Lesson 14: Cardiac

Emergencies
 Introduction
• Cardiovascular disease is the leading cause of death
for men and women in the United States
• Coronary heart disease is the most common type of
cardiovascular disease
• Two common cardiac emergencies are heart attack
(also known as myocardial infarction) & cardiac arrest
• A heart attack refers to a condition in which the blood
flow to the heart muscle is compromised and the heart
begins to die
• The term cardiac arrest refers to a condition in which the
heart stops beating

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 Cardiac Chain of
• Survival
Cardiopulmonary resuscitation (CPR)
is a combination of chest
compressions and rescue breaths

• Cardiac Chain of Survival:

 Early recognition and early access
 Early CPR
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 RED CROSS defibrillation
 Early advanced medical care
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 Cardiac Chain of
•
Survival
CPR artificially takes over the
functions of the lungs & heart
• Only about 1/3 of the normal
blood flow to the brain. Therefore,
CPR alone is not enough

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 Recognizing Signals of a
Heart Attack
• Heart attacks are caused
by an obstruction in the
coronary arteries
• This blockage leads to
death of the heart muscle
• Pain is described as:
 Uncomfortable pressure
 Squeezing
 Crushing
 Tightness
 Aching
 Constricting
 Heavy sensation in the
chest

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 Recognizing Signals of a
Heart Attack
(continued)

• Any severe chest pain, pain lasting longer

than 3 to 5 minutes or chest pain
accompanied by other signals of a heart
attack should receive emergency medical
care immediately
• Other signals include:
 Trouble breathing
 Paleness
 Ashen skin or bluish skin, particularly around
the face
 Skin may also be moist
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 Recognizing Signals of a
Heart Attack
(continued)

• As with men, women’s most common heart

attack signal is chest pain or discomfort
• Women are somewhat more likely to
experience other warning signals,
particularly:
 Shortness of breath
 Nausea or vomiting
 Back or jaw pain

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 Care for a Heart Attack
• Follow CHECK—CALL—CARE
• Call 9-1-1 or the local emergency number
• Have the victim stop all physical activity
• Loosen any restrictive clothing and have the victim
rest
• Monitor the victim closely
• Be prepared to perform CPR or use an AED
• Talk to bystanders to find out what happened
• Assist the victim to take prescribed medication
• Do not try to drive the victim to the hospital
yourself
• Aspirin may be given under certain circumstances,
after 9-1-1 has been
called
• Demonstrate
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 Angina Pectoris
• Angina pectoris develops when the heart needs
more oxygen than it gets
• When the coronary arteries are narrow & the heart
needs more oxygen, heart muscle tissues may not
get enough oxygen
• Pain associated with angina seldom lasts longer
than 3 to 5 minutes
• Nitroglycerin temporarily widens the arteries &
therefore helps relieve the pain
• If there is no relief after 10 minutes, call for help

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 Cardiac Arrest
• Cardiac arrest occurs when the heart
stops beating or beats too ineffectively to
generate a pulse and blood cannot be
circulated to the brain and other vital
organs
• A victim in cardiac arrest is unconscious
and shows no signs of life
• Causes:
– Cardiovascular disease
– Drowning
– Suffocation
– Certain drugs
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 Cardiac Arrest
(continued)

• Signs of life include:

 Normal breathing
 Movement
 A pulse (for children & infants)
• The victim’s skin may be pale, ashen or
bluish, particularly around the face. The
face may also be moist from perspiration
• In some cases, a victim of cardiac arrest
may not have shown any warning signals.
This condition is called sudden death

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Lesson 15: CPR & Unconscious
Choking: Adult/Child/Infant
 Introduction
• An adult victim who is in cardiac arrest is
unconscious and shows no signs of life.
• CPR can help circulate blood containing
oxygen by a combination of chest
compressions (1.5 to 2 in) and rescue
breaths.
• When you perform CPR, give cycles of 30
compressions and 2 rescue breaths for
an adult.

