Table of Contents
Pretest
Pretest Answers
PART I: PREPARATORY
1. The ABCDs of Emergency Cardiovascular Care
Introduction
Risk Factors for Coronary Artery Disease
Sudden Cardiac Death
Chain of Survival
- Early Recognition and Activation
- Early CPR
- Early Defibrillation
- Early Advanced Cardiac Life Support
- Integration of Post-Cardiac Arrest Care
Phases of Cardiopulmonary Resuscitation
Patient Assessment
- Scene Safety
- General Impression
- Primary Survey
- Secondary Survey
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2. Airway Management: Oxygenation and Ventilation
Anatomy of the Respiratory System
- Upper Airway
- Lower Airway
Lung Volumes and Capacities
- Lung Volumes
- Lung Capacities
- Ventilation Rates
Devices for Assessing Oxygenation and Ventilation
- Pulse Oximetry
- Carbon Dioxide Monitoring
Oxygen Delivery Devices
- Nasal Cannula
- Simple Face Mask
- Partial Rebreather Mask
- Nonrebreather Mask
Manual Airway Maneuvers
- Head Tilt-chin Lift
- Jaw Thrust
- Jaw Thrust without Head Tilt
Suctioning
- Purpose of Suctioning
- Suction Catheters
- Upper Airway Suctioning
- Lower Airway Suctioning
Airway Adjuncts
- Oral Airway
- Nasal Airway
Techniques of Positive Pressure Ventilation
- Mouth-to-Barrier Device Ventilation
- Mouth-to-Mask Ventilation
- Bag-Mask Ventilation
Advanced Airways
- Esophageal-Tracheal Combitube
- King Laryngeal Tube Airway
- Laryngeal Mask Airway
- Tracheal Intubation
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3. Rhythms and Management
Introduction
Section 1: Anatomy Review and Basic Electrophysiology
Coronary Arteries
Basic Electrophysiology
- Myocardial Cell Types
- Properties of Cardiac Cells
- Cardiac Action Potential
- Refractory Periods
- Conduction System
The Electrocardiogram
- Electrodes
- Leads
- Electrocardiogram Paper
- Waveforms and Complexes
- Segments and Intervals
Rhythm Recognition
- Sinus Rhythm
- Sinus Arrhythmia
Section 2: Tachydysrhythmias: Too Fast Rhythms
Narrow-QRS Tachycardias
- Sinus Tachycardia
- Atrial Tachycardia
- AV Nodal Reentrant Tachycardia
- AV Reentrant Tachycardia
- Junctional Tachycardia
Wide-QRS Tachycardias
- Intraventricular Conduction Defects
- Accelerated Idioventricular Rhythm
- Ventricular Tachycardia
Irregular Tachycardias
- Multifocal Atrial Tachycardia
- Atrial Flutter and Atrial Fibrillation
- Polymorphic Ventricular Tachycardia
Section 3: Bradydysrhythmias: Too Slow Rhythms
Sinus Bradycardia
- What Causes It?
- What Do I Do About It?
Junctional Escape Rhythm
- What Causes It?
- What Do I Do About It?
Ventricular Escape Rhythm
- What Causes It?
- What Do I Do About It?
Atrioventricular (AV) Blocks
- First-Degree AV Block
- Second-Degree AV Blocks
- Third-Degree AV Block
Section 4: Cardiac Arrest Rhythms
Ventricular Tachycardia
Ventricular Fibrillation
Asystole (Cardiac Standstill)
Pulseless Electrical Activity
The Resuscitation Team
- Goals of the Resuscitation Team
- Configuration of the Resuscitation Team
- Code Organization - "Phase Response"
- Helping the Caregivers
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4. Electrical Therapy
Introduction
Defibrillation
- Definition and Purpose
- Energy, Voltage, and Current
- Monophasic versus Biphasic Defibrillation
- Transthoracic Impedance
- Defibrillation Ð Procedure
Automated External Defibrillators (AEDs)
- AED Features
- AED Operation
- Special Considerations
- Maintenance
Synchronized Cardioversion
- Description and Purpose
- Procedure
Defibrillation and Cardioversion
- Special Considerations
- Possible Complications
- Possible Errors
Transcutaneous Pacing
- Procedure
- Limitations
- Possible Complications
- Pacemaker Malfunction
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5. Acute Coronary Syndromes
Introduction
Pathophysiology of Acute Coronary Syndromes
- Plaque Rupture
- Thrombus Development
- Coronary Artery Obstruction
- Other Causes of Acute Coronary Syndromes
Forms of Acute Coronary Syndromes
- Unstable Angina
- Myocardial Infarction
History and Clinical Presentation
- Patient History
- Typical Symptoms
- Anginal Equivalents
- Atypical Presentation
- Physical Examination
Patient Evaluation
- Electrocardiogram Findings
- Cardiac Biomarkers
- Imaging Studies
Initial Management of Acute Coronary Syndromes
- General Measures
- Analgesic and Anti-ischemic Therapy
- Antiplatelet Therapy
- Aspirin and Clopidogrel
- Glycoprotein IIb/IIIa Inhibitors
- Anticoagulant Therapy
- Percutaneous Coronary Intervention
- Fibrinolytic Therapy
- Coronary Artery Bypass Graft Surgery
Complications of Acute Myocardial Infarction
- Dysrhythmias
- Ventricular aneurysm
- Ventricular septal rupture
- Papillary muscle rupture
- Cardiac wall rupture
- Hypotension
- Ventricular Failure
- Pericarditis
- Embolic Complications
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6. Acute Stroke
Objectives
Introduction
Stroke Facts
Classification of Stroke by Anatomic Location
Ischemic and Hemorrhagic Stroke
- Ischemic Stroke
- Hemorrhagic Stroke
Stroke Chain of Survival
- Detection
- Dispatch
- Delivery
- Door
- Data
- Decision
- Drug
- Disposition
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PART II: CASE STUDIES
Case 1: Respiratory Arrest
Case 2: Pulseless Ventricular Tachycardia/Ventricular Fibrillation with an AED
Case 3: Pulseless Ventricular Tachycardia/Ventricular Fibrillation
Case 4: Asystole
Case 5: Pulseless Electrical Activity
Case 6: Acute Coronary Syndromes
Case 7: Symptomatic Bradycardia
Case 8: Unstable Tachycardia NEW!
Case 9: Stable Tachycardia NEW!
Case 10: Acute Ischemic Stroke NEW!
Posttest
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Answer Appendix
Glossary
