Study up on cardiovascular pipe problems for the EMT exam. The body’s vasculature can develop leaks that cause fluid to leave the system quickly. On occasion, part of the vasculature can weaken, potentially causing massive failure. Check out these common vasculature conditions.
| Problem | Signs and Symptoms | Action Steps |
|---|---|---|
| Aortic aneurysm/dissection | A weakening in the aorta’s wall causing it to bulge out (aneurysm) or tear (dissection) resulting in loss of pressure and bleeding. Patient may complain of sudden tearing or knifelike pain in chest or centered between shoulder blades; may have unequal pulses in arms or legs; may experience a rapid drop in blood pressure, tachycardia, or tachypnea. In rare cases, may have a palpable abdominal mass. | Move patient quickly but carefully; lay supine if possible. Administer oxygen to maintain saturation. Maintain body temperature. |
| Hypertensive emergency | Sudden rise in blood pressure over minutes to a few hours. Patient may have a rapid onset of headache; a spontaneous nosebleed; sudden ringing in the ears (tinnitus); a strong, bounding pulse; or very high blood pressure. | Place patient in position of comfort; try to keep head elevated. Maintain oxygen saturation levels with supplemental oxygen. Attempt to control any nosebleed by pinching near base of nose and having patient lean forward. |
| Severe infection (sepsis) | Toxins from bacteria cause vasculature to leak fluids to surrounding tissue (third spacing). Patient may have signs of infection (fever, nausea, vomiting, diarrhea); decreasing oral fluid intake; hypotension, tachycardia, or tachypnea. Skin may be hot, dry, and pale with dark purple-colored areas where microbleeding is occurring (purpura), especially in dependent body areas of the back, buttocks, and legs. | Place patient in supine position and monitor closely for signs of difficulty breathing. If patient is in shock, administer supplemental oxygen to maintain saturation and prevent body temperature loss. |
| Anaphylaxis | Massive immune response causes vasculature to dilate and leak fluid. Patient may identify source of allergen (a bee sting or peanuts, for example); may aucultate stridor or wheezing; may have hives or swelling of upper airway, hypotension, tachycardia, or tachypnea. | Remove allergen if possible; assist patient with prescribed epinephrine autoinjector; if patient is in shock, administer supplemental oxygen to maintain saturation and prevent body temperature loss. |
A 53-year-old male is lifting several boxes at work when he feels sudden, knife-like pain in the middle of his back. He is awake and anxious, with cool, pale, and diaphoretic skin. He has a history of back surgery and hypertension. His radial pulse is weak, fast, and thready; you cannot detect pedal pulses. Of the following suspected conditions, which is most likely?
(A)Aortic abdominal aneurysm
(B)Ruptured vertebral disk
(C)Unsuspected angina
(D)Diaphragmatic hernia
The correct answer is Choice (A). The faint, fast, radial pulse and loss of pedal pulses point to a loss of blood pressure, which isn’t likely to result from a vertebral disk rupture, angina, or a diaphragmatic hernia, Choices (B), (C), and (D), respectively.