Caring for a Heart Attack Victim as a CNA
Today, I want to cover the topic of heart attacks. With our patients oftentimes being elderly, it can be quite common for us to be in a situation where heart attacks happen, and we need to be able to respond quickly. First, I want to discuss what a heart attack is.
What is a Heart Attack?
A heart attack is caused from a portion of the heart not receiving enough oxygen. This can happen for a variety of reasons. It can be caused by an embolus (or blood clot) that is traveling through the arteries and blocks a portion of the artery. A heart attack can also be caused by a slow buildup of cholesterol in the artery, which weakens the artery wall, and can sooner or later dislodge and block the artery; or it can continue to become increasingly dense which can also cause blockage. Either way, what is important for us to know is that the problem lies in a portion of the hearts tissue being unoxygenated (ischemic), due to poor blood supply to the tissues, and more or less the tissue is starting to die.
Assessment of a Heart Attack
The first step to treating a patient for a heart attack is realizing that the patient is actually having a heart attack. The following are some common signs of a heart attack that you may see in your patients.
Pressure/Pain in the Chest, is the most obvious and common sign of a heart attack. This can of course be caused by a variety of conditions, such as a pulmonary embolism, heartburn, and sometimes trauma. Oftentimes, for our heart attack patients, there will be a sudden onset of pain that often radiates to the left arm, but can really radiate anywhere. Oftentimes, female patients will have the pain radiating to their backs, and sometimes they will present as having abdominal pain and not chest pain. Women can be a bit trickier than male patients to assess. The pain is often described as ‘crushing’ pain, or a pressure in the chest.
Increased Breathing Rate: Oftentimes, you will find an increased breathing rate, or shortness of breath in a heart attack victim. This shortness of breath comes from the lack of oxygen going to the heart. The patient’s body goes into overdrive to try and save itself. Therefore, the heart starts pumping faster and harder, and the brain tries to increase oxygen levels in the blood by increasing the respiratory rate.
Profuse Sweating: Also called diaphoresis, the patient’s body is working hard to stay alive. Additionally, there is a release of adrenaline (epinephrine) that is causing the body to work even harder, even though the patient may be at rest.
Treatment of a Heart Attack
Call 911! Get the paramedics out there immediately. There are certain drugs that the paramedics can give that can really help out in a heart attack situation. It’s important to get them there immediately.
Getting the acute chest pain victim oxygen is a priority. This is a medication, so you must assist your patient with his or her current prescribed dosage or call your nurse to get permission to administer oxygen. We want to get this patient’s blood as oxygenated as possible – 100% oxygen via nasal cannula or non-rebreather is the treatment of choice. Increased oxygen may help to oxygenate the ischemic tissues. Also, be mindful of your facility’s protocols in this situation, and always follow what they have set forth as protocols for treatment.
Keep the patient calm, and do not have the patient exercise in any way, shape or form. Do not walk him or her to their bed, and do not have him do anything except lie down and get comfortable.
As a CNA, you are not able to give a patient medication; however, if they are on certain medications, you may assist them with those medications. If your patient takes nitroglycerine, and/or aspirin, and has been told to take these pills by his or her doctor in this type of emergency, you may get the pills and hand them to the patient. There are certain important things such as blood pressure, allergies, and the use of sexually enhancing drugs to consider when your patient tries to take these meds. Thus, it’s best to ask the RN to help, or to make sure the patient knows what he or she is doing.
Lastly, get all paperwork ready for the paramedics. The paramedic will want to get this patient out and to the hospital immediately. Therefore, the faster you can give them a report and get him out of there, the better.