Oxygenation: Respiratory Function & Cardiovascular System Part II
Objectives
1. Recognize the emergencies related to the respiratory and cardiovascular system.
2. Explain ways that caregivers can decrease the exposure of clients to infection.
3. Differentiate between medical and surgical asepsis.
Introduction:
The cardiorespiratory systems, the cardiac and respiratory systems, include the heart, blood
vessels, lungs, and airways. The heart and lungs together help in the efficient transportation of
blood across the body from the heart, along with the facilitation of oxygen and carbon dioxide
exchange.
What Are the Most Common Cardiovascular Medical Emergencies?
Cardiovascular emergencies, if left untreated or unnoticed, can become life-threatening. So, a
detailed assessment of the patient's history and condition is important. The first step in an
emergency setting is to assess the airway, breathing, and circulation of the patient.
The most common medical emergencies pertaining to the cardiovascular system are as follows:
1. Myocardial Infarction (MI): It is a cardiovascular emergency that is caused due to
occlusion of one of the arteries and cardiac muscle becoming hypoxic (reduced oxygen
supply). It is diagnosed through ECG (electrocardiogram). Patients complain of chest pain
that radiates nausea, fatigue, dyspnea (shortness of breath), dizziness, diaphoresis, and
anxiety.
2. Angina Pectoris: It is caused when the arteries are partially occluded due to atherosclerotic
damage or narrowing. Angina can be stable or unstable. Stable angina refers to a condition
in which chest pain is elicited after a certain exertion. Unstable angina occurs when there
may be no exertion, and it is often unpredictable. Unstable angina patients present to the
emergency department with acute exacerbations of the symptom. Medication to dilate
blood vessels, control heart rate and blood pressure, and blood thinners will be prescribed
by the doctors.
3. Pericarditis: Pericarditis is a condition in which the pericardium is inflamed. Pericardium
is the fibrous sac surrounding the heart. It occurs due to infection in most cases. Pericarditis
can complicate conditions like cardiac arrest or myocardial infarction. Patients usually
experience non-specific infection symptoms, dyspnoea, and severe chest pain.
Dysrhythmias are also evident. Supportive therapy like short-term sedation and aggressive
antibiotic therapy is done to treat this if the infection is due to bacteria.
4. Dysrhythmia: A cardiovascular emergency that is characterized by an abnormal heart
rhythm. Common dysrhythmias include tachycardias and bradycardias. Tachycardia is a
condition in which the heart rate is higher than 100 beats per minute, including atrial flutter,
atrial or ventricular fibrillation, and long QT syndrome. Bradycardia refers to a condition
in which the heart rate is lower than 60 beats per minute.
5. Hypertensive Crisis: This is an emergency situation in which the patient's blood pressure
is abnormally high, and there is a high risk of acute end-organ damage. The cause can be
renal or endocrine dysfunction. Management of this condition necessitates close
monitoring of patients along with managing complications like renal or liver failure.
What Are the Most Common Respiratory Medical Emergencies?
Respiratory emergencies can range from mild breathing difficulty to life-threatening conditions.
Respiratory compromise can lead to respiratory failure if left unnoticed and untreated. Detailed
assessment of the history and condition of the patients is essential. Some of the respiratory
emergencies are:
1. Pneumonia: Pneumonia is a bacterial infectious disease that is characterized by an acute
inflammatory reaction in the lungs. There will be presenting symptoms like fatigue, fever,
hemoptysis (coughing up with blood), dyspnea, and pleuritic chest pain. Crackles are
evident on auscultation. Aggressive and immediate administration of broad-spectrum
antibiotics is carried out in the emergency department. The causative bacteria is identified
through blood cultures or sputum samples.
2. Asthma: Asthma is a chronic lung disease in which there is hyper-reactive inflammation
and airway narrowing. Patients with exacerbation will complain of severe dyspnoea,
wheezing, coughing, tightness of the chest, and distress. Management includes oxygen
administration along with inhaled beta-2 agonists, which will help improve air entry and
relax the narrowed airways.
3. Pneumothorax: Pneumothorax refers to the accumulation of air around the lungs in the
pleural space resulting in lung collapse. It can be caused due to trauma, and there can be a
spontaneous pneumothorax. Patients usually complain of chest pain, tachycardia, and
dyspnea. On examination, there will be absent lung sounds in the affected or collapsed
lung's side. Pneumothorax is managed by inserting a drain between the ribs to empty the
pleural space. It is done in the emergency setting under local anesthesia.
4. Pulmonary Embolism: Pulmonary embolism occurs due to the occlusion of blood vessels
in the lungs, which is due to a blood clot or atherosclerotic plaque deposition. Patients
present with worsening dyspnoea, cough, tachycardia, anxiety, and diaphoresis (excessive
abnormal sweating). Diagnosing can be very challenging, and the physician orders a
number of laboratory investigations, such as CT (computed tomography) scans,
electrocardiography (ECG), ultrasonography, and ABG (arterial blood gas) analysis.