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 Unconscious Choking:
Adult
• The care for an unconscious choking
adult is very similar to the skill of adult
CPR, except that you look for a foreign
object in the victim’s mouth between
compressions & breaths
• Chest compressions are used to help
force air from the victim’s lungs to
dislodge a foreign object

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 Child Introduction

• Children seldom initially suffer a cardiac

emergency. Instead, they suffer a respiratory
emergency that results in a cardiac emergency
• Use the emergency action steps: CHECK—CALL—
CARE to determine if you need to perform CPR
• A child is in cardiac arrest if he or she is
unconscious, shows no signs of life (movement or
breathing) including no pulse
• CPR can help circulate blood containing oxygen
through a combination of chest compressions and
rescue breaths
• When you perform CPR, give cycles of 30
compressions and 2 rescue breaths for a child.

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 Unconscious Choking:
Child
• The care for an unconscious choking
child is very similar to the skill of
child CPR except that you look for a
foreign object in the child’s mouth
between compressions and breaths
• Chest compressions (1-1 ½ ) are used
to help force air from the child’s
lungs to dislodge the object

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 Introduction
• Unlike adults, infants seldom initially suffer a
cardiac emergency. Instead, they suffer a
respiratory emergency that results in a cardiac
emergency
• An infant is in cardiac arrest if he or she is
unconscious, shows not signs of life (movement
and breathing) including no pulse in an infant
• CPR can help circulate blood containing oxygen
through a combination of chest compressions
(1/2 -1in) & rescue breaths
• When you perform CPR, give cycles of 30
compressions and 2 breaths for an infant

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 Unconscious
Choking:Infant
• If you attempt rescue breaths but are unable to
make the chest clearly rise, you must act quickly
to get air into the infant.
• Care for an unconscious choking infant is very
similar to the skill of infant CPR, with the
exception that you look for a foreign object in the
mouth between compressions and breaths
• Chest compressions are used to help force air
from the infant’s lungs to dislodge the object

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 Lesson 18: Adult AED
(Automated External Defibrillation)
 Introduction

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 Introduction
(continued)

• Most victims of sudden cardiac

arrest need an electric shock,
called defibrillation
• Each minute that defibrillation is
delayed reduces the victim’s
chances of survival by about 10%
• The sooner the shock is
administered, the greater the
likelihood of the victim’s survival
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 Automated External
Defibrillation
• Disease or injury can disrupt the heart’s
electrical system and damage the heart
• An automated external defibrillator (AED)
is a machine that analyzes the heart’s
rhythm and, if necessary, tells you to
deliver a shock to a victim of a sudden
cardiac arrest
• Defibrillation is an electric shock that
interrupts the heart’s chaotic electrical
activity during sudden cardiac arrest,
which is most commonly caused by an
abnormal rhythms such as ventricular
fibrillation. The shock may help restore the
heart’s ability to function as a pump
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 Safety Precautions When
Using an AED
• When using an AED, follow these precautions:
 Do not touch the victim while the AED is analyzing
 Do not touch the victim while defibrillating
 Do not use alcohol to wipe the victim’s chest dry
 Do not defibrillate someone around flammable materials
 Do not use an AED in a moving vehicle
 Do not use an AED on a victim in contact with water
 Do not use an AED and/or electrode pads designed for
adult victims & child under age 8 or weighing less than 55
pounds unless pediatric pads specific to the device are
not available

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 Safety Precautions When
Using an AED
(continued)

 Do not use an AED on a victim

wearing a nitroglycerin patch
or other patch on the chest
 Do not use a mobile phone or
conduct radio transmission
within 6 feet of the AED
 Do not place the pads directly
over a pacemaker or other
implanted
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 Using and AED
Introduction
• Each minute that defibrillation is
delayed reduces the victim’s
chances of survival by about 10%
• The sooner the shock is
administered, the greater the
likelihood of the victim’s survival

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Adult AED
Infant/Child AED
 Automated External
Defibrillation
• Ventricular fibrillation is a type of an
abnormal heart rhythm that can occur in
young children.
• Most cardiac arrests in children are not
sudden. The most common causes of
cardiac arrest in children are:
 Airway problems
 Breathing problems
 Trauma or an accident
 A hard blow to the chest (Commotio Cordis)
 Congenital heart disease
 Sudden infant death syndrome (SIDS)
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 Automated External
Defibrillation
(continued)

• AEDs equipped with pediatric AED

pads are capable of delivering lower
levels of energy (Joules) to a victim
between the ages of 1 & 8 or
weighing less than 55 lbs
• Pediatric pads should not be used on
adult victims

