Firefighters respond to a variety of a calls every day, these include (but are not limited to): fire-related, medical, MVCs and HazMat. Response statistics from Toronto Fire Service’s 2011 annual report show that while fire-related calls have been relatively stagnant throughout the last 7 years, medical calls have been significantly increasing (table 1; figure 1). Heart disease and stroke account for roughly 350,000 hospitalizations per year in Canada and first responses to related illnesses and symptoms will undoubtedly be common (Heart and Stroke Foundation of Canada, 2014). Myocardial Infarction (often referred to as a heart attack) is a common cardiac condition that firefighters will encounter in their career. This paper will discuss Myocardial Infarctions in greater detail than the first responder level and explore what the conditions is at the greater health-care provider level.
A myocardial infarction occurs when blood supply to the heart is limited or stopped because of blockage in a coronary artery. Narrowing of coronary arteries as a result of artherosclerotic plaque buildup “causes more than 90% of heart attacks” (Heart and Stroke Foundation of Canada, 2011). As plaque builds up in the arteries, there is an increased chance that the plaque will rupture and cause a bleed that, subsequently, clots (thrombus). Ischemia (reduced blood flow to tissues) to the tissue the coronary artery supplies with become damaged and, with long enough occlusion, die (American Heart Association, 2012).
Signs and Symptoms
Most myocardial infarctions begin with mild pain or discomfort in the chest. Those suffering often aren't sure what's wrong and wait too long before getting help (American Heart Association, 2012). It is impera...
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...ete occlusion of the vessel and results in greater tissue death. The damage in a transmural MI will generally extend much deeper into the muscle tissue (Heuther and McCance, 2012).
In the event of a myocardial infarction, there is an extreme inflammatory response once the heart begins to repair itself. The necrotic tissue is broken down by enzymes and transported to other parts of the body to be disposed of (Heuther and McCance, 2012). The scar tissue that initially replaces the necrotic tissue is weak and, as a result, it will take the patient a few weeks until they feel as if they can return to low levels of activity. After about six weeks, the necrotic tissue has been completely replaced by scar tissue. However, since the scar tissue cannot contract and relax as cardiac muscle does, it will result in permanent dysfunction (Huether and McCance, 2012).
Roger, Go, Lloyd-Jones, et al. states “Cardiovascular disease is the leading cause of death in the United States for men and women of all racial and ethnic groups.” (As cited in Hinkle & Cheever 2014, p. 729). There are different types cardiovascular diseases and they have a lot in common in terms of characteristics. This paper will focus on discussing acute coronary syndrome and myocardial infarction. To distinguish the two from each other, it is important to know the similarities and differences in etiology, clinical manifestations, medical management, collaborative care and nursing management for these two diseases.
These mechanisms contribute to the signs and symptoms of heart failure. However, the manifestations are nonspecific and do...
...normal activities after two weeks. These activities include returning to work as well as normal sexual activity. A moderate heart attack requires limited, gradually increasing activity for four weeks, while a large heart attack results in a six week recovery period. These time frames are necessary for the dead heart muscle to substantially complete the scarring process. During this healing period, patients
It is essential to the human body that the heart pump sufficient nutrient rich blood to the body’s cells, because the body won’t be able to function normally otherwise. When a heart muscle is unable to pump enough blood through to meet the body’s regular demand it is characterized as heart failure. Heart failure can usually be treated through conventional heart therapies and symptom management strategies, however conventional therapies don’t work for all patients with heart failure, this is what is depicted as advanced heart failure or end-stage heart failure. In other words “End stage” heart failure is when the condition becomes so severe that all conventional treatments no longer work, the only treatment that works for end stage heart failure is to have a heart transplantation-surgery to remove a person's diseased heart and replace it with a healthy heart from a deceased donor. However there are two large encompassing problems with this treatment. The first problem is that the patient is subject to shortages in donor organ availability and thus possible further decompensation and potential death while awaiting transplantation. According to the American Heart Association, there are over 500,000 new cases of end-stage heart failure in the United States every year. With only 2200 donor hearts available every year nearly 20-30% of the patients who die while they await a transplant. The second problem with this mode of treatment is that not all patients qualify for heart transplantation. Patients who have another disease in addition to end-stage heart failure do not qualify for heart transplantation. The discrepancy between the clinical need for donor hearts and the total number of hearts available, as well as the lack of treatment o...
The cardiovascular system keeps blood circulating throughout our bodies constantly, and without it, many of the activities that we do would not be possible! The heart is the main organ of the cardiovascular system because it pumps the blood, and also a major organ of the human body because of how it is able to allow our bodies to work. Unfortunately, the heart may fail to function at times when blood flow is reduced as a result of blockage. This is more commonly known as a heart attack, or myocardial infarction. According to “Heart Disease Statistics,” approximately 715, 000 Americans suffer a heart attack every year . This deadly disorder of the heart can be diagnosed from symptoms, as well as from imaging and tests, and it is possible to
An acute myocardial infraction is commonly known as a heart attack. A heart attack is a serious medical emergency that can cause death if not taken serious! “Every year, there are more than 3 million cases in America.” Says Mayo Clinic. Although, a heart attack can happen at any age the majority of the victims are 40 and up. An attack occurs when the blood supply to a part of the heart is damaged or interrupted. Heart attacks are usually caused by obesity, stress, high blood pressure, smoking and many other diseases or poor decision.
