Cardiac Emergencies

Heart Attack

Also called myocardial infarction occurs when the blood and oxygen supply to the heart is reduced causing damage to the heart muscle and preventing blood from circulating effectively. It is usually caused by coronary heart disease.

The term “angina pectoris” means literally “a constriction of the chest”. Angina occurs when coronary arteries, which supply the heart muscle with blood, become narrowed and cannot carry sufficient blood to meet increased demands during exertion or excitement.

What to Look for:

Chest pain, discomfort or pressure. Pain may be associated from discomfort to unbearable crushing sensation in the chest. Person may describe it as pressure, squeezing, tightness, aching or heaviness in the chest. Some individual may not show signals at all.

What to do:

Have patient stop what he or she is doing and sit or lie him/her down in a comfortable position. Do not let him/ her to move around
Have someone call the physician or ambulance for help
If patient is under medical care, assist him/her in taking his/her prescribed medicine/s

Cardiac Chain of Survival

Early Access

Recognition of cardiac arrest and early activation of emergency response system. Call other emergency numbers.

2 . Early Cardio-Pulmonary Resuscitation

It is most effective when started immediately after the victim’s collapse. The probability of survival approximately doubles when it is initiated before the arrival of EMS.

3. Early Defibrillation

It is most likely to improve survival. It is the key intervention to increase the chances of survival of patients with “out-of-hospital” cardiac arrest.

4. Early Advance Cardiac Life Support

It is provided by highly trained personnel like paramedics, provision of advanced care outside the hospital would be possible.

5. Post Cardiac Arrest Care

After out-of-hospital cardiac arrest, transport patient to an appropriate hospital with a comprehensive post–cardiac arrest treatment system of care that includes acute coronary interventions, neurological care, goal-directed critical care, and hypothermia.

Transport the in-hospital post–cardiac arrest patient to an appropriate critical-care unit capable of providing comprehensive post–cardiac arrest care.

Cardiac Arrest

Is a condition occurs when the heart stops contracting and no blood circulates thru the blood vessels and vital organs are deprived of oxygen.

What to do:

I. Cardio-Pulmonary Resuscitation

Is a combination of chest compression and rescue breathing. Refer to figure how to do compression

II. Chest compression only (Hands only) CPR

Is done if a person is unwilling or unable to perform mouth-to- mouth ventilation for an adult victim, chest compression-only CPR should be provided rather than no attempt at CPR being made.

Chest compression only (Hands only) compression-only CPR is recommended only in the following circumstances:

When a rescuer is unwilling or unable to perform mouth-to- mouth or rescue breathing
For use in dispatcher-assisted CPR instructions where the simplicity of this modified technique allow untrained bystanders to rapidly intervene.

Automated External Defibrillator-a computerized device that is attached to a pulse less victim with adhesive pads.

This must be used for effective resuscitation for patient of cardiac arrest. In many cases however, CPR alone cannot correct the underlying heart problem: defibrillation delivered by an AED is needed, the electrical impulse allows the heart to develop spontaneous effective rhythm on its own.

Defibrillation is the treatment of irregular, sporadic or absent heart rhythms by an electrical current to the heart.

The most effective treatment for VF is electrical defibrillation.
The probability of successful defibrillation decreases quickly over time.
VF deteriorates to asystole if not treated.

Use of AED Pads

ADULT (Victims 9 Years of Age and Older)

Use only adult pads (do NOT use child pads or a child key or switch for victims 8 years of age and older).

CHILD (Victims 1 to 8 Years of Age)

Use child pads if available. If you do not have child pads, you may use adult pads as long as the pads do not touch.
If the AED has a key or switch that will deliver a child shock dose, turn the key or switch.
For unwitnessed, out-of-hospital cardiac arrest in children, perform 5 cycles or 2 minutes of CPR before using and attaching the AED.
For any in-hospital cardiac arrest or for any sudden collapse of a child out-of-hospital, use AED as soon as it available.

Use AEDs only when victims have the following 3 clinical findings:

No Response
No Breathing
No Pulse

Lone Rescuer with an AED

• The lone rescuer should quickly activate the emergency response system and get the AED.

• The rescuer should then return to the victim and begin the steps of CPR.

• The AED should be used only if the victim does not respond, has no breathing, and has no pulse.

There are 2 exceptions to this rule:

If the victim is an adult and a likely victim of asphyxial arrest, the rescuer should give 5 cycles of CPR before activating the emergency response system and getting AED.
If the victim is a child and the rescuer did not witness the arrest, the rescuer should give 5 cycles of CPR before activating the emergency response system and getting the AED.

Special situation when not to use AED

1. The victim is less than 1 year old.

2. The victim has a hairy chest.

3. The victim is immersed in water or water is covering the victim’s chest.

4. The victim has an implanted defibrillator or pacemaker.

5 . The victim has a transdermal patch or other on the surface of the skin where the AED electrode pads are placed.