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Outline Chest Pain/Heart Attack Stroke Fits + fainting Making a 999 Call
Terminology Physiology: The biological study of the functions of living organisms and their parts Pathology: the study of the origin, nature, and course of diseases Pathophysiology: the study of the changes of normal mechanical, physical, and biochemical functions, caused by disease
Heart Attack/MI (myocardial infarction)
Heart Attack Definition: Death of, or damage to, a region of heart muscle due to an insufficient blood supply Coronary Heart Disease caused almost 50,000 premature deaths in the UK in 2008
Cardiac Anatomy & Physiology
MI Pathophysiology Build up of fatty deposits in lining of coronary artery, forming a plaque
Treatment
MI Pathophysiology Build up of fatty deposits in lining of coronary artery, forming a plaque Fatty plaque ruptures, exposing blood cells and clotting agents to sticky products in plaque Blood clot (thrombus) forms and blocks artery, cutting off blood supply to distal heart muscle
Symptoms Crushing chest pain, may radiate to arms + neck Shortness of breath Nausea + Vomiting Anxiety Dizziness
Baz interview Patient interview video
Treatment Call 999 Sit in supported position with knees bent Give aspirin (300mg) if available Check for GTN spray and administer Be prepared to give CPR Reassure patient
Stroke
Stroke Definition: A stroke is caused by the interruption of the blood supply to the brain, usually because a blood vessel is blocked by a clot or bursts
Anatomy and Physiology Blood to the brain supplied mainly by the carotid arteries These arteries break down into small arterioles to supply the brain with blood
Anatomy
Brain attack 80% of strokes Pathophysiology: Ischaemic Stroke The same processes as in MI lead to narrowing of carotid arteries Clots can form and travel along artery until they become lodged This cuts off blood supply to brain tissue distal to the blockage
Pathphysiology Haemorrhagic stroke 10% of strokes are caused by bleeding into the brain when a vessel bursts Blood puts pressure on brain tissue Difficult to distinguish without imaging First aid treatment is the same for both types
Symptoms One sided weakness in face, arm or leg on one side Sudden dimness, blurring or loss of vision, particularly in one eye Loss of speech, difficulty talking or understanding Sudden severe headache with no obvious cause
Symptoms
Treatment Time is critical Call 999 Keep patient in comfortable position Do not give food or drink Reassure patient
Mary video Patient Interview video
Seizures/Fits
Seizures Definition: Uncontrolled electrical activity in the brain, which may produce a physical convulsion Approximately 2% of people will have 2 or more seizures in their lifetime In the UK 65 people suffer their first seizure every day Epilepsy: the tendency to have recurrent seizures. It has many causes
Anatomy & Physiology Normal brain function requires an orderly, organized, coordinated discharge of electrical impulses Electrical impulses enable the brain to communicate with the spinal cord, nerves, and muscles as well as within itself Seizures may result when the brain's electrical activity is disrupted
Pathophysiology Causes of seizures: Head injury Flashing lights Alcohol Drugs Hypoglycaemia (low blood sugar) Brain tumour In many seizures no cause is identified
http://www.youtube.com/watch?v=mrzy2a2j nuw
Treatment Protect patient from injury Place in recovery position when seizure finished Reassure patient Do not restrain patient or put anything in mouth Stay with patient until recovery complete Be aware of anxious friends/relatives
Treatment Call 999 If First seizure Seizure lasts longer than 5 minutes Injury sustained You think its necessary
Syncope (fainting) Loss of consciousness due to temporary reduction in blood flow to the brain Twice as common in women Often preceded by feeling of light headedness, dizziness or visual disturbance Many causes Emotional Prolonged standing Exercise
Syncope - Treatment Lie patient down and raise legs Manage airway if necessary Remove environmental stimuli If patient is kept upright fitting may occur If conscioussness not regained after a few minutes, call 999
999 Call
999 Calls Handled centrally (no local knowledge) If landline used address automatically recognised If mobile used then location will be first question asked Main problem, gender, age Is patient alert and breathing Further questions and advice will follow depending on situation LOCATION MAIN PRIORITY
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