Course Library

Cardiac Patient Management

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
2. 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
   4. 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
5. 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

Content Creator: James Stone
CAPCE Course Number: 20-EMTP-F3-7101
NJ Course Number: 141112
Total CE Hours: 1
Level: Basic
EMT-CE uses the NEMSES guidelines as the foundation for every course outline.