CAD/ MI
Paramedics 38 with Ordille at Palomar College
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Textbook: Paramedic Care: Principles & Practice Vols 1-5 PKG
Created: 2011-02-26
Size: 42 flashcards
Views: 43
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- any disease process that causes abnormalities in the coronary vessels
- decreased O2 Tx to heart muscle
- 2 types
- arteriosclerosis
- atherosclerosis
- hardening of vessel walls
- due to calcium deposits
- inability to dilate
- HTN
- more likely of the 2 to lead to MI, AAA
- building up/ occlusion on vessel walls
- progressive and degenerative
- fatty material/ cholesterol
- smoking
- most common at branches
- arrhythmias
- HTN
- angina
- MI
- aneurysm
- CVA
- heart failure
- cardiogenic shock
- syncope
- (L) ventricular hypertrophy
- smoking
- obesity
- diet
- DM
- HTN
- stress
- age
- sex
- heredity
- race
- lack of perfusion
- no permanent damage of ischemia is reversed in a timely manner
- elevated ST
- L ventricle can lose up to 25% of muscle and still function effectively
- Tissue damage from prolonged ischemia
- Can return to normal function, but not normal efficiency
- ST depression
- Tissue death
- Irreversible if not taken care of 4-6min
- Will not ever function again
- Inverted Q waves
- Ischemia without injury
- O2 demands of heart are beyond what is being provided
- Build up of lactic acid
o Chest discomfort
o Pressure, crushing
o Indigestion
o Levine sign
o Jaw, arm, shoulder pain
o Caused by exertion
o Relieved by rest
o N/V
o 3-5min
o Caused by exertion
o Relieved by rest
o Pre-infarct
o May cause ischemia/injury
o May immediately precede MI
o Spasm of coronary artery
o Exposure to cold, temperature
o Cocaine use
- Chest pain present 70-90% of time (pressure)
- Death to portion of heart muscle
- ½ million deaths/yr
- Most commonly caused by artherosclerosis
o Occlusion of the coronary artery
o Affected tissue becomes ischemic
o Leads to infarction and cell death
o Angina
o Skins
o N/V
o Pain responds to MS (or not)
Arrhythmiaso No s/s
o Elderly
o Women
o DM
o 10-20%
o Cardiogenic shock
- 40%
- 80% death
o (r) side Heart failure
o CHF
o Aneurysm (DO NOT GIVE NTG!)
o Arrhythmias
o Lidocaine
o Amorodione
o Atropine
o Arrhythmias may be from blockage of coronary artery
o Small: (1) finger
o Medium: (2) fingers
o Large: (3) fingers
- BP= CO x PVR
- Resting BP above 140/90
- Effects 2/3 of population
o Diastolic over 100
o Need 5-20% reduction within a few hours= no/limited organ damage
o Organs at risk
- Heart
- Brain
- Liver
- Kidneys
- Lungs
o Malignant hypertension
o Hypoperfusion to brain (like CVA)
o BP 210/120
o Loss of integrity of blood-brain barrier
o Leads to fluid on the brain
- Major difference is posturing
- s/s of CVA
o L ventricular failure
o Hypertrophy of cells
Increased risk for Aneurysm- CVA
- Pregnancy
- Renal Failure
- PE
- MI
- Back up into systemic
- Increased preload> pressure on the L atria> decrease O2 capacity of lungs
- Dependent edema
o Sacrum
o Pedal
o Facial
o Anasacra (swelling of entire body)
- Most common cause of hospitalization over 65yo
o L sided failure (most common)
- Backup
o Valve disease
o Chronic HTN
o PE
o MI
o Cor Pulmonale
- Hypertrophy of R ventricle caused by Pulmonary HTN
- COPD
o Increased Na+ intake
o Chest pressure
o HTN
o Tachycardia
o JVD
o Edema
- Ascites (abdominal)
o Engorged liver
o S3 sounds
- Lungs most common cause
- L ventricle fails as pump
- Blood not completely ejected from L ventricle
- Back up into pulmonary circulation
- (r) ventricular infarct
- Chronic HTN
- COPD
- All should be suspected on AMI, also
o Rales
o Hanging legs, Tripod
o SOB
o Frothy sputum
o HTN
o LOC
o Tachycardia
- Accessory muscle use AND
o At least 15 yo
o RR at or above 25/min
o SpO2 92% or less
o COPD, Asthma, CHF
o Moderate to severe respiratory distress
- Less than 15 y/o
- Facial trauma
- Unable to maintain own airway
- CPR
- Vomitting
- Possible pneumothorax
- CPR
- Lung infections
- Toxins
- Allergens
- Smoke inhalation
- ARDS
- High altitude (HACE)
- sounds impaired diastolic filling
- Increased fluid between visceral and parietal pleura
- Limits ventricular filling
- Decreased SV
- Beck’s Triad
o JVD
o Hypotension
o Muffled heart
o IV drug users
o Tattoos
o Can lead to CHF
o Pre-existing disease
Pace-makerso Hurts upon (differentiate from MI pain)
- Inspiration
- Laying down
- coughingAbout this deck
Textbook: Paramedic Care: Principles & Practice Vols 1-5 PKG
Created: 2011-02-26
Size: 42 flashcards
Views: 43
About StudyBlue
Dennis