Cardiac Patient Management

Course overview

Objectives Describe the signs and symptoms of cardiac distress List various cardiac conditions based on these signs and symptoms Identify appropriate pharmacological management based on patient signs and symptoms Content Information Covered 1 Assessment 1 Primary Survey 1 Level of responsiveness 1 Restlessness anxiety 2 Feeling of impending doom 2 Airway 3 Breathing 1 Rate and depth 2 Effort 3 Breath sounds 4 Significance of findings 4 Circulation 1 Pulse 1 rate 2 quality 2 Skin 1 color 2 temperature 3 moisture 4 edema 3 Blood pressure 2 History 1 Chief complaint 2 History of the present illness 1 Chest discomfort pain 1 signs and symptoms 2 OPQRST evaluation 2 Respiratory 1 dyspnea 1 continuous 2 exertional 3 non exertional 4 orthopneic 2 cough 1 dry 2 productive 3 Related signs and symptoms 1 nausea vomiting 2 fatigue 3 palpitations 4 headache 5 recent trauma 3 Past medical history 1 SAMPLE history 2 Previous heart disease surgery 1 angina 2 previous AMI 3 hypertension 4 heart failure 5 valve disease 6 aneurysm 7 pulmonary disease 8 diabetes 9 COPD 10 renal disease 3 Current past medications 1 prescribed 2 over the counter 3 home remedies 4 recreational drug use 4 Family history 3 Secondary Survey Management refer to the current American Heart Association guidelines 1 Place in proper position 2 Evaluation and appropriate management of ventilations respirations 1 Oxygen saturation evaluation 2 pulse oximetry 3 May be unreliable in cardiac arrest toxic inhalation 1 Appropriate management of any related ventilatory respiratory compromise 1 BVM assistance 2 PEEP 3 CPAP BiPAP 4 MTV ATV 2 Appropriate oxygen therapy Evaluation and appropriate management of cardiac compromise 1 Manual and auto BP 2 Mechanical CPR 3 AED 5 Pharmacological interventions 1 Aspirin 2 Nitroglycerin 3 Oral glucose 6 Consider AEMT Paramedic assistance at the scene 7 Appropriate transportation 3 Specific Cardiovascular Emergencies refer to current American Heart Association guidelines 1 Acute Coronary Syndromes ACS Heart Failure 2 Hypertensive Emergencies 1 Systolic BP greater than 160 mmHg 2 Diastolic BP greater than 94 mmHg 3 Signs and symptoms 1 Strong bounding pulse 2 Skin warm dry or moist 3 Headache 4 Ringing in ears 5 Nausea vomiting 6 Nose bleed 4 Assessment 3 Cardiac Arrest 4 Pharmacological Agents 1 Aspirin 1 Generic and trade names 2 Indications 3 Contraindications 4 Actions 5 Side effects 6 Precautions 7 Expiration date 8 Dosage 9 Administration 2 Nitroglycerin 1 Generic and trade names 2 Indications 3 Contraindications 4 Actions 5 Side effects 6 Precautions 7 Expiration date 8 Dosage 9 Administration 3 Role of Medical Oversight in Medication Administration 4 Patient Assisted Administration 5 Documentation Consider Age Related Variations for Pediatric and Geriatric Patients for Assessment and Management of Cardiac Compromise 1 Pediatric 1 Cardiac problems typically associated with congenital heart condition 2 Cardiovascular compromise often caused by respiratory compromise 2 Geriatric typical MI presentation often related to other underlying disease processes 1 Diabetes 2 Asthma