Cardiology and Resuscitation
Recognising the sick heart
Build a systematic approach to chest pain: onset, character, radiation, associated symptoms (sweating, nausea, breathlessness), and risk factors. Understand the difference between angina and infarction in terms of duration and relief. Learn the red flags that mandate urgent transport: crushing pain with autonomic features, pain at rest, syncope, or signs of cardiogenic shock (pallor, cool clammy skin, hypotension, altered consciousness).
Rhythm recognition at EMT level
Know the shockable rhythms - ventricular fibrillation and pulseless ventricular tachycardia - versus non-shockable rhythms (asystole, pulseless electrical activity). Understand that an AED analyses rhythm and advises a shock; the operator must ensure everyone is clear and must not touch the patient during analysis or delivery. Recognise that fine VF can mimic asystole and that asystole is confirmed, not assumed.
Cardiac arrest sequence
Be able to describe high-quality CPR: rate, depth, full recoil, minimal interruptions, and rotation of compressors. Know that compressions take priority over ventilation once advanced airway management is in place, and that early defibrillation is the single most important intervention in shockable arrest.
Traps in questions
Questions often test the next action rather than the ideal action - e.g. after a shock is delivered, resume compressions immediately rather than checking a pulse. Do not choose 'check pulse for a minute' or 'give oxygen before compressions'. Beware answers that interrupt CPR to move a patient unless the scene is unsafe.
Rule of thumb
If the patient is unresponsive and not breathing normally, treat as cardiac arrest - agonal gasps are not normal breathing.