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Recognizing and Managing Acute Coronary Syndrome

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Recognizing and Managing Acute Coronary Syndrome PowerPoint Presentation

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Published on : Mar 14, 2014
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Slide 1 - Drill of the MonthDeveloped by Gloria Bizjak Recognizing and Managing Acute Coronary Syndrome
Slide 2 - Drill of the Month 2 Recognizing and Managing Acute Coronary Syndrome Student Performance Objective: Given information, resources, and opportunity for discussion and practice, EMTs will be able to: Define acute coronary syndrome and related terms. List causes of acute coronary syndrome. List general risk factors of acute coronary syndrome. List general symptoms of acute coronary syndrome. Describe and demonstrate assessment and care of a patient suspected of having acute coronary syndrome. EMTs will follow acceptable Maryland medical practice and Maryland Medical Protocols for Emergency Medical Providers.
Slide 3 - Drill of the Month 3 Recognizing and Managing Acute Coronary Syndrome Overview: Definitions Causes Risk Factors Symptoms Assessment and care
Slide 4 - Drill of the Month 4 Acute Coronary Syndrome: Definitions Acute coronary syndrome Umbrella term: includes group of clinical symptoms of AMI Includes angina and heart attack Chest or anginal pain and other symptoms Low oxygen levels to heart Caused by plaque build-up
Slide 5 - Drill of the Month 5 Acute Coronary Syndrome: Definitions Acute coronary syndrome Includes several signs and symptoms Chest and epigastric pain/discomfort Radiating pain to arm, shoulders, jaw Difficulty breathing/shortness of breath Sudden onset of sweating, nausea, vomiting NOTE: Any type of chest discomfort or signs and symptoms of acute coronary syndrome is serious and needs immediate treatment
Slide 6 - Drill of the Month 6 Acute Coronary Syndrome: Definitions Specific terms Acute: Sudden onset w/severe, sharp pain (compare to chronic) Syndrome: Group of symptoms characteristic of disease/disorder Myocardial: Referring to the heart muscle Ischemia: Decrease of blood supply
Slide 7 - Drill of the Month 7 Acute Coronary Syndrome: Definitions Specific terms Angina: Severe constricting pain w/the sensation of choking/suffocating Heart attack: Blockage of a coronary artery causing tissue damage/death Plaque: Deposits of fatty material (lipids) on arterial wall
Slide 8 - Drill of the Month 8 Acute Coronary Syndrome: Causes Causes: Plaque Made up of lipids, accumulates in arteries Narrows arteries and blocks blood flow Build-up and narrowing is ‘coronary artery disease’ Pain from restricted blood flow causes angina Breaks away from arterial wall, blocks artery or causes a clot resulting in heart attack
Slide 9 - Drill of the Month 9 Acute Coronary Syndrome: Risk Factors Risk factors: Gender and age Men (commonly) Women 15 years post menopausal Increased age
Slide 10 - Drill of the Month 10 Acute Coronary Syndrome: Risk Factors Risk factors: Medical Diabetes mellitus (DM) Hypertension Hyperlipidemia: Includes fats, oils, waxes, sterols, nucleic acids, triglycerides Hypercholesterolemia: Cholesterol is a lipid Prior cerebrovascular accident: Over 7% of patients with ACS had prior stroke
Slide 11 - Drill of the Month 11 Acute Coronary Syndrome: Risk Factors Risk factors: Medical Inherited metabolic disorders Connective tissue disease: Commonly known diseases include— Autoimmune diseases, such as lupus, rheumatoid arthritis Inherited diseases, such as Marfan’s Syndrome Scurvy and other
Slide 12 - Drill of the Month 12 Acute Coronary Syndrome: Risk Factors Risk factors: Other Smoking history Metamphetamine use Occupational stress
Slide 13 - Drill of the Month 13 Acute Coronary Syndrome: Symptoms Symptoms Chest discomfort May radiate to arm, shoulders, jaw, back May feel like crushing pain, muscle ache, toothache Anginal pain Shortness of breath (SOB) w/exertion Shortness of breath when lying down (orthopnea)
