Caring for a Heart Attack Victim as a CNA
OK so today I want to discuss the topic of heart attacks. With our patients often times 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. It can also be caused by a slow build up of cholesterol in the artery, this weakens the artery wall, and can sooner or later dislodge and block the artery or it can continue to become more and more dense which can also cause blockage. Either way, whats 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 always going to be realizing that the patient is actually having a heart attack. These are some common signs of a heart attack that you may see in your patients.
Pressure/pain in the chest, this 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, heart burn, and sometimes trauma. Often
times for our heart attack patients the pain will be a sudden onset, the pain often radiates to the left arm but can really radiate anywhere. Often times 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 more tricky then male patients to assess. The pain is often described as crushing pain, or a pressure in the chest.
Increased Breathing Rate: Often times 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 patients body goes into overdrive to try and save itself. So 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 patients body is working hard to stay alive, also 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. Its 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 facilities protocols in this situation and always follow what they have set forth as protocols for treatment.
Keep the patient calm, do not have the patient exercise in any way shape or form. Do not walk him to his bed, do not have him do anything except lay down and get comfortable.
As a CNA you are not able to give a patient medications, 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 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 paper work ready for the paramedics. The Paramedic will want to get this patient out and to the hospital immediately. So the faster you can give him a report and get him out of there the better.
Test Your Heart Attack Knowledge
Heart Attack Quiz
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