NREMTP Review-Alyssa 🚒🚑 Cardiac
P-Wave
Atrial depolarization (Contraction)
QRS Complex
Ventricular Depolarization
T-wave
Ventricular Repolarization
Small Box
0.04 seconds'
Large Box
.20 seconds
5 large Boxes=1 second
30 large=6 Seconds
PR Interval
Measured from the start of the P-wave to the start of the QRS
Normal-.12-.20 seconds (3-5 small boxes)
QRS Width
.04-.12 seconds (1-3 small boxes)
QT Segment
Measured from the Q-wave to the end of the T-wave
Normal-.40-.48
Ischemia
Lack of oxygenated blood flow to a muscle
Injury
When ischemia is prolonged, muscles become damaged
Infarction
Muscle death
Angina vs Unstable Angina vs Myocardial Infarction
Coronary Arteries (1/3 or 33% of the blood in every beat goes to the Myocardium)
RCA-Right Coronary Artery (Supplies blood to the right side, Right atrium, Right ventricle)
LCA (Left Coronary Artery)-LAD-Left anterior Descending (Supplies blood to the left ventricle, left atrium, Septum)
Circumflex-Supplies blood to the lateral wall and posterior heart
Angina (Chest pain due to ischemia)
CAD
Coronary Artery Disease
Atherosclerosis-A buildup of fats/plaques/lipids/cholesterol in the coronary arteries
Syndrome
Not just 1 thing, it is a collection of conditions
ACS
Acute Coronary Syndrome
Unstable Angina
STEMI
NSTEMI
Inferior Wall M.I=Right sided M.I
Blockage is in the RCA
ST Elevations-Leads II, III, aVF
Immediately do a V4R (Right sided EKG)
The Right ventricle is involved
PRELOAD PROBLEM (Volume)
INOTROPIC PROBLEM
DO NOT GIVE NTG until you have ruled out a full right sided MI
This is the ONLY MI where we DO give IV Fluids!!!!!!
120/80
Systolic
Pressure in the arteries during contraction
Diastolic
Pressure in the arteries during relaxation (Filling)
PRELOAD-ALWAYS think VOLUME
The total amount of blood in the ventricles at the end of diastole
The ventricles are preloading getting ready for the next beat/contraction
AFTERLOAD-ALWAYS think PRESSURE/RESISTANCE
The total resistance the left ventricle must overcome to pump out the blood
Examples
20 M shot x 2 in the abdomen. Internal Bleeding=Decreased Preload
VS-BP-72/48, HR-116=Decreased Afterload
65 F-History of CHF-JVD, Pedal edema, Crackles=Increased Preload
VS-BP-198/110, HR-114=Increased Afterload
Inotropy (Strength)
Refers to the strength of the contraction
Chronotropy (Speed)
Refers to the HR
Dromotropic (electricity)
Refers to the hearts ability to conduct electrical impulses
3 Types of Anginas
Stable Angina (Partial Blockage)
Onset of CP from exertion (walking, exercise, yard work)
Predictable
Lasts less than 1 hour
The CP goes away w/ rest/NTG
Unstable Angina (larger blockage)
Onset of CP while at rest
The CP does NOT go away w/ Rest/NTG
Prinz Metals Angina (variant angina)
An onset of CP, due to spasms in the coronaries
Spasms=Vasoconstriction
causes-cold temps. meds, caffeine, workout supplies