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Cardiac Monitoring
Cardiac monitoring generally refers to continuous or intermittent monitoring of heart activity to assess a patient's condition relative to their cardiac rhythm. Cardiac monitoring is usually carried out using electrocardiography, which is a noninvasive process that records the heart's electrical activity and displays it in an electrocardiogram. It is different from hemodynamic monitoring, which monitors the pressure and flow of blood within the cardiovascular system. The two may be performed simultaneously on critical heart patients. Cardiac monitoring for ambulatory patients (those well enough to walk around) is known as ambulatory electrocardiography and uses a small, wearable device, such as a Holter monitor, wireless ambulatory ECG, or an implantable loop recorder. Data from a cardiac monitor can be transmitted to a distant monitoring station in a process known as telemetry or biotelemetry. Cardiac monitoring in an emergency department setting focuses primarily on the monitori ...
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Holter Monitor
In medicine, a Holter monitor (often simply Holter) is a type of ambulatory electrocardiography device, a portable device for cardiac monitoring (the monitoring of the electrical activity of the cardiovascular system) for at least 24 hours. The Holter's most common use is for monitoring ECG heart activity (electrocardiography or ECG). Its extended recording period is sometimes useful for observing occasional cardiac arrhythmias which would be difficult to identify in a shorter period. For patients having more transient symptoms, a cardiac event monitor which can be worn for a month or more can be used. The Holter monitor was developed at the Holter Research Laboratory in Helena, Montana, US by experimental physicists Norman J. Holter and Bill Glasscock, who started work on radio telemetry in 1949. Inspired by a suggestion from cardiologist Paul Dudley White in the early 1950s, they redirected their efforts toward development of a wearable cardiac monitoring device. The Holter ...
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Myocardial Infarction
A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck or jaw. Often it occurs in the center or left side of the chest and lasts for more than a few minutes. The discomfort may occasionally feel like heartburn. Other symptoms may include shortness of breath, nausea, feeling faint, a cold sweat or feeling tired. About 30% of people have atypical symptoms. Women more often present without chest pain and instead have neck pain, arm pain or feel tired. Among those over 75 years old, about 5% have had an MI with little or no history of symptoms. An MI may cause heart failure, an irregular heartbeat, cardiogenic shock or cardiac arrest. Most MIs occur due to coronary artery disease. Risk factors include high blood pressure, smoking, diabetes, ...
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Heart Rate
Heart rate (or pulse rate) is the frequency of the heartbeat measured by the number of contractions (beats) of the heart per minute (bpm). The heart rate can vary according to the body's physical needs, including the need to absorb oxygen and excrete carbon dioxide, but is also modulated by numerous factors, including, but not limited to, genetics, physical fitness, stress or psychological status, diet, drugs, hormonal status, environment, and disease/illness as well as the interaction between and among these factors. It is usually equal or close to the pulse measured at any peripheral point. The American Heart Association states the normal resting adult human heart rate is 60–100 bpm. Tachycardia is a high heart rate, defined as above 100 bpm at rest. Bradycardia is a low heart rate, defined as below 60 bpm at rest. When a human sleeps, a heartbeat with rates around 40–50 bpm is common and is considered normal. When the heart is not beating in a regular pattern, this is ref ...
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Defibrillator Monitor Closeup
Defibrillation is a treatment for life-threatening cardiac arrhythmias, specifically ventricular fibrillation (V-Fib) and non-perfusing ventricular tachycardia (V-Tach). A defibrillator delivers a dose of electric current (often called a ''counter-shock'') to the heart. Although not fully understood, this process depolarizes a large amount of the heart muscle, ending the arrhythmia. Subsequently, the body's natural pacemaker in the sinoatrial node of the heart is able to re-establish normal sinus rhythm. A heart which is in asystole (flatline) cannot be restarted by a defibrillator, but would be treated by cardiopulmonary resuscitation (CPR). In contrast to defibrillation, synchronized electrical cardioversion is an electrical shock delivered in synchrony to the cardiac cycle. Although the person may still be critically ill, cardioversion normally aims to end poorly perfusing cardiac arrhythmias, such as supraventricular tachycardia. Defibrillators can be external, transve ...
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Defibrillator Monitor
Defibrillation is a treatment for life-threatening cardiac arrhythmias, specifically ventricular fibrillation (V-Fib) and non-perfusing ventricular tachycardia (V-Tach). A defibrillator delivers a dose of electric current (often called a ''counter-shock'') to the heart. Although not fully understood, this process depolarizes a large amount of the heart muscle, ending the arrhythmia. Subsequently, the body's natural pacemaker in the sinoatrial node of the heart is able to re-establish normal sinus rhythm. A heart which is in asystole (flatline) cannot be restarted by a defibrillator, but would be treated by cardiopulmonary resuscitation (CPR). In contrast to defibrillation, synchronized electrical cardioversion is an electrical shock delivered in synchrony to the cardiac cycle. Although the person may still be critically ill, cardioversion normally aims to end poorly perfusing cardiac arrhythmias, such as supraventricular tachycardia. Defibrillators can be external, transve ...