Slide 14 - Drill of the Month 14 Acute Coronary Syndrome: Symptoms Symptoms Paroxysmal nocturnal dyspnea Waking in the middle of the night w/long-lasting SOB Patient stands at window to catch his/her breath Patient sleeps on stacked pillows to elevate head/chest Patient sleeps in recliner
Slide 15 - Drill of the Month 15 Acute Coronary Syndrome: Symptoms Symptoms Difficulty breathing Sudden sent of diaphoresis, nausea, vomitting Palpitations Anxiety
Slide 16 - Drill of the Month 16 Acute Coronary Syndrome: Symptoms Possible findings on examination Rales Jugular vein distention (JVD) Hypertension or hypotension
Slide 17 - Drill of the Month 17 Acute Coronary Syndrome: Assessment and Care Assessment: Perform General Patient Care (Maryland Protocols) Size up scene; gather info Perform initial assessment Perform focused history, physical exam History of present illness—OPQRST questions SAMPLE history Baseline vital signs
Slide 18 - Drill of the Month 18 Acute Coronary Syndrome: Assessment and Care Assessment: Perform General Patient Care (Maryland Protocols) Follow treatment protocols Communicate with hospital, other response personnel Disposition: determine priority and mode of transport
Slide 19 - Drill of the Month 19 Acute Coronary Syndrome: Assessment and Care Emergency care Place patient in position of comfort Patients with SOB or difficulty breathing: sitting up Hypotensive patients: lying down Patients with both: let them decide position or change position Give a high concentration of oxygen Be prepared for respiratory or cardiac arrest
Slide 20 - Drill of the Month 20 Acute Coronary Syndrome: Assessment and Care Emergency care Transport immediately if: This is patient’s first episode—no cardiac history Patient has cardiac history but no nitroglycerine Patient’s systolic blood pressure is less than 100 mm Hg
Slide 21 - Drill of the Month 21 Acute Coronary Syndrome: Assessment and Care Emergency care Assist patient in taking own nitroglycerine (Refer to Nitroglycerine protocol) Repeat 3-5 minutes with persistent chest pain If BP is greater than 90 mm Hg (consult if BP drops more than 20 mm HG) If pulse is greater than 60 bpm
Slide 22 - Drill of the Month 22 Acute Coronary Syndrome: Assessment and Care Emergency care Assist patient in taking own nitroglycerine (Refer to Nitroglycerine protocol) Doses Maximum 3 doses (medical consult for additional) 3 doses include patient taken and EMT assisted NOTE: CONTRAINDICATED if patient has taken erectile dysfunction meds w/i 48 hours (medical consult) ViagraTM, LevitraTM, CialisTM
Slide 23 - Drill of the Month 23 Acute Coronary Syndrome: Assessment and Care Emergency care Assess for shock signs/symptoms Provide care for shock Monitor the airway Reassess vital signs every 5 minutes
Slide 24 - Drill of the Month 24 Recognizing and Managing Acute Coronary Syndrome Student Performance Objective: Given information, resources, and opportunity for discussion and practice, EMTs will be able to: Define acute coronary syndrome and related terms. List causes of acute coronary syndrome. List general risk factors of acute coronary syndrome. List general symptoms of acute coronary syndrome. Describe and demonstrate assessment and care of a patient suspected of having acute coronary syndrome. EMTs will follow acceptable Maryland medical practice and Maryland Medical Protocols for Emergency Medical Providers.
Slide 25 - Drill of the Month 25 Recognizing and Managing Acute Coronary Syndrome Review: Define the following terms: Acute coronary syndrome Acute Syndrome Ischemia Myocardial Angina Heart attack Plaque
Slide 26 - Drill of the Month 26 Recognizing and Managing Acute Coronary Syndrome Review Acute Coronary Syndrome List causes of acute myocardial syndrome Name the risk factors of acute myocardial syndrome Describe the symptoms of acute myocardial syndrome Explain the assessment and care of acute myocardial syndrome