Cardiac Arrest, Hematological, Abdominal & Renal Emergencies

• Cardiac Arrest


  Most serious outcome from Cardiac Compromise
• Reasons for Cardiac Arrest

  • Most common/leading cause is ventricular fibrillation
  • Significant myocardial ischemia & death
  • Cardiac electrical conduction defect
• Most common cause of sudden cardiac arrest following AMI is from a cardiac arrhythmia
• Chain of Survival


  • Early access
  • Early CPR
  • Early defibrillation
  • Early ALS
  • Post cardiac arrest care & recovery
• Types of Defibrillators


  • Manual
  • Automated
  • AED
• Manual Defibrillator


  Counter-shocks are administered by the care provider manually (pre-hospital)
• EMT can't practice manual defibrillation as it needs a higher level of caretaker
• Automated Defibrillator


  Provides the rest of the rhythm analysis and provisions of electrical counter shocks
• AED


  Assesses electrical activity, used when patient is unresponsive, pulseless, and breathless, and arrest isn't due to trauma
• Don't use AED when arrest isn't witnessed or occurred >4-5 min prior
• Indications for 12 lead ECG Acquisition

  • Chest pain, pressure, discomfort
  • Radiating pain (neck, shoulder, back, or other)
  • Shortness of breath/difficulty breathing
  • Nausea/vomiting
  • Epigastric pain
• Tachycardia


  Heart rate higher than 100 bpm
• Bradycardia


  Heart rate lower than 60 bpm
• Population less likely to complain of chest pain

  • Women
  • Elderly
  • Diabetics
  • People with failure history
• 12 Lead ECG Procedure

  1. Bond on electrodes

  2. Verify all leads are securely attached

  3. Have patient relax, no arms on metal stretcher

  4. Contact Medical Control & advise of ECG BLS 12 lead transmission

  5. Ambulance must be totally stopped

  6. Consult with Medical Control for transport decision

  7. Monitor patient for changes in clinical condition

  8. Prepare to repeat 12 Lead ECG @ 10 min. intervals or upon change in patient's condition

  9. Be prepared to give full medical report to physician at hospital & provide copy of the 12 lead
• STEMI is ST Elevation Myocardial Infarction
• Hema


  Prefix for blood
• Hemoptysis


  Coughing up blood
• Hemoteria


  Blood in urine
• Hematchezia


  Bright red blood in stool
• Hematemasis


  Vomiting blood
• Exannating


  A lot of blood coming from patient
• Venous bleeding


  No oxygenated blood (dark red)
• Arterial bleeding


  Oxygenated blood (bright red)
• Melna


  Blood in stool
• Ventricle


  Pumps blood
• Atrium


  Receives blood
• Imminent Cardiovascular Collapse


  Grey skin (ashen)
• Jaundice


  Yellow skin-liver dysfunction (toxic blood)
• Thromboembolism


  Blood clot floating through blood vessels
• If clot lodges in coronary artery

  Acute myocardial infarction (AMI) happens
• Ischemia


  Decreased blood flow