Chapter 9

1. Chapter 9 Circulatory Emergencies

2. Lesson Objectives (1 of 2) • Describe the anatomy and physiology of the circulatory system. • Define shock, list its causes, recognize its signs and symptoms, and know how to manage it. • Recognize and manage internal bleeding.

3. Lesson Objectives (2 of 2) • Identify the signs and symptoms of heart disease and chest pain and know how to manage a patient with suspected angina and heart attack.

4. Anatomy and Physiology • Components of the circulatory system • Heart • Blood vessels • Blood

5. Shock (1 of 4) • Occurs when blood flow is inadequate to maintain the supply of oxygen. • Two most important causes of shock: • Low blood volume • Low blood pressure • Loss of 1 to 1.5 pints of blood in an adult can cause the first stages of shock.

6. Shock (2 of 4) • What to look for: • Rapid, weak pulse • Rapid breathing • Pale or bluish (cyanotic) skin, nail beds, and lips • Damp, clammy skin • Restlessness, anxiety, and weakness • Altered level of responsiveness

7. Shock (3 of 4) • What to do: • Requires hospital treatment • Check breathing and examine for bleeding. • Control bleeding and treat major injuries. • Lay victim on back and elevate feet 6 to 12 inches.

8. Shock (4 of 4) • What to do: • Keep victim sheltered and warm. • Give only clear liquids if victim is alert enough to swallow. • For shock due to dehydration, give lightly salted water or sports drinks. • Evacuate.

9. Internal Bleeding (1 of 3) • Can be caused by disorders such as stomach ulcers, miscarriages, and injuries that do not break the skin. • Can be caused by fractures of the pelvis, hip, or thigh. • Can be life threatening. • Difficult to detect.

10. Internal Bleeding (2 of 3) • What to look for: • Painful, tender, rigid abdomen • Fractured ribs or bruises on the chest • Unexplained signs of shock • Vomiting or coughing up blood • Black or bloody stools • Vaginal bleeding or abdominal pain in a pregnant woman

11. Internal Bleeding (3 of 3) • What to do: • Check breathing repeatedly. • Be prepared for vomiting. • Elevate the legs 6 to 12 inches. • Evacuate immediately.

12. Heart Disease and Chest Pain (1 of 7) • Causes of chest pain • Heart disease • Lung problems • Infections • Muscle strain • Contusions • Abdominal problems

13. Heart Disease and Chest Pain (2 of 7) • Consider serious disease when chest pain is: • Associated with shortness of breath, weakness, cyanosis, and cold, clammy skin • Heavy, crushing, burning, or squeezing pain beneath the breastbone • Radiating to the neck, jaw, throat, arms, or shoulders • Occurring in a person with a history of heart or lung disease

14. Heart Disease and Chest Pain (3 of 7) • Most often caused by coronary artery disease. • Pain relieved by rest or nitroglycerin and pain lasting less than 15 minutes is called angina. • More severe, longer lasting pain not relieved by rest or nitroglycerin can signal a heart attack.

15. Heart Disease and Chest Pain (4 of 7) • What to look for: • SAMPLE history indicates previous pain, history of heart or lung disease, chest injury, unusual activity, recent respiratory infection. • Abnormal pulse and respirations. • Altered responsiveness • Shortness of breath. • Symptoms of infection. • Assessment of chest pain

16. Heart Disease and Chest Pain (5 of 7) • What to do: • For angina: • If the victim has nitroglycerin, assist with administration. • Repeat twice at 3-minute intervals if pain continues. • If pain continues longer than 15 minutes, suspect heart attack.

17. Heart Disease and Chest Pain (6 of 7) • What to do: • For heart attack: • Keep victim sheltered and warm. • Give the victim one aspirin. • Give the victim only water or clear, bland liquids to drink. • Evacuate immediately.

18. Heart Disease and Chest Pain (7 of 7) • Changes in cardiac rhythm • Normal heartbeat is regular in rhythm, though may beat fast or slow. • Heartbeat may be irregular at high altitudes or in victims of hypothermia. • Evacuate if heart rate is greater than 120 beats/min at rest.