DEALING WITH CARDIC EMERGENCIES
General Overview:
Differential diagnosis of non-traumatic chest pain is challenging. Therefore any patient exhibiting signs and symptoms of chest pain that cannot be attributed to a non-cardiac origin, should be managed as if the origin is cardiac. Younger people may complain of rapid uncontrolled heart rate without chest pain.
Treatment for Cardiac Emergencies:
- Reduce anxiety and activity. Place patient in a position of comfort. Avoid walking if possible.
- Administer high-flow/high-concentration oxygen, if available.
- Assist patient with administration of his or her nitroglycerin, 0.4mg SL spray or tablet, may be repeated every 5 minutes for a total of three doses if the systolic BP remains above 90mmHg.
- Administer one-half adult aspirin (160mg) or two baby aspirin (8lmg each) every 24 hours.
Evacuation Guidelines for Cardiac Emergencies:
Evacuate Rapidly:
- Any patient with chest pain that does not relieve within 20 minutes.
Evacuate:
- Any patient with non-traumatic chest pain that subsided with rest or medication.
- Any patient with sustained periods of rapid heart rate.
References:
ACLS Provider Manual. Dallas, Texas: American Heart Association, 2002.
BLS for Healthcare Providers. Dallas, Texas: American Heart Association, 2002.
“Cardiac/Circulatory.” United States Special Operations Command. Special Operations Forces Medical Handbook. Jackson, Wyoming: Teton NewMedia, 2001. 4-1.
Emergency Medical Technician-Basic: National Standard Curriculum Module 4 Medical/Behavioral Emergencies and Obstetrics/Gynecology. 22 June 1995. National Highway Traffic Safety Administration United States Department of Transportation. 2 Dec 2004. <www.nhtsa.dot.gov/people/injury/ems/pub/emtbnsc.pd>
Schimelpfenig, Tod and Linda Lindsey. “Respiratory and Cardiac Emergencies, Seizures, Diabetes and Unconscious States.” Wilderness First Aid 3rd ed. Mechanicsburg, Pennsylvania: Stackpole Books, 2000. Chapter 18.
The Merck Manual 16th Edition. Rathaway, New Jersey: Merck & Co., Inc., 1992.
Tilton, Buck. “Cardiac Emergencies.” Wilderness First Responder 2nd ed. Guilford, Connecticut: The Globe Pequot Press, 2004. Chapter 23.