Transcript Early Heart Attack Care - Southern Ohio Medical Center

Early Heart
Attack Care
Heart attacks have beginnings
For Questions, call Amy Fraulini, MSN, RN
Director of Critical Care and Heart Services
(740)356-8305 [email protected]
Heart Attack:
A community problem…
with a community solution
Cardiovascular Disease Mortality Rates
County
Mortality Rate per 100,000
Adams
283.2
Jackson
328.0
Lawrence
346.8
Pike
300.0
Scioto
401.2
Greenup, KY
332.5
Lewis, KY
327.8
Ohio
303.1
Kentucky
324.4
United States
279.2
BLUE indicates those counties which exceed the state of Ohio’s mortality rate
Source: US CDC Mortality Database
Course Outline
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Anatomy and Physiology 101: Your Heart
Who’s at risk for heart disease?
A Heart Attack in Progress
Concepts of Early Heart Attack Care
Recognition and Intervention
Delay and Denial
You: The Early Heart Attack Caregiver
Part 1
Anatomy &
Physiology 101:
Your Heart
The Human Heart
• Location
– Middle of the chest
• Size
– That of a fist
• Purpose
– Pumps blood throughout the body
• Weight
– 7 - 12 ounces
• Capacity
– Pumps 1,800 gallons of blood & beats over
100,000 times daily
The Human Heart & Coronary Arteries
SUPERIOR VENA CAVAL
BRANCH (NODAL ARTERY)
ANTERIOR R.
ATRIAL
BRANCH OF
R. CORONARY
ARTERY
L. CORONARY ARTERY
CIRCUMFLEX BRANCH OF
L. CORONARY ARTERY
RIGHT
CORONARY
ARTERY
GREAT CARDIAC VEIN
ANTERIOR
CARDIAC
VEINS
ANTERIOR
INTERVENTRICULAR
(ANTERIOR DESCENDING)
BRANCH OF L.
CORONARY ARTERY
SMALL
CARDIAC
VEIN
The Human Heart & Coronary Arteries
OBLIQUE VEIN OF L.
ATRIUM
GREAT CARDIAC VEIN
SUPERIOR VENA CAVAL
BRANCH (NODAL ARTERY)
SINOATRIAL
(S-A) NODE
CIRCUMFLEX BRANCH OF
L. CORONARY ARTERY
CORONARY SINUS
POSTERIOR VEIN
OF L. VENTRICLE
SMALL
CARDIAC
VEIN
R. CORONARY
ARTERY
MIDDLE
CARDIAC VEIN
POSTERIOR
INTERVENTRICULAR
(POSTERIOR DESCENDING)
BRANCH OF R.
CORONARY ARTERY
The Human Heart: Electric Pump
Who’s at risk for Heart Disease?
• Some persons are more likely
than others to have a heart attack
because of their “risk factors”
• There are
– Factors you can control
– Factors you cannot control
Risk factors we can control:
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Smoking
High blood pressure
High blood cholesterol
Overweight and obesity
Physical inactivity
Diabetes
Risk factors we cannot control:
• Pre-existing coronary heart disease, including a
heart attack, prior angioplasy, bypass surgery,
or angina
• Age
• Family history of heart disease
– A father or brother diagnosed before age 55
– A mother or sister diagnosed before age 65
Part 3
A Heart
Attack in
Progress
Heart Attack Facts
• #1 Killer of Adults BOTH Men and Women
• 1.1 million Americans suffer a heart attack
each year
• 460,000 of those heart attacks are fatal
• Hundreds of thousands survive but are left
with a damaged heart
Some different presentations of
heart attack
• Sudden, severe pain that stops you in your
tracks.
• Gradual increasing pain with damage
occurring over a period of hours.
• Very early presentation with mild symptoms
over hours or days.
Ischemia & Angina Pectoris
Partial block
producing
chest pain
Area of
decreased
blood supply
Coronary Artery Disease
Complete Obstruction: AMI
Area of Infarct
Part 4
Concepts
of Early
Heart
Attack Care
Are all heart attacks created equal?
Progress:
Heart Attack Treatment
• Prehospital Cardiac Care
• Thrombolytic Therapy (clot busters)
• Angioplasty (preferred treatment with optimal
outcomes)
• Decrease in time to treatment
saved
heart muscle
improvement in quality of
life
Too Little Progress:
Heart Attack Recognition
• Most heart attack patients do not benefit from
optimal medical advances……………WHY?
Delay
• in recognizing and
responding to the
early warning signs
of a heart attack
Why Early Heart Attack Care?
• Early Care: Recognize & Respond
– often mild symptoms, usually normal activity
• Late Care: Obvious Emergency & Respond
– incapacitating pain, diminished activity
• Too Late Care: Critical Emergency & Respond
– unconscious, CPR, defibrillation, probable death
• 85% of the heart damage takes place within the first
two hours.
Part 5
Recognition
& Intervention
Early Symptoms of a
Heart Attack
• Non-Specific Heart Attack
Symptoms:
• Specific Heart Attack
Symptoms
– weakness/fatigue
– chest discomfort
– clammy/sweating
– chest pressure
– nausea/indigestion
– dizziness/nervousness
– shortness of breath
– neck/back/jaw pain
– feeling of doom
– elbow pain
– chest ache
– chest burning
– chest fullness
Part 6
Delay
& Denial
Why do we delay?
Denial and Procrastination
= Our Heart’s Enemy!
It’s nothing really serious
“I’ll just rest a bit”
I’m too busy right now
“I don’t have time
to be sick”
I don’t want to be a problem
“If it turns out to be
nothing, I’ll be
embarrassed by the
fuss made.”
Paramedics BEWARE!
First responders
can easily be
swayed by patient
rationalizations
and denials
It’s probably heartburn or
indigestion
“I’ll take
something for it”
I’m strong!
“Just walk it off,
grin and bear it”
I’m healthy
“I have no serious
medical problems…I
exercise.”
I’ll just wait it out
“Everything will be
OK.”
Part 7
YOU:
The Early
Heart Attack
Caregiver
Who is the Caregiver?
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Spouse
Children
Parent
Co-worker
Friend
Exercise Partner
Anyone who cares about you!
What to ask and look for
• Do you have any chest discomfort?
• Is it tightness, pressure, pain in the center of your chest?
• Is the discomfort also in your arms or jaw or neck or throat
or back?
• Are you sick to your stomach?
• Is the person sweaty or clammy?
• What were you doing when the symptoms started?
• Do the symptoms go away with rest?
• Are you having any shortness of breath?
Listen to your Heart
and be a Winner
• Be aware of pressure, not necessarily pain, in your chest.
• Be aware if it increases with activity and subsides with rest.
• Don’t try to rationalize it away. Be honest with yourself and
others.
• Call 9-1-1 or have someone drive you to the nearest
emergency room.
• Don’t go to your doctors office or wait for an appointment.
• Recognize the subtle danger signs and act on them before
damage occurs.
Remember to Call 9-1-1
WHY?
• EMS can begin treatment immediately-even before arrival at
the hospital
• The heart may stop beating during a heart attack. EMS have
the equipment needed to start the heart again
• Heart attack patients have emergency needs that can be met
by the EMS….such as oxygen, heart medications, and pain
relief treatments
• EMS are linked to the hospital and doctors to give them
needed resources during this critical time
Any questions?
www.somc.org
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