Cardiac Conditions

1. Cardiac Conditions Caring for children with cardiac conditions in a community program 2015-02-12

2. How the Heart Works • Collects oxygen-poor blood from body and pumps it to the lungs to get oxygen • Pumps blood to the lungs and body by a sequence of organized contractions

3. Types of cardiac conditions • Congenital heart defects • Slows down or blocks blood flow in the heart or in the blood vessels near the heart • Arrhythmias • Abnormal heart beats • Genetic cardiac conditions • Acquired cardiac conditions • Occurs from infection

4. Treatment • Medication • Surgery • Heart transplant • Fontan procedure • Pacemaker • Internal Cardioverter Defibrillator (ICD)

5. Activity restrictions • Most children with cardiac conditions can participate in physical activities without restrictions • For some children, competitive or excessively stressful activities may be restricted

6. Infective Endocarditis • Inflammation caused by an infection in the lining of the heart • Caused by bacteria that gets into blood • Can lead to permanent damage of the heart • May require antibiotics before medical or dental procedure Inform EMS that child has cardiac condition

7. Congestive Heart Failure • Sweating during quiet time • Persistently rapid/labored breathing • Shortness of breath • Rapid heart rate or irregular heart rate • Chest pain • Nasal flaring • Blueness on or around the mouth, eyes, ears, and/or finger tips • Listlessness (tired and unwilling to do normal activities) • Inability to stop coughing • Skin becomes increasingly pale or blue • Suddenly tired

8. Responding to Congestive Heart Failure • Have child rest. • If condition doesn’t improve, contact parent/guardian. • If symptoms do not improve and parent/guardian or emergency contact cannot be reached within 5 to 10 minutes, activate 911/EMS. • Place child on the floor in recovery position (lying on left side). • Keep the airway open. Loosen any tight restrictive clothing. • Stay with child until EMS personnel arrive. If the child has noisy gurgled breathing, call 911/EMS.

9. Loss of consciousness • Call 911/EMS if child does not regain consciousness within one minute. • Implement CPR and the use of an AED, if available. • Notify parent/guardian.

10. Child specific information • Type of cardiac condition • Activity restrictions • Additional information Health Care Plans are located in child file and binder

11. Syncope • Temporary loss of consciousness • Passing out or fainting • Usually occurs without warning and often during exercise • Call 911/EMS if child does not regain consciousness within one minute. • Implement CPR and the use of AED, if required. • Notify parent/guardian.

12. Tachycardia • Heart rate too fast to count • May experience fatigue, dizziness, lightheadedness, chest pain, shortness of breath, upset stomach, weakness • Have the child rest. • If symptoms continue for 20 minutes and parent/guardian or emergencycontact cannot be reached, call 911/EMS. • Stay with child until EMS arrive.

13. Bradycardia • Slow heart rate • May experience decreased level of activity, weakness, paleness, dizziness • Contact parent/guardian. • If child's condition does not improve in 20 minutes and you are unable to contact parent/guardian or emergency contact, call 911/EMS.

14. Pacemakers • Battery operated device used to maintain normal heart rhythm • May experience bradycardia and syncope • Some devices may interfere with the function of the defibrillator • Some sports may need to be avoided if they result in a blow to the chest

15. Internal CardioverterDefibrillator (ICD) If child experiences an internal shock • Put child in recovery position (lying on left side). • Ensure child’s safety. • If child is responsive and received one shock, contact parent/guardian. • If parent/guardian or emergency contact cannot be reached, call 911/EMS. • If child is not responsive or received more than one shock, call 911/EMS.

16. Internal CardioverterDefibrillator (ICD) • Battery operated device implanted for in chest or abdomen • If ICD is not working and child experiences tachycardia or syncope – call 911/EMS • Some sports may be restricted if they may result in a blow to the chest • Some devices may interfere with the function of the defibrillator

17. Heart Transplant • Anti-rejection drugs • 5 minute warm up, 5 minute cool down for vigorous exercise • Needs at least 2 litres of water daily • Contact parent if child ill or exposed to communicable disease • Other precautions • Avoid undercooked food • Avoid grapefruit • Avoid dusty areas, smoke • Avoid animals, gardening

18. Blood thinners External bleeds • Mouth bleeds • Nose bleeds • Surface cuts Internal bleeds • Bruising • Joint & muscle bleeds • Life-threatening bleeds

19. Surface cutsNose bleedsMouth bleeds Put on gloves. Clean skin. Apply firm continuous pressure until bleeding stops. Apply bandage or dressing. Encourage ice. Call parent/guardian if bleeding does not stop after 20 minutes. If unable to reach parent/guardian or emergency contact, call 911/EMS.

20. Bruising Notify parent/guardian if bruise is increasing in size. Muscle & Joint Bleeds • Have child rest. • Apply ice to injury. • Elevate injured body part. • Contact parent/guardian. • If unable to contact parent/guardian or emergency contact after 15 minutes, call 911/EMS.

21. Life-threatening Bleeds If a child has a significant injury to the head, eye, neck, chest or abdomen (with or without signs) Call 911/EMS. Notify parent/guardian.