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 Safety Precautions When
Using an Infant/Child AED
• When using an AED, follow these precautions:
 Do not touch the child while the AED is analyzing
 Do not touch the child while defibrillating
 Do not use alcohol to wipe the child’s chest dry
 Do not defibrillate someone around flammable
materials
 Do not use an AED in a moving vehicle
 Do not use an AED on a child in contact with water

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 Safety Precautions When
Using an Infant/Child AED
(continued)

– Do not use an AED and/or electrode

pads designed for adult victims on a
child under age 8 or weighing less than
55 pounds unless pediatric pads
specific to the device are not available
– Do not use a mobile phone or radio
within 6 feet of the AED

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 Closing Cardiac
Emergencies
• The primary signal of a heart attack is chest pain
• CPR helps to circulate blood and oxygen to the brain and
vital organs when the heart stops
• It is vital to call 9-1-1 or the local emergency number
immediately
• CPR must be started promptly and followed by rapid
advanced life support to give the victim a chance of
survival
• Utilizing each link of the Cardiac Chain of Survival is
essential for the victim to have the best chance of survival
and recovery

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 Closing Choking Adult:
Unconscious
• When performing CPR on an adult, give 30
chest compressions at a rate of about 100
compressions per minute, followed by 2 breaths
• The care for an unconscious choking adult is
very similar to the skill of adult CPR, except
that you look for a foreign object in the victim’s
mouth between compressions and breaths

• Questions?
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 Closing Choking Child
Unconscious
• Recognize the signals of a respiratory
emergency quickly. Often children suffer a
respiratory emergency that can ultimately
lead to a cardiac emergency
• When giving CPR to a child, do cycles of 30
compressions and 2 breaths, at a rate of
about 100 compressions per minute
• The care for an unconscious child is very
similar to the skill of child CPR, except that
you look for a foreign object in the child’s
mouth between compressions and breaths

• Questions?
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 Closing Choking Infant
Unconcsious
• When giving CPR to an infant, use 2-3
fingers to compress the chest, while
maintaining an open airway
• When giving CPR to an infant, do cycles of
30 compressions and 2 breaths, at a rate
of about 100 compressions per minute
• Care for an unconscious choking infant is
very similar to the skill of infant CPR, with
the exception that you look for a foreign
object in the mouth between
compressions and breaths

• Questions?
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 Closing Using AED on a
Infant/Child
• Ventricular fibrillation is a type of abnormal
heart rhythm
• This abnormal heart rhythm can occur in
young children
• An AED is a machine that analyzes the heart’s
rhythm and, if necessary, tells you to deliver a
shock to a victim of sudden cardiac arrest
• This shock, called defibrillation, may help the
heart reestablish an effective rhythm
• AEDs equipped with pediatric pads are capable
of delivering lower levels of energy to a victim
between the ages of 1 and 8 or weighing less
than 55 pounds

• Questions?
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 Closing

• Ventricular fibrillation is a type of

abnormal heart rhythm
• This abnormal heart rhythm can
occur in young children
• An AED is a machine that analyzes
the heart’s rhythm and, if necessary,
tells you to deliver a shock to a
victim of sudden cardiac arrest
• This shock, called defibrillation, may
help the heart reestablish an
effective rhythm.
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 Basic CPR Guidelines for Performing All Levels
Action Adult Child Infant
1 – Puberty Less than 1 Year

Establish Responsiveness Phone EMS immediately Phone EMS immediately

If you are alone – Give 5 cycles of CPR & THEN call
EMS
Open Airway Use Head Tilt/Chin Lift
Check for Breathing Open the airway - LOOK, LISTEN & FEEL
  Take between 5 to 10 seconds
 

Breaths - If not breathing Give 2 breaths that make the chest rise
1 Second each
Begin CPR If unresponsive - Immediately begin CPR – Chest Compressions
Push hard and push fast
Allow the chest to recoil fully after each compression
DON'T STOP

Location of Compression Centre of breastbone between nipples Just below nipple line on breast
bone
Method of Compression Two Hands – heel of one hand on top of the Two fingers
other – May use one hand for child
Depth of Compression 1½ to 2 in. or 1-1 ½ in. Child, .5-1 in. Infant
4 -5 cm
Rate Of Compression 100 Per minute
Compression/ Ventilation 30:2
Ratios