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Defibrillation Course

Defibrillation Course. Cross Section of the Heart. Flow of Blood Through The Heart. Heart Anatomy. LOCATION: retrosternal – behind the sternum SIZE AND SHAPE: Little bigger than the size of your fist Base – top of the heart Apex – Bottom of the heart. Organ Layers:

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Defibrillation Course

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  1. Defibrillation Course

  2. Cross Section of the Heart.

  3. Flow of Blood Through The Heart

  4. Heart Anatomy LOCATION: retrosternal – behind the sternum SIZE AND SHAPE: Little bigger than the size of your fist Base – top of the heart Apex – Bottom of the heart

  5. Organ Layers: Inside layer – endocardium (smooth muscle that lines the chamber) Middle layer – myocardium (thickest muscle layer) Outside Layer – epicardium Pericardium – Protective sac surrounding the heart, 30cc of pericardial fluid acts as a lubricant and cushion.

  6. Heart Chambers ATRIAL – superior chambers (if you are superior you are at the top) - Right collects blood from the vena cavas. - Left collects oxygenated blood from the lungs.

  7. VENTRICLES – inferior chambers - Right pumps blood to lungs (LOW pressure) - Left pumps blood out to body (HIGH pressure) SEPTUM – wall that separates the two sides of the heart

  8. The 4 Chambers of the Heart Right Atrium Left Atrium Receives blood from veins; pumps to right ventricle. Receives blood from lungs; pumps to left ventricle. Right Ventricle Left Ventricle Pumps blood to the lungs. Pumps blood through the aorta to the body.

  9. Heart Valves Function – to control blood flow through the heart. Atrioventicular Valves (separate the atria & ventricles) Tricuspid Valves (right side) Mitral (Bicuspid) (left side) Semilunar Valves Pulmonic (right side)-between the right ventricle & pulmonary artery. Aortic (left side)-between the left ventricle & the aorta.

  10. Great VesselsLargest in the body to carry blood to and from the heart. Vena Cava: Superior – brings back blood from head and upper extremities Inferior – brings back blood from area below the heart

  11. Pulmonary Artery – carries deoxygenated blood to the lungs. Pulmonary Vein – carries oxygenated blood back to the heart. Aorta – carries oxygenated blood to the body.

  12. Coronary Arteries 2 main arteries which sit on the surface of the heart; come off aortic arch. IMPORTANCE – provides blood to the heart muscle itself (myocardium).

  13. Flow of Blood Through The Heart

  14. Oxygen Low Concentration Vena Cavae Right Atrium (Tricuspid Valve) Right Ventricle (PulmonaryValve) Pulmonary Artery L U N G S

  15. Oxygen High Concentration Pulmonary Vein Left Atrium (Mitral Valve) Left Ventricle (Aortic Valve) Aorta TO THE BODY

  16. Blood Flow Through the Heart It’s coloring time…

  17. Pumping Action of the Heart Stroke volume – the amount of blood ejected from the ventricles with one contraction (60-100ml). Cardiac Output – the amount of blood pumped through the circulatory system per minute. FORMULA = heart rate x stroke volume Normal Adult Heart Rate: 60-100 times per minute

  18. What regulates the heart? “Fight or Flight Response” In response to the autonomic nervous system - Parasympathetic Nervous System When activated, slows down the heart rate. - Sympathetic Nervous System Speeds up the heart rate.

  19. Arteriosclerosis – hardening of the arteries Atherosclerosis – fat and cholesterol deposits line the vessels

  20. Cardiac Assessment What is the chief complaint? 1. Chest pain or discomfort – OPQRSTI 2. Previous episodes & history 3. Shoulder or neck pain 4. Dyspnea – worse with exertion? 5. Syncope 6. Palpitations 7. Past Medical History

  21. Properties of the Heart Automaticity ability to beat on its own Conductivity ability to pass impulses from cell to cell Contractibility ability to receive an electrical impulse and contract Excitability ability to respond to an electrical stimulus Rhythmiticity when stimulated, has rhythm

  22. Depolarization: When the heart contracts or pumps blood Repolarization: When the heart is resting and refilling (RE=Rest)

  23. What’s In a Heart Beat? Electrocardiograph – Machine used to measure electrical heart activity.

  24. Isoelectric Line – the black line on an ECG Electrocardiogram – the read out or strip of paper showing the electrical activity.

  25. ECG Placement - AED

  26. Pacemakers of the Heart • SA Node (sinoatrial) - Dominant pacemaker with an intrinsic rate of 60 - 100 beats/minute. • AV Node (atrial ventricular) - Back-up pacemaker with an intrinsic rate of 40 - 60 beats/minute. • Purkinje Fibers- Back-up pacemaker with an intrinsic rate of 20 - 40 bpm.

  27. Cardiac Conduction System

  28. Cardiac Conduction & the ECG SA node AV node Bundle of His Bundle Branches Purkinje fibers

  29. What happens in a single heart beat??? - The “PQRST” • P wave • Atrial depolarization • SA Node Fires • QRS • Ventricular depolarization • AV Node Fires • T wave • Ventricular Repolarization ATRIA RELAX BEFORE VENTRICLES CONTRACT

  30. The PR Interval Atrial depolarization + delay in AV junction (AV node/Bundle of His) (delay allows time for the atria to contract before the ventricles contract)

  31. Types of AEDs Monophasic Sends single shock (energy current) from one pad to the other Biphasic Sends shock in both directions, measures resistance, and adjusts energy Causes less damage to heart muscle

  32. Rationale for Early Defibrillation • Most frequent initial rhythm in sudden cardiac arrest is ventricular fibrillation (VF) • The only effective treatment for VF is defibrillation • Probability of successful defibrillation decreases rapidly over time

  33. Safety Considerations • Water • Dry patient’s chest; remove from wet environment. • Metal • Ensure no one is in contact with the patient and they are not touching any metal.

  34. Additional Safety Considerations Medication Patch • If patch is visible on the chest, remove it with gloved hands before delivering shock.

  35. Safety Considerations DO NOT defibrillate in a moving ambulance – stop the vehicle to deliver the shock. Road noise interferes in the operation and it decreases the chance of shocking another person Use the proper pads: Adult pads for 8 and older and/or signs of puberty & Child Pads for 1 – 8 years old

  36. Time is Critical • Immediately………….>95% • 1 – 3 min……………..84% • 4-6 min………………28 – 40% • >10 min……………...<5%

  37. Causes of Cardiac Arrest Other Than Heart Disease • Drowning • Trauma • Electrocution • Acid Base imbalance • Electrolyte imbalance • Drug toxicity • Hypovolemia • Hypoxia

  38. Chain of Survival

  39. Rhythms you NEED to know!!! Ventricular Fibrillation - VF

  40. Ventricular Tachycardia – VT

  41. Asystole Normal Sinus Rhythm

  42. Pulseless Electrical Activity – PEA Agonal – Dying Heart

  43. Artifact

  44. Premature Ventricular Contractions – PVC’s

  45. Pacemaker

  46. THE END

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