1. First Aid for Colleges and Universities 10 Edition Chapter 16 © 2012 Pearson Education, Inc. Cardiovascular and Stroke Emergencies Slide Presentation prepared by Randall Benner, M.Ed., NREMT-P

2. Learning Objectives Identify the two types of coronary artery disease. Describe the physiological process involved in –Angina pectoris –Congestive heart failure –Myocardial infarction –Stroke © 2012 Pearson Education, Inc.

3. Learning Objectives List the signs and symptoms, and demonstrate management of –Angina –Congestive heart failure –Myocardial infarction –Stroke Describe and demonstrate the first aid care of –A victim who does not have a pulse –A victim who is responsive © 2012 Pearson Education, Inc.

4. Introduction Acute coronary syndrome (ACS) encompasses many conditions leading to low oxygen states to the heart. Heart attacks and associated heart disease are the #1 killer of Americans annually. The First Aider should consider every patient with chest pain as having an acute coronary event until proven otherwise. © 2012 Pearson Education, Inc.

5. Coronary Artery Disease What is coronary artery disease? –A serious disease that affects the functioning of the arteries supplying blood to the heart –Results in diminished or occluded blood flow –Victims eventually can experience chest pain or heart attack. Types of coronary artery disease –Atherosclerosis –Arteriosclerosis © 2012 Pearson Education, Inc.

6. Coronary Artery Disease Artherosclerosis –Plaque develops on inner lining of arteries –Reduces blood flow to the heart Arteriosclerosis –Calcium deposits in arterial walls limits the ability of the arteries to constrict or dilate © 2012 Pearson Education, Inc.

7. Cardiac Risk Factors © 2012 Pearson Education, Inc.

8. Angina Also known as angina pectoris –“Pain in the chest” –Signals the heart’s need for more oxygen –Two types: stable and unstable angina –Symptoms between the two types are often similar © 2012 Pearson Education, Inc.

9. Angina Stable and unstable angina –Stable often occurs with exertion –Unstable often occurs without any prediction Other common signs and symptoms –Dyspnea (shortness of breath) –Profuse perspiration –Light-headedness –Palpitations –Nausea and/or vomiting –Pale and cool skin © 2012 Pearson Education, Inc.

10. Congestive Heart Failure (CHF) Heart fails to pump blood effectively to the body Can occur from hypertension, heart attacks, etc. Fluid can build up behind a failing left heart ventricle Fluid then shifts into alveoli impairing oxygenation © 2012 Pearson Education, Inc.

11. Congestive Heart Failure (CHF) Signs and symptoms –Pain may or may not be present –Severe respiratory distress is common –Wheezing in the lungs, rapid breathing –Distended neck veins –Swelling of feet and lower legs –Confusion or anxiousness –Tripod positioning and abdominal distension © 2012 Pearson Education, Inc.

12. Congestive Heart Failure Symptoms © 2012 Pearson Education, Inc.

13. Myocardial Infarction (MI) Commonly known as heart attack Death to heart muscle occurs Complete blockage of a coronary blood vessel Can result in quick deterioration into cardiac arrest Generally associated with coronary artery disease Among the most severe/dangerous of the ACS conditions © 2012 Pearson Education, Inc.

14. Myocardial Infarction (MI) Signs and symptoms –Depends on degree of heart damage –Chest pain is most common symptom –25% of MI’s are “silent” –Shortness of breath, profuse sweating, nausea/vomiting, weakness, anxiety, rapid or slow heart rate, fainting, cyanosis (“blueness”) © 2012 Pearson Education, Inc.

15. First Aid Care for Cardiac Emergencies Time is critical in treating any acute coronary syndrome –Activate EMS. –Perform an initial assessment. –Note type, quality, and location of pain. –Encourage the victim to chew one adult aspirin or two low-dose baby aspirins. –Loosen restrictive clothing. –Monitor vital signs. –Know location of closest AED and be prepared to start CPR. © 2012 Pearson Education, Inc.

16. Stroke Any condition that impairs circulation to the brain –Cells die from a lack of oxygen in minutes –Characteristics depend on extent of stroke and amount of brain damage Causes and types of strokes –Ischemic (thrombotic and embolic) –Hemorrhagic stroke © 2012 Pearson Education, Inc.

17. Causes of Strokes © 2012 Pearson Education, Inc.

18. Types of Strokes Thrombotic –Cerebral artery blocked by a clot that develops in the blood vessel –A type of ischemic stroke –Often preceded by a transient ischemic attack (TIA) Embolic –Blocked cerebral blood vessel from clot that travels from elsewhere in the body –A type of ischemic stroke © 2012 Pearson Education, Inc.

19. Types of Strokes Transient ischemic attack (TIA) –Brief spell, similar to a stroke –Occurs when there is a temporary blockage of cerebral blood vessel –Lasts from a few minutes to usually less than one hour –Presents like a traditional stroke © 2012 Pearson Education, Inc.

20. Types of Strokes Hemorrhagic stroke –Vessel in brain bursts –Blood floods the surrounding brain tissue –Loss of blood flow and compression causes brain injury © 2012 Pearson Education, Inc. Brain of a victim of stroke from cerebral hemorrhage.

21. General Signs and Symptoms of Stroke © 2012 Pearson Education, Inc.

22. Stroke Management Activate EMS. Handle the victim carefully. Place victim in semi-sitting position if conscious. Use left lateral positioning if unconscious. Assess airway, breathing, and circulation functions. Support any impaired ABC functions. Maintain normal body temperature. © 2012 Pearson Education, Inc.

23. Stroke Management Give nothing by mouth. Don’t get distracted by the type of stoke; use general stroke protocols. Keep victim warm, quiet, and shielded from onlookers if needed. © 2012 Pearson Education, Inc.

24. Summary Cardiovascular diseases are the number one killer of Americans annually. Encountering a victim of CHF, MI, angina, or stroke is very common. Ensure that the airway, breathing, and circulatory functions are intact until EMS arrives. These type of patients can rapidly deteriorate into cardiac arrest. All victims with chest pain should be suspected of having ACS, and treated accordingly. © 2012 Pearson Education, Inc.