NREMT Exam Cardiology Module
The structure of the heart is what allows the heart to function effectively and efficiently. Understanding the anatomy of the heart is the basis for understanding how the heart functions in pumping blood throughout the entire body to deliver oxygen to the tissues of the body. This then allows us to make sense of what is occurring when the heart is not functioning properly. This module covers the basic anatomy of the heart including its chambers, valves and blood supply.
The heart functions to pump blood to the entire body in a miraculously efficient and effective way 24/7, 365 days a year for almost 100 years in some people. In this module you will learn how the blood moves through the heart during the cardiac cycle and the phases of contraction and relaxation that take place. You will also discover how the heart’s ability to pump blood depends on the pressure outside and inside the cardiac system and how to measure these. The key to understanding how to resuscitate an unhealthy heart is to first understand how the heart was meant to function.
According to the American Heart Association, 6 million Americans are living with heart failure and 900,000 new cases are diagnosed each year. If this is the case, as a first responder you will definitely come in contact with patients suffering from heart failure as well as its complications. Knowing the pathophysiology behind heart failure will help you understand how best to treat and support these patients.
ACUTE CORONARY SYNDROMES
Because of the prevalence of cardiovascular disease in America, most of our population is at an increased risk for Heart attack and stroke. In this module we concentrate on acute coronary syndromes. These are syndromes causing lack of 02 to the heart muscle, preventing its function, and in a worse case scenario, leading to heart attack, and even death. Unstable angina, myocardial ischemia and myocardial infarction fall into the category of acute coronary syndromes.
As important as the heart is in pumping blood to the body to deliver oxygen, without the vascular system, delivery would be impossible. Disorders of the vasculature can lead to decreased perfusion despite adequate cardiac output and heart health. In this module we discuss some of the most common vascular issues as well as rarer but emergent conditions that the first responder must be able to recognize and treat.
SHOCK AND RESUSCITATION
The role of emergency medicine, both prehospital and in-hospital is to recognize and resuscitate the unstable patient. Stability of a patient is dependent on a few different factors, but one of the most important is perfusion. Perfusion is the delivery of blood, and thus oxygen, to the tissues and is required to sustain life. Patients who suffer from hypoperfusion enter into a state known as shock and without early identification and intervention will continue to decompensate. In this module we discuss the pathophysiology of this state, how it presents, and the best treatment modalities to prevent further decompensation of our patients.
ADVANCED CARDIAC LIFE SUPPORT (Paramedic)
The skills of managing advanced cardiac life support do not replace the most important aspect of resuscitation which is high quality CPR. Good quality chest compressions and early defibrillation are still the only two things that have been clinically proven to decrease mortality from cardiac arrest. However, as more advanced practitioners we are called to build on these skills to resuscitate critically unstable patients, who, if left untreated, would quickly decompensate into cardiac arrest. In this module we will focus on the core principles associated with advanced management of cardiac life support and resuscitation.
Cardiac tamponade is a rare but fatal condition that, if left undiagnosed, can lead to swift decompensation and death of the patient. In this module we discuss the pathophysiology of cardiac tamponade as well as its presentation and treatments so that you will be well prepared to recognize this life threatening condition in the field and act quickly to provide the patient with the care they need.
Infection of the cardiac tissue is an often overlooked etiology for fever and sepsis. Though not as common as pneumonia and urinary tract infections, infections of the cardiac tissues can occur and lead to poor outcomes if undiagnosed. In this module we will cover the different types of cardiac infections, however keep in mind that many of these patients will present similarly. Patients who have general infectious symptoms such as fever and fatigue without an obvious source should be considered to be possible cases of cardiac infections. If their infectious symptoms are combined with signs and symptoms of heart failure, the chance of a cardiac infection becomes much higher. An understanding of how these infections occur and present will help prevent the first responder from overlooking cardiac infections as a possible diagnosis in their patients.
CONGENITAL HEART DEFECTS
Congenital defects are caused by genetic alterations leading to changes in normal anatomy and function at birth. Typically these alterations cause changes in multiple organ systems, however this module focuses on the heart defects that can occur and how they will present. The focus here is not to memorize the different defects but to recognize findings and risk factors that should raise suspicion for such conditions in infants and children to allow for early identification and treatment.
EKG 101 (Paramedic)
In terms of education in paramedicine, you’ll find yourself studying EKG’s easily 50% of your time. Electrocardiogram interpretation is an essential paramedic skill that takes time and practice to master. In this module we start with the very basics. We’ll learn how the heart’s electrical system works, and how we map it out to create an EKG rhythm.
EKG INTERPRETATION (Paramedic)
Electrocardiogram interpretation is a major foundation of paramedic medicine. The changes you can make in your patient care due to adequate identification and diagnosis of cardiac issues through the use of EKG analysis may be what sets you apart the most from other providers. With the prevalence of cardiac emergencies, and the growing cardiac health problem, first responders will always be called often to situations involving the heart. Before you can treat cardiac emergencies, you have to first identify what kind they are. This is why it’s important to start with becoming an expert in EKG interpretation.
CARDIAC BLOCKS (Paramedic)
Heart blocks are a family of conditions that involve interruption of the normal cardiac conduction system. This category includes both AV blocks as well as bundle branch blocks. Patients may present in stable condition or can be at risk of decompensation which is why it is critical for the paramedic to be able to identify these rhythms quickly.
EKG PRACTICE (Paramedic)
In this module we will go through some common EKGs that the paramedic should be able to identify. We will utilize the 5 step approach to EKG interpretation as taught in the EKG 101 module. As you work through each rhythm strip, follow the 5 steps to identify the type of rhythm being presented.