Congenital Heart Defects-Congenital Heart Defects for EMS

Congenital Heart Defects for EMS

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The document by Nick Salzman provides a comprehensive overview of Congenital Heart Defects (CHDs) with a focus on emergency medical services (EMS). CHDs are prevalent, affecting 1% of newborns, with 25% of these cases considered critical, necessitating intervention within the first year. Understanding and identifying CHDs are crucial for EMS providers given that these conditions can present unusually and may be discovered in scenarios like home births, poor prenatal care, substance abuse, and unexpected pregnancies.<br /><br />CHDs are classified into acyanotic and cyanotic lesions, with ductal-dependent lesions requiring special attention as they need the ductus arteriosus to remain open for proper circulation. Acyanotic defects include conditions like Ventricular Septal Defect (VSD), which is common and presents symptoms like poor feeding and irritability due to pulmonary congestion. Cyanotic defects include Tetralogy of Fallot (ToF) known for "Tet Spells," which are hypercyanotic episodes requiring specific interventions like the knee-to-chest position.<br /><br />Particularly severe CHDs like Hypoplastic