Question

When recording information into the medical record for a patient diagnosed with inflammation of the lining of the heart, what terms should the CCMA use?

An EKG is performed and the patient loses consciousness. The EKG tracing reveals ventricular fibrillation. What should the CCMA do first next and why?

Proper in-text citation of sources (APA style) and a minimum of 100 words per discussion post is expected (without considering bibliography).

Answer 1

The certified clinical medical assistant collecting history and recording about a patient with inflammation of the lining of the heart in medical record. The patient was diagnosed to have myocarditis.

Myocarditis is diffuse and focus inflammation of the myocardium of the heart. The causes of the Myocarditis are virus such as coxsackie virus type A and B, bacteria, fungi, radiation therapy, pharmacological, auto immunodisorders, and chemical factors.

The clinical features include hyperthermia, tiredness, palpitation malaise, myalgias, pharyngitis, breathing difficulty, nausea, vomiting, and lymphadenopathy. Physical examination finding includes faint heart sounds, gallop rhythm, and a systolic murmur sound. Pulses alternans can be palpated in which the pulse will be regular alternate and strong beats Diagnostic evaluation includes laboratory blood test includes leukocytes, atypical lymphocytosis, increased ESR, and increased CRP, elevated troponin, elevated vital titers. Electrocardiogram shows dysarrythmias.

Main management include according to the causes the patient receives medication. If the cause is known, for example for hemolytic streptococci penicillin will be administered, advised bed rest. If the patient heart failure, heart failure management has been initiated such as digoxin, diuretic, oxygen therapy. If the receives digitalis for heart failure, patient should be monitored for digitalis toxicity. Elastic pressure stockings, active and passive exercises are advised in order to prevent thrombus and embolization.

Much patient experience sudden cardiac death due to dysarrythmias (Ventricular fibrillation). Rapid treatment has to be initiated in order to save life of patient by restoring spontaneous circulation in the means of cardiopulmonary resuscitation

When a patient had loss of consciousness and ECG shows ventricular fibrillation,

a. follow CAB algorithm (circulation, airway, breathing) in order to save or consume time and save the life of a patient and avoiding time by following Airway, breathing, circulation method

              Start Cardiopulmonary resuscitation

Give oxygen and attach monitor and defibrillator

Rhythm is shockable

Ventricular fibrillation

Shock (biphasic 120-200j) start

   CPR 2 minutes/ cycles (obtain IV injection)

Rhythm is shockable (to give to bring herat rhythem normal)

         Shock (shock j can be increased like 200, 300, 360)

CPR 2 minutes/5 cycles

       Epinephrine every 3-5 minutes

Consider advanced airway

Rhythm is shockable

Shock ( shock j can be increased like 200, 300, 360)

          CPR 2 minutes/ cycles

Amiodarone (1st dose 300mg and 2^nd dose 150mg)

Treat reversible causes