Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Chapter 14 Cardiac and Respiratory Emergencies Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer OBJECTIVES DIRECTORY 1.Define new terms introduced in this chapter Describe how the cardiac and respiratory systems work together to bring oxygen to the cells and eliminate wastes Use assessment findings and patient complaints to recognize patients having cardiac and respiratory emergencies , 30, Formulate questions to obtain a relevant history from patients with cardiac and respiratory problems , Recognize cardiac emergency patients who have both typical and atypical presentations

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer OBJECTIVES DIRECTORY 6.Describe what happens in myocardial infarction and angina pectoris Describe what happens in asthma, chronic bronchitis, emphysema, congestive heart failure, and pneumonia Differentiate between patients with adequate breathing and patients with inadequate breathing Explain the importance of managing the airway, breathing, and circulation (ABCs), and administering oxygen to patients with cardiac and respiratory problems ,

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer OBJECTIVES DIRECTORY 10.Demonstrate emergency care of patients with cardiac and respiratory problems ,

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer MULTIMEDIA DIRECTORY Slide 24Coronary Artery Disease Animation Slide 25Information about AEDs Video

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer TOPICS Anatomy and Physiology: Respiratory System Review Anatomy and Physiology: Cardiovascular System Review Cardiac Emergencies Respiratory Emergencies

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer INTRODUCTION Frequent cardiac and respiratory complaints Potentially serious complaints

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Case Study: The Call Dispatch –You are called to the police station for a person in custody –Having a “heart attack” –You are advised that the patient is conscious and agitated Scene –You find three officers holding the patient, who appears to be having difficulty breathing, in a chair

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Anatomy and Physiology: Respiratory System Review Back to Topics

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Anatomy and Physiology: Respiratory System Review

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Anatomy and Physiology: Cardiovascular System Review Back to Topics

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Anatomy and Physiology: Cardiovascular System Review Left atria receives oxygenated blood Blood flows from left atria to left ventricle Blood flows through a system of arteries Blood travels back to the heart through venules and vena cava Blood flows from the right atria to the right ventricle Blood is pumped to the lungs Back to Objectives

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Cardiac Emergencies Back to Topics

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Cardiac Emergencies Myocardial infarction Angina pectoris Rhythm disturbances Back to Objectives

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Signs and Symptoms of Cardiac Emergencies Various presentations “Classic” chest pain Sudden cardiac arrest

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Signs and Symptoms of Cardiac Emergencies Chest pain or discomfort (may radiate) Difficulty breathing Nausea and vomiting Weakness Dizziness Sweating or cool, clammy skin Feeling of irregular or skipped heart beats Back to Objectives

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer EMR Patient Assessment: The Cardiac Patient SAMPLE

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer EMR Patient Assessment: The Cardiac Patient O—Onset P—Provocation Q—Quality R—Region, radiation, relief S—Severity T—Time Back to Objectives

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer EMR Emergency Care: The Cardiac Emergency Patient Check ABCs Administer Oxygen Update EMS Obtain history using SAMPLE and OPQRST Obtain vital signs Back to Objectives

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer EMR Emergency Care: The Cardiac Emergency Patient Perform a physical exam Monitor the patient for changes in condition Ask about medications Transfer care to EMS

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Coronary Artery Disease Click on the screenshot to view an animation about coronary artery disease. Back to DirectoryBack to Objectives

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Information about AEDs Click on the screenshot to view a video with information about AEDs. Back to DirectoryBack to Objectives

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Respiratory Emergencies Back to Topics

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Common Respiratory Conditions Asthma Chronic bronchitis Emphysema

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Common Respiratory Conditions Chronic obstructive pulmonary disease (COPD) Congestive heart failure –Pulmonary edema –Peripheral edema Pneumonia Back to Objectives

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Look for signs of distress –Altered mental status –Inability to speak easily –Poor chest movement –Increased work of breathing –Poor skin condition History –SAMPLE EMR Patient Assessment: Respiratory Complaints Photo: © Ray Kemp / 911 Imaging Back to Objectives

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Case Study: The Response 25-year-old male breathing adequately but with difficulty Sitting with his hands on his knees You hear an unusual musical sound when he exhales He can only speak one or two words at a time with difficulty

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer EMR Patient Assessment: Respiratory Complaints Signs and symptoms –Trouble lying flat? –Short of breath when active? –Gained weight over past several days? –Fluid accumulation in lower legs? –Have a cough? Productive? Color? –Pain or heaviness in chest, jaw, or arms? –Pain when breathing? Back to Objectives

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer EMR Patient Assessment: Respiratory Complaints Compliant with medications Listen with a stethoscope on the chest, at the patient’s sides, and on the back at the bases of the lungs –Good air movement –Abnormal sounds Back to Objectives

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Position patient Administer oxygen Update EMS Reassure patient Monitor the patient Transfer care to EMS EMR Emergency Care: Respiratory Complaints Back to Objectives

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Case Study: Transition Tells you that he has asthma, but he does not have his inhaler You apply oxygen via nonrebreather mask at 15 lpm You complete a history, vital signs, and exam You provide a report to paramedics who have arrived Transported to the ED under police guard

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer CONTINUED

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer REVIEW Define the following terms –Accessory muscle use –Alveoli –Asthma –Wheezing –Stethoscope –Congestive heart failure –Myocardial infarction CONTINUED

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer REVIEW Define the following terms –Cardiac arrest –Sudden cardiac death –Chronic bronchitis –Emphysema –COPD –Pneumonia –Tripod position Back to Objectives

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer STOP, REVIEW, REMEMBER What does the “O” stand for in the OPQRST mnemonic? a)Occlusion b)Occlusive dressing c)Onset d)On scene CONTINUED

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer STOP, REVIEW, REMEMBER Which of the following is a sign or symptom of MI? a)Difficulty breathing b)Chest discomfort c)Nausea d)All of the above CONTINUED

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer STOP, REVIEW, REMEMBER What lung sound is a musical sound heard on expiration and is consistent with patients having an asthma attack? a)Stridor b)Crackles c)Wheezing d)Whistling

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer REVIEW Discussion 1.Differentiate between MI and angina pectoris. 2.Discuss the information to be obtained during the OPQRST assessment. 3.Explain the importance of obtaining an accurate history when dealing with respiratory emergency patients. 4.Discuss the difference between emphysema and chronic bronchitis.

Copyright ©2011 by Pearson Education, Inc. All rights reserved. EMR Complete: A Worktext Daniel Limmer Please visit and click on the mykit links to access content for this text. REINFORCE AND REVIEW