Chapter 16
First Aid for Colleges
and Universities
10 Edition
Cardiovascular
and Stroke
Emergencies
Slide Presentation prepared by
Randall Benner, [Link]., NREMT-P
© 2012 Pearson Education, Inc.
Coronary Artery Disease
• What is coronary artery disease?
– A disease affects the functioning of the
arteries supplying blood to the heart
– Results in diminished or occluded
blood flow
– Victims eventually can experience
chest pain or heart attack.
• Types of coronary artery disease
– Atherosclerosis
– Arteriosclerosis
• the opening of the coronary artery is
narrowed
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Coronary Artery Disease
• Artherosclerosis
– fatty substances–called
plaque–and other
debris are deposited
on the inner lining of
the arterial wall.
• Arteriosclerosis
– Calcium deposits in
arterial walls limits the
ability of the arteries to
constrict or dilate
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Introduction
• Acute coronary syndrome (ACS) involves many
conditions leading to low oxygen states to the
heart. (myocardial ischemia) unstable angina
and myocardial infarction
• Common sign and symptom is chest pain
• The First Aider should consider every patient
with chest pain as having an acute coronary
event until proven otherwise.
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Cardiac Risk Factors
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Angina
• Also known as angina pectoris
– “Pain in the chest”
– Signals the heart’s need for more oxygen
– Indication that the heart demand for oxygen is less
than supply
– Two types: stable and unstable angina
– Symptoms between the two types are often similar
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Angina
• Stable and unstable angina
– Stable occurs with physical activity, emotional
excitement or cold weather.
– Unstable often occurs without any prediction (not
related to myocardial workload, during rest and sleep)
• common signs and symptoms
– chest pain
– Located under the sternum
– radiate to the jaw, neck, left shoulder, left arm, and
left hand
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Angina
• Other common signs and symptoms
– Dyspnea (shortness of breath)
– Profuse perspiration
– Light-headedness
– Palpitations
– Nausea and/or vomiting
– Pale and cool skin
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Congestive Heart Failure (CHF)
• Heart fails to pump blood
effectively to the body
• Can occur from
hypertension, heart
attacks, etc.
• Fluid can build up behind a
failing left heart ventricle
• Fluid then shifts into alveoli
impairing oxygenation
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Congestive Heart Failure (CHF)
• Signs and symptoms
– Pain may or may not be present
– Severe respiratory distress is
common
– Wheezing in the lungs, rapid
breathing
– Distended neck veins
– Swelling of feet and lower legs
– Confusion or anxiousness
– Tripod positioning and abdominal
distension
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Congestive Heart Failure Symptoms
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Myocardial Infarction (MI)
• Commonly known as heart attack
• Among the most severe/dangerous of the ACS
conditions
• Complete blockage of a coronary blood vessel
• Death to heart muscle occurs
• Can result in quick deterioration into cardiac
arrest
• Generally associated with coronary artery
disease
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Myocardial Infarction (MI)
• Signs and symptoms
– Depends on degree of heart damage
– Chest pain is most common symptom
– Shortness of breath, profuse sweating,
nausea/vomiting, weakness, anxiety, rapid or slow
heart rate, fainting, cyanosis (“blueness”)
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First Aid Care for Cardiac Emergencies
• Time is critical in treating any acute coronary
syndrome
– Activate EMS.
– Perform an initial assessment.
– Note type, quality, and location of pain.
– provide rescue breathing if the respiratory rate or
volume becomes inadequate
– Encourage the victim to chew one adult aspirin or two
low-dose baby aspirins.
– Loosen restrictive clothing.
– Monitor vital signs.
– Know location of closest AED and be prepared to
start CPR.
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Stroke
• Any condition that impairs circulation to the brain
– Cells die from a lack of oxygen in minutes
– Characteristics depend on the site of the stroke and
amount of brain damage
– sudden onset of brain dysfunction.
• Causes and types of strokes
– Ischemic: clot blocking the flow of blood in a cerebral
vessel (thrombotic and embolic)
– Hemorrhagic stroke: ruptured vessel in the brain
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Types of Strokes
• Thrombotic
– Cerebral artery blocked by a clot that develops in the
blood vessel
– Often preceded by a transient ischemic attack (TIA:
the blockage is partial or lasts only a few minutes.)
• Embolic
– Blocked cerebral blood vessel from clot that travels
from elsewhere in the body
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Types of Strokes
• Hemorrhagic stroke
– Vessel in brain bursts
– Blood floods the surrounding brain tissue or into the
spinal fluid that surrounds the brain.
– Loss of blood flow and compression causes brain
injury
– sudden headache followed by a sudden change in
mental status and coma.
Brain of a victim of stroke from cerebral hemorrhage.
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General Signs and Symptoms of Stroke
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Stroke Management
• Activate EMS.
• Handle the victim carefully.
• Place victim in semi-sitting position if conscious.
• Use left lateral positioning if unconscious.
• Assess airway, breathing, and circulation
functions.
• Support any impaired ABC functions.
• Maintain normal body temperature.
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Stroke Management
• Give nothing by mouth.
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