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Cath Lab
A catheterization laboratory, commonly referred to as a cath lab, is an examination room in a hospital or clinic with diagnostic imaging equipment used to visualize the arteries of the heart and the chambers of the heart and treat any stenosis or abnormality found. Equipment Most catheterization laboratories are "single plane" facilities, those that have a single X-ray generator source and an X-ray image intensifier for fluoroscopic imaging. Older cath labs used cine film to record the information obtained, but since 2000, most new facilities are digital. The latest digital cath labs are biplane (have two X-ray sources) and use flat panel detectors. Staff Cardiac catheterization laboratories are usually staffed by a multidisciplinary team. This may include a medical practitioner (normally either a consultant cardiologist or radiologist), cardiac physiologist, radiographer and nurse. Medical practitioner (interventional cardiologist/electrophysiologist) The consultant cardi ...
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Methemoglobin
Methemoglobin (British: methaemoglobin) (pronounced "met-hemoglobin") is a hemoglobin ''in the form of metalloprotein'', in which the iron in the heme group is in the Fe3+ (ferric) state, not the Fe2+ (ferrous) of normal hemoglobin. Sometimes, it is also referred to as ferrihemoglobin. Methemoglobin cannot bind oxygen, which means it cannot carry oxygen to tissues. It is bluish chocolate-brown in color. In human blood a trace amount of methemoglobin is normally produced spontaneously, but when present in excess the blood becomes abnormally dark bluish brown. The NADH-dependent enzyme methemoglobin reductase (diaphorase, a type of diaphorase) is responsible for converting methemoglobin back to hemoglobin. Normally one to two percent of a person's hemoglobin is methemoglobin; a higher percentage than this can be genetic or caused by exposure to various chemicals and depending on the level can cause health problems known as methemoglobinemia. A higher level of methemoglobin will tend t ...
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Carbon Monoxide
Carbon monoxide (chemical formula CO) is a colorless, poisonous, odorless, tasteless, flammable gas that is slightly less dense than air. Carbon monoxide consists of one carbon atom and one oxygen atom connected by a triple bond. It is the simplest molecule of the oxocarbon family. In coordination complexes the carbon monoxide ligand is called carbonyl. It is a key ingredient in many processes in industrial chemistry. The most common source of carbon monoxide is the partial combustion of carbon-containing compounds, when insufficient oxygen or heat is present to produce carbon dioxide. There are also numerous environmental and biological sources that generate and emit a significant amount of carbon monoxide. It is important in the production of many compounds, including drugs, fragrances, and fuels. Upon emission into the atmosphere, carbon monoxide affects several processes that contribute to climate change. Carbon monoxide has important biological roles across phylogenetic ...
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Emergency Medicine
Emergency medicine is the medical speciality concerned with the care of illnesses or injuries requiring immediate medical attention. Emergency physicians (often called “ER doctors” in the United States) continuously learn to care for unscheduled and undifferentiated patients of all ages. As first-line providers, in coordination with Emergency Medical Services, they are primarily responsible for initiating resuscitation and stabilization and performing the initial investigations and interventions necessary to diagnose and treat illnesses or injuries in the acute phase. Emergency physicians generally practise in hospital emergency departments, pre-hospital settings via emergency medical services, and intensive care units. Still, they may also work in primary care settings such as urgent care clinics. Sub-specializations of emergency medicine include; disaster medicine, medical toxicology, point-of-care ultrasonography, critical care medicine, emergency medical services, hy ...
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Vital Sign
Vital signs (also known as vitals) are a group of the four to six most crucial medical signs that indicate the status of the body's vital (life-sustaining) functions. These measurements are taken to help assess the general physical health of a person, give clues to possible diseases, and show progress toward recovery. The normal ranges for a person's vital signs vary with age, weight, gender, and overall health. There are four primary vital signs: body temperature, blood pressure, pulse (heart rate), and breathing rate (respiratory rate), often notated as BT, BP, HR, and RR. However, depending on the clinical setting, the vital signs may include other measurements called the "fifth vital sign" or "sixth vital sign". Vital signs are recorded using the LOINC internationally accepted standard coding system. Early warning scores have been proposed that combine the individual values of vital signs into a single score. This was done in recognition that deteriorating vital signs often ...
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Paramedic
A paramedic is a registered healthcare professional who works autonomously across a range of health and care settings and may specialise in clinical practice, as well as in education, leadership, and research. Not all ambulance personnel are paramedics. In some English-speaking countries, there is an official distinction between paramedics and emergency medical technicians (or emergency care assistants), in which paramedics have additional educational requirements and scope of practice. Duties and functions The paramedic role is closely related to other healthcare positions, especially the emergency medical technician, with paramedics often being at a higher grade with more responsibility and autonomy following substantially greater education and training. The primary role of a paramedic is to stabilize people with life-threatening injuries and transport these patients to a higher level of care (typically an emergency department). Due to the nature of their job, paramedics work ...
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