Myocardial infarctions are caused by vascular endothelial disruption most often associated with plaque build-up or atherosclerosis that develops over several years and causes thrombus formation which in turn
Signs and symptoms come along with any disease, some symptoms may be noticeable but sometimes there's just no symptoms at all. The common symptom for Coronary Heart Disease is chest pain and/or discomfort. This happens when the heart is not getting oxygen and blood. How strong the chest pains are varies from patient to patient. The chest pains my feel like the heart is being squeezed. The pain may be felt below the sternum but also in the neck, arms, stomach, and upper back. The chest pain usually occurs when the patient is doing activities or is in motion but it goes away with rest or a medicine called Nitroglycerin. Other symptoms are sho...
Succinctly speaking, a myocardial infarction is not a disease but rather an event occurring due to the progression of coronary heart disease. 1(p.125) With coronary heart disease, the flow of blood which supplies the heart with oxygen is blocked, reducing the amount of oxygen received by the cardiac muscles and resulting in damage or death of cardiac muscle....
Every year communities struggle each year around the nation with issues of life safety. In 2012, the nation’s fire departments responded to 31,854,000 responses that resulted in the deaths 0f 2,855 civilians and injuring 16,500 causing an estimated $12,427 million dollars in damage. (United States Fire Administration, 2014) These incidents put at risk 345,950 career and 783,300 volunteer firefighters that resulted in the deaths of 81 individuals (U.S. Department of Homeland Security, 2013) and nearly 70,000 reported injuries. ( Karter & Molis, 2013) These numbers represent incidents that are determined to be in the line of duty but do not take into consideration the long-term health risk issues that may develop. Evidence shows that he hazards associated with Fire and Emergency Services are consistent across the board whether paid or volunteer and jeopardize the lives and health of each individual, placing administrative and physical control measures reduces this risk to firefighter within an organization. While it is impossible to eliminate the hazards firefighters face, it is important to identify these hazards as the first step in reducing the potential for loss of life and wellbeing both physically and mentally.
One of the leading causes of death in the United States is heart disease. “Approximately every 29 seconds one American will have a heart attack, and once a minute one American will die from a heart attack” (Ford-Martin and Odle, 915). According to the Gale Encyclopedia of Alternative Medicine men over the age of 45 and women over the age of 55 are considered at risk for heart disease. Heart disease is a major cause of death. It is beneficial to individuals who seek to prevent heart disease to recognize the risks leading to heart attacks as they are one of the primary indications of developing heart disease; especially those that fall into the at risk age groups. These risks consist of some that cannot be changed such as heredity risks, or those that can change such as smoking habits. It is very important to know these specific risks for prevention and to understand the symptoms of heart attacks, such as sweating or the feeling of weakness so if these or other symptoms occur people are aware. Finally heart disease treatment is of vital importance if you experience a heart attack so you can learn how to prevent another one from occurring.
The term, ischemia, denotes inadequate blood supply to tissues due to blockage of the arterial inflow, while, reperfusion injury is defined as the injury caused by the restitution of blood flow after an ischemic peroid, leading to death of cells that were only reversibly injured at the time of blood flow restitution. [63]. The final infarct size after an MI event is therefore the result of the ischemic and reperfusion damage. For this reason, the term that best describes this process of myocyte death in reperfused MI is myocardial ischemia/reperfusion (I/R) injury [64]. In the early hours post myocardial ischemia, injured cardiac cells can release several molecules, including adenosine, opioids, and bradykinin, which activate the G protein signaling pathways therefore promoting myocardial survival. While in the late phase, myocardial ischemia induces upregulation of growth factors and cytokines, including VEGF, ILGF and SDF-1, in the injured myocardium, hence promoting a cardio-protective state. The liver also participates in cardioprotection through the up regulation and release of secretory proteins, including FGF21 and TFF3, which also promote cardiomyocyte survival. [65]. Foundational studies performed about three decades ago with animal models demonstrated that an early reperfusion was able to limit infarct size [66]. Then fibrinolysis was indisputably associated with a decrease in mortality in patients with STEMI [67].A decade later; primary angioplasty was shown to be more superior than fibrinolysis [68]. Currently primary coronary angioplasty (PCI) has been established as the backbone treatment for STEMI patients. The period from the onset of symptoms of MI (representative of the time of coronary occlusion) and reperfusio...
Oxygen was first admitted to the client with chest pain over 100 years ago (Metcalfe, 2011). Chest pain is a large bracket that can contain many different conditions, but for the purpose of this analysis it is focused manly upon a myocardial infarction. A myocardial infarction is mainly referred to as a heart attack, and occurs when one or more coronary arteries leading to the heart reduce or completely stop blood flow (Tuipulotu, 2013 ). Administering high concentrations of oxygen to patients with chest pain is now embedded in guidelines, protocols and care pathways, even with a lack of clear supporting evidence (Nicholson, 2004 ). High concentration of oxygen means that up to 60% is administered (Knott, 2012). More recent research has suggested that the use of oxygen in this scenario is unnecessary and can lead to unwanted side effects, especially in normoxic cardiac patients (Moradkham & Sinoway, 2010 ). The aim of this comparative analysis is to dismantle and understand both the benefits and risks of the commonly known practice of administration of oxygen to the client with chest pain. Through completing this analysis using recent and appropriate evidence a more improved practice can be given and understood.
Myocardial infarction occurs when the coronary arteries are blocked by a blood clot. It is commonly known as “heart attack”. The heart needs its own constant supply of oxygen and nutrients to work properly. Two coronary arteries delivery oxygenated blood to the heart, and if one of these two arteries fail or become blocked, then a portion of the heart will not acquire the necessary oxygen. This clot could be because of CAD (coronary artery disease), which happens when the inner walls of the coronary arteries thicken because of build up of cholesterol, fatty deposit, calcium among other elements that are carried in the blood (Boston Scientific, 2009).