Cardiology in emergency room

Description

APPROACH TO A PATIENT WITH CHEST PAIN

• Initial approach

• Prompt triage

• Place on cardiac monitor on patient with visceral type of chest pain (discomfort,

heaviness, or aching), abnormal vital signs, and dyspnoea.

• ECG performed within 10 minutes of ER visit.

• Establish IV line and supplemental oxygen if SpO2< 93 %

• Focus on immediate life threat and stabilize airway, breathing and circulation

• Take focused history concerning on character of pain, presence of associated symptoms,

and history of other cardiopulmonary conditions.

• Be aware of atypical chest pain like radiation to right arm, epigastric pain, chest wall

tenderness, dyspepsia.

• Rule out other life-threatening conditions like aortic dissection, pulmonary embolism,

pneumothorax, pericarditis, pericardial tamponade, pneumonia and oesophageal

rupture.

Investigation:

• 12 lead ECG: within 10 minutes of ED arrival and interpreted by ER doctor. Serial ECGs for

persistent pain or changes in pain. Focus on ECG changes like T wave changes, ST segment

changes of >0.5 mm, pathological Q waves, new or presumably new bundle branch block

or sustained Ventricular tachycardia.

• Chest X- ray to assess wide mediastinum indication aortic dissection or consolidation for

pneumonia.

• Point of care echocardiography– if available

APPROACH TO ECG INTERPRETATION

1. Wide vs narrow

2. Fast vs slow

3. Regular vs irregular

4. Ischaemia

5. Rhythm

6. Axis

7. Intervals

Steps 1-3: identify fatal arrhythmias

Step 4: identify MI or cardiac ischemia

Steps 5-7: provide hints of underlying cardiac etiologies

leap training

About Us Creating a wise, educated doctor who helps others medically and spiritually Training doctors to diagnose all common and rare diseases, both in theory and in practice, on real patients Training doctors to deal with all problems and obstacles that lead to an error in diagnosis Creating an integrated doctor who masters his work, knows his goal and has the ability to meet his personal needs and ambition

What You Will Learn!

• Cardiac arrest bsc
• Care cardiac surgery
• CABG
• Cardiac rehabilitation

Who Should Attend!

• all Physicians interested in CARDILOGY IN EMERGENCY ROOM

TAKE THIS COURSE