell death is known as biological death. known as biological death.

CPRCPR

If a person is in cardiac arrest, they If a person is in cardiac arrest, they are unconscious, not breathing and are unconscious, not breathing and show no other signs of life.show no other signs of life.

Cardiopulmonary resuscitation Cardiopulmonary resuscitation (CPR) can help circulate blood that (CPR) can help circulate blood that contains oxygen to vital organs by contains oxygen to vital organs by combination of chest compressions combination of chest compressions and rescue breaths.and rescue breaths.

CPR AdultCPR Adult Give cycles of 30 chest compressions with 2 Give cycles of 30 chest compressions with 2

rescue breaths.rescue breaths. Position hands in the center of the chest over the Position hands in the center of the chest over the

breastbonebreastbone Position the shoulders over the handsPosition the shoulders over the hands Compress the chest smoothly to a depth of at least 2 Compress the chest smoothly to a depth of at least 2

inches 30 times in about 18 secondsinches 30 times in about 18 seconds Give 2 rescue breathsGive 2 rescue breaths

Continue CPR until:Continue CPR until: Scene becomes unsafeScene becomes unsafe You find signs of lifeYou find signs of life An AED is readyAn AED is ready You are too exhausted to continueYou are too exhausted to continue Another trained responder arrives and takes over. Another trained responder arrives and takes over. http://www.instructorscorner.org/media/videos/

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CPR ChildCPR Child Give cycles of 30 chest compressions with 2 Give cycles of 30 chest compressions with 2

rescue breaths.rescue breaths. Position hand in center of the childPosition hand in center of the child ’’s chest and the other s chest and the other

hand on the forehead to maintain an open airwayhand on the forehead to maintain an open airway Position the shoulders over the handsPosition the shoulders over the hands Compress the chest smoothly to a depth of about 2 inches Compress the chest smoothly to a depth of about 2 inches

30 times in about 18 seconds30 times in about 18 seconds Give 2 rescue breathsGive 2 rescue breaths

Continue CPR until:Continue CPR until: Scene becomes unsafeScene becomes unsafe You find signs of lifeYou find signs of life An AED is readyAn AED is ready You are too exhausted to continueYou are too exhausted to continue Another trained responder arrives and takes over. Another trained responder arrives and takes over.

CPR InfantCPR Infant Give cycles of 30 chest compressions with 2 Give cycles of 30 chest compressions with 2

rescue breaths.rescue breaths. Position 2 or 3 fingers in center of the infantPosition 2 or 3 fingers in center of the infant’’s chest and s chest and

the other hand on the forehead to maintain an open the other hand on the forehead to maintain an open airwayairway

Compress the chest smoothly to a depth of about 1 ½ Compress the chest smoothly to a depth of about 1 ½ inches 30 times in about 18 secondsinches 30 times in about 18 seconds

Give 2 rescue breathsGive 2 rescue breaths Continue CPR until:Continue CPR until:

Scene becomes unsafeScene becomes unsafe You find signs of lifeYou find signs of life An AED is readyAn AED is ready You are too exhausted to continueYou are too exhausted to continue Another trained responder arrives and takes over. Another trained responder arrives and takes over. http://www.instructorscorner.org/media/videos/b4.html

Do Not Stop CPR unless:Do Not Stop CPR unless:

1.1. You see an obvious sign of life such You see an obvious sign of life such as breathing.as breathing.

2.2. An AED is ready to use.An AED is ready to use.

3.3. Another trained responder or EMS Another trained responder or EMS personnel take over. personnel take over.

4.4. You are too exhausted to continue.You are too exhausted to continue.

5.5. The scene becomes unsafe. The scene becomes unsafe.

AED BasicsAED Basics

Automated External Automated External DefibrillatorDefibrillator

An AED is a portable electronic An AED is a portable electronic device than analyzes the heart’s device than analyzes the heart’s electrical rhythm and if necessary electrical rhythm and if necessary prompts you to deliver a shock to a prompts you to deliver a shock to a person in sudden cardiac arrest. person in sudden cardiac arrest.

If a person is unconscious and not If a person is unconscious and not breathing, use an AED as soon as breathing, use an AED as soon as available in conjunction with CPRavailable in conjunction with CPR

AEDs can help the heart re-establish an AEDs can help the heart re-establish an effective rhythm by delivering a shock effective rhythm by delivering a shock that disrupts the chaotic electrical activity that disrupts the chaotic electrical activity of the heart long enough for the heart to of the heart long enough for the heart to establish an effective rhythm on its own.establish an effective rhythm on its own.

AEDs are simple and save to use when the AEDs are simple and save to use when the manufacturer’s instructions are followed.manufacturer’s instructions are followed.

The sooner an AED is used and CPR is The sooner an AED is used and CPR is performed, the more likely the person will performed, the more likely the person will survive. survive.

AEDs can be used on anyone in cardiac AEDs can be used on anyone in cardiac arrest, including children and infants. arrest, including children and infants.

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