Daily Archives: August 23, 2013

DAY 8: AUGUST 14TH

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It’s the second to last day of the MIM program. I’m excited yet sad that its ending. I’ve learned a good amount of information in the eight days I’ve been there. However, today was no difference. Dr. Raj made another appearance. He gave us like a practice case from the emergency department. I thought it was very interesting. I learned about what to do when a patient comes in. You would ask  then what’s wrong, then take their vital signs (see Day 5 post), ask about their social history, pass medical history, medications. Social History may include

  • where they work
  • living conditions
  • family history
  • sexual habits
  • any alcohol/drug abuse

CARDIAC ARREST TREATMENT OVERVIEW!!

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CARDIAC ARREST TREATMENT OVERVIEW

If its acute then

  • asses for pulse and breathing
  • call 911
  • begin CPR
  • automatic defibrillator
  • transport to an emergency department

If long term then treatment includes

  • implantable defibrillator

CARDIAC ARREST TREATMENT-STEP #1

  • must act IMMEDIATELY
  • asses for pulse and breathing

CARDIAC ARREST TREATMENT-STEP #2

  • CALL 911 QUICKLY
  • describe the incident
  • the dispatcher will give directions

CARDIAC ARREST TREATMENT-STEP #3

  • begin CPR
  • if no pulse, begin IMMEDIATELY! DO NOT BE AFRAID
  • pump on the chest to help blood to circulate through the heart
  • start on patient over the age of eight
  • place hands on the mid chest over the sternum

CARDIAC ARREST TREATMENT-STEP #4

  • AUTOMATIC EXTERNAL DEFIBRILLATOR
  • this a portable device with sensors to place on the chest that delivers an electrical shock
  • the computer analyzes the patient ‘s rhythm and instructs provider to deliver a shock

CARDIAC ARREST TREATMENT-STEP #5

  • transport to a medical facility

CARDIAC ARREST PREVENTION

  • LONG TERM
  • IMPLANTABLE CARDIAC DEFIBRILLATOR
  • placed under the skin with electrodes in the heart
  • monitors the rhythm of the heart
  • delivers short, high-energy, shock if ventricular tachycardia or other arrhythmia discovered
  • patient will feel  a jolt

 

DAY 7: AUGUST 13TH

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It’s my second day of week two at the MIM program. Today we learned about another cardiovascular disease known as cardiac arrest and the difference between a heart attack (myocardial infaraction) and cardiac arrest. Again, Dr. Raj joined us and gave us a valuable lesson on cardiac arrest. In addition, we also a EMT, who showed us how to do CPR ( cardiopulmonary resuscitation). This lesson was extremely useful and I actually felt like I could actually SAVE A LIFE!

Cardiac Arrest is the sudden unexpected loss of heart function such as the electrical disturbance in the heart that disturbs the pumping action of the heart, which would led to the stopping of blood flow to the rest of the body. In simpler terms to remember, the heart stops. Cardiac arrest is a leading cause of death especially high in minority communities. It affects up to 380, 000 people a year in the US. This would translate into approximately 1,000 people a day, which would then translate into 1 person every 2 minutes. 95% of people die before help arrives because the brain dies within 6 minutes of not receiving oxygen. Survival improves up to 43% with early CPR and defibrillation. The heart has an internal electrical system. This controls the beating of the pump. Apart of the electrical system of the heart you have the SA, AV, and His Bundle. SA stands for sinoatrial node which is a specialized bundle of neurons located in the nodal tissue located in the upper part of the right atrium. The SA acts as an natural pacemaker. The function of the SA is to set the rate of contraction for the heart. It also spontaneously contracts and generates nerve impulses that travel throughout the heart wall causing both atria to contract. AV stands for atrioventricular node which is a section of nodal tissue that lies on the right side of the partition that divides the atria, near the bottom of the right atrium. The function of the AV is to delay cardiac impulses from the sinoatrial node to allow the atria to contract and empty their contents first.  His Bundle or Bundle of His is a large bundles of fibers that carry impulses to the walls of the ventricles.  Cardiac arrest is also caused by arrhythmia. Arrhythmia is an abnormal rhythm in the heart. There are many types of arrhythmia with different complications in the atria and ventricles. Most common arrhythmia is known as ventricular fibrillation (V-fib) which leads to cardiac arrest. The different types of arrhythmia is supraventricular tachycardia (SVT), ventricular tachycardia, and ventricular fibrillation. The ventricles quiver uselessly and do not pump blood. The risk factors of cardiac arrest

  • often link to a heart attack
  • family history of CAD (coronary artery disease)
  • smoking
  • other disorders (diabetes, hypertension)
  • lack of exercise
  • drugs
  • age
  • gender
  • nutritional imbalance

The symptoms of cardiac arrest often occur with no warning

  • sudden collapse
  • no pulse
  • not breathing
  • unconsciousness

A person may have symptoms such as

  • dizziness
  • chest pain
  • shortness of breath
  • palpitations
  • vomiting

Cardiac arrest is often diagnosis by clinical diagnosis but if the patient survives then they will receive medical attention. The underlying cause can be detected by

  • blood tests
  • electrocardiogram (EKG)
  • echocardiogram
  • electrophysical testing
  • coronary angiogram

Cardiac arrest can be treated by

  • asses for pulse and breathing
  • call 911
  • begin CPR
  • automatic defibrillator
  • transport to an emergency department
  • implantable defibrillator (long term)

Dr. Raj also discuss the difference between a heart attack and cardiac arrest.

CARDIAC ARREST VS. HEART ATTACK (MYOCARDIAL INFARACTION)

CARDIAC ARREST

  • heart stops beating or beats so abnormally that pump does not work
  • problem with the electrical system

MYOCARDIAL INFARACTION

  • heart continues to beat
  • heart muscle does not receive blood because of a blockage
  • heart muscle is damaged or dies

~ REPRESENTS CAN LEAD TO..

CORONARY ARTERY DISEASE~HEART ATTACK~VENTRICULAR FIBRILLATION~CARDIAC ARREST~UNCONSCIUOS~COMA~MAYBE DEATH 😦