NREMT EMT 4: Patient Treatment and Transport - Cardiac Emergencies, Chest Pain Assessment, Aspirin Administration, AED Use, Cardiopulmonary Resuscitation, CPR, per AHA Guidelines

What This Is: Cardiac Emergencies

Cardiac emergencies happen when the heart stops beating or doesn't get enough blood flow. Imagine someone's heart is like a pump that's not pumping water (blood) to the rest of their body. If the pump stops or gets clogged, the person can collapse, turn blue, and even die. Cardiac emergencies are like a car crash – you need to act fast to save a life.

Key Steps / Core Facts

• Chest Pain Assessment: Check for chest pain (pressure, tightness, or discomfort) and radiation (pain spreading to arms, neck, jaw, or back). Ask OPQRSTI (Onset, Provocation, Quality, Region, Radiation, Severity, Time, and Inhibiting factors). (OPQRSTI)
• Aspirin Administration: Give aspirin (81mg or 325mg) if the person is conscious and not allergic. Aspirin helps prevent a heart attack. (ACLS)
• AED Use: Use an Automated External Defibrillator (AED) if the person is unresponsive and not breathing. Follow the AED's voice prompts. (AED)
• CPR Compression Depth: Do CPR compressions at least 2 inches deep – like pushing down a soda can. (CPR)
• CPR Rate: Do 100-120 compressions per minute – like tapping your foot to music. (CPR)
• CPR Ratio: Do 30 compressions followed by 2 breaths – like a 30-2 rhythm. (CPR)
• CPR Duration: Continue CPR for 2 minutes before calling for help – like waiting for an ambulance. (CPR)
• CPR Red Flags: Stop CPR if the person starts breathing or has a pulse – like a heartbeat. (CPR)
• CPR Position: Place the person on their back on a firm surface – like a bed or floor. (CPR)
• CPR Airway: Open the person's airway by tilting their head back – like a neck crick. (CPR)
• CPR Breaths: Give breaths that make the person's chest rise – like inflating a balloon. (CPR)

What Laypeople Can Do

• If someone collapses, first check for danger (oncoming traffic, fire). Then shout and tap their shoulder.
• If the person is unresponsive and not breathing, call 911 and use an AED if available.
• If the person is conscious and having chest pain, ask them to sit down and stay calm.
• If the person is having a heart attack, try to keep them calm and comfortable until help arrives.

Common Mistakes

• Mistake: Not calling 911 fast enough.
• Fix: Call 911 immediately if someone collapses or has a heart attack.
• Mistake: Not using an AED when available.
• Fix: Use an AED if the person is unresponsive and not breathing.
• Mistake: Not doing CPR correctly.
• Fix: Follow the AED's voice prompts and do CPR compressions at least 2 inches deep.

Quick Practice Scenarios

• A friend collapses while walking down the street. What should you do first?

Call 911 and check for danger (oncoming traffic, fire).

• A family member is having chest pain while cooking dinner. What should you do first?

Ask them to sit down and stay calm, and try to keep them comfortable until help arrives.

• A neighbor is unresponsive and not breathing after a heart attack. What should you do first?

Call 911 and use an AED if available.

Last-Minute Exam Cram

• Normal heart rate: 60-100 beats per minute
• Aspirin dose: 81mg or 325mg
• CPR ratio: 30 compressions followed by 2 breaths
• AED use: follow voice prompts
• Chest pain radiation: pain spreading to arms, neck, jaw, or back
• Agonal breathing: not normal breathing – start CPR
• CPR duration: 2 minutes before calling for help
• CPR position: firm surface on back
• CPR airway: open by tilting head back
• CPR breaths: make chest rise
• OPQRSTI: assessment sequence