Management is supportive therapy in which oxygen, intravenous fluids, and analgesics are
administered to ease the symptoms. Antithrombotic therapy is carried out if the cause is a
blood clot.
5. Acute Bronchiolitis: It is a condition in which the bronchioles are severely inflamed due
to viruses, most commonly. Affected individuals have symptoms of a cold or a viral
infection, especially chest pain, severe cough, dyspnea, chest pain, and fatigue. Supportive
therapy with medications and humidified oxygen administration is carried out to ease
coughing.
6. COPD (Chronic Obstructive Pulmonary Disease): COPD is an irreversible progressing
disease with emphysema (alveoli enlargement) and bronchitis (bronchioles' inflammation).
There can be severe dyspnea, purulent (pus-containing) sputum production, chest pain, and
distress. Supportive therapy is carried out.
7. Inhalational Injury: Inhalation injuries are caused due to inhalation of certain substances
that can be toxic. These include hot gas in case of fire accident, including inhalation of
smoke and carbon monoxide. Inhalation of water in a near drowning accident, and
ingestion or inhalation of a foreign body. The patient may complain of a variety of non-
specific symptoms, including coughing, dyspnoea, tachypnea, gagging, choking, and
pleuritic chest pain. Intensive and invasive supportive therapies are carried out to manage
patients with inhalation injuries.
Conclusion:
Cardiovascular and respiratory emergencies are the most common in the emergency care setting.
Identifying the symptoms and swift intervention can reduce the incidence of potentially fatal
complications like organ damage. The cardiorespiratory system effectively functions to provide
circulation and remove waste products from all organs in the body. The harmony of the
cardiorespiratory system can be disrupted by the aforementioned diseases. It is advised never to
neglect a symptom and always seek the emergency department when there is any kind of difficulty.
• 5 Key Ways To Control Infection
1. Wash hands thoroughly, and at the right time
2. Use the correct PPE
The most essential rules are:
• Only use PPE once, before removing for disposal
• When using gloves, be sure to put them on immediately before care is provided and
remove immediately after
• Be sure to change gloves between each task – even if these tasks are provided for the
same person
• Always change gloves between caring for different residents
• Dispose of used PPE promptly and in the correct bin for its waste type.
3. Manage linen appropriately
Care givers should:
• Wear appropriate PPE, such as gloves and aprons
• Put dirty linen directly into bags or containers, segregated by category, before being
taken to the laundry area
• Arrange for items to be put straight into the relevant machine, without further sorting and
unnecessary exposure
• Wash hands immediately after the task.
4. Educate visitors
5. Dispose of human waste appropriately
Medical asepsis and surgical asepsis
Medical asepsis and surgical asepsis are two approaches used in healthcare settings to prevent
the transmission of microorganisms, but they differ in their objectives and methods.
Medical Asepsis: Medical asepsis focuses on reducing the number of microorganisms in the
medical environment to prevent their spread. It involves practices such as regular hand hygiene,
proper cleaning and disinfection of surfaces and equipment, and the use of personal protective
equipment (PPE) like gloves and masks.
Surgical Asepsis: Surgical asepsis, also known as sterile technique, aims to create a completely
sterile environment by eliminating microorganisms altogether. It is crucial during invasive
procedures, surgeries, and other sterile interventions. Surgical asepsis involves techniques like
sterilization of instruments, wearing sterile gloves and gowns, and creating a sterile field.
To contribute to asepsis in an office setting, medical assistants can implement several practices:
• Regular cleaning and disinfection of surfaces and equipment.
• Proper handling and disposal of contaminated materials and waste.
• Adherence to hand hygiene protocols, including aseptic hand washing techniques.
• Proper use of personal protective equipment (PPE) when necessary.
Following established protocols for instrument sterilization and handling.
Implementing infection control measures like respiratory etiquette and isolation precautions when
needed.
Aseptic hand washing is a critical component of infection prevention. Health professionals should
follow these steps:
1. Wet hands with water and apply an appropriate amount of soap or antiseptic solution.
2. Rub hands together, ensuring all surfaces (palms, back of hands, between fingers,
fingertips, and wrists) are lathered for at least 20 seconds.
3. Rinse hands thoroughly with water, allowing water to flow from wrists to fingertips.
4. Dry hands with a disposable towel or air dryer.
5. Use the towel to turn off the faucet and open the door if necessary.
In addition to hand hygiene, health professionals should practice other aseptic precautions, such
as wearing gloves and masks when required, maintaining a clean environment, and following
specific protocols for invasive procedures to minimize the risk of transmitting microorganisms.
Steps of Handwashing
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N o s h e e n S id d iq u e
M S N , P o s t R N ,C C N , R N , R M
