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Medical: 5

Cardiology: 2 ════════════════════════════════════════════════════════════════════════════════════ ══════════════════════════

        • (1)

          Sense of urgency for reperfusion

        • (2)

          No relief with medications

        • (3)

          Hypotension/ hypoperfusion

        • (4)

          Significant changes in ECG

      • b.

        No transport

        • (1)

          Patient refusal

        • (2)

          Referral

  • G.

    Support and communications strategies

    • 1.

      Explanation for patient, family, significant others

    • 2.

      Communications and transfer of data to the physician

  • VIII.

    Myocardial infarction

    • A.

      Epidemiology

      • 1.

        Precipitating causes (as with angina)

        • a.

          Atherosclerosis

        • b.

          Persistent angina

        • c.

          Occlusion

        • d.

          Non-traumatic

          • (1)

            Recreational drugs

        • e.

          Trauma

    • B.

      Morbidity/ mortality

      • 1.

        Sudden death

      • 2.

        Extensive myocardial damage

      • 3.

        May result in ventricular fibrillation

        • a.

          Prevention strategies

          • (1)

            Relieve pain

          • (2)

            Effect reperfusion

    • C.

      Initial assessment findings

      • 1.

        Airway/ breathing

        • a.

          Labored breathing may or may not be present

      • 2.

        Circulation

        • a.

          Peripheral pulses

          • (1)

            Quality

          • (2)

            Rhythm

        • b.

          Changes in skin

          • (1)

            Color

          • (2)

            Temperature

          • (3)

            Moisture

    • D.

      Focused history

      • 1.

        Chief complaint

        • a.

          Typical onset of discomfort, usually of long duration, over 30 minutes

        • b.

          Typically unrelieved by rest and/ or nitroglycerin preparation

        • c.

          Epigastric pain or discomfort

        • d.

          Atypical

      • 2.

        Contributing history

        • a.

          First time

        • b.

          Recurrent

        • c.

          Increasing frequency and/ or duration

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────────────────────────── United States Department of Transportation National Highway Traffic Safety Administration Paramedic: National Standard Curriculum

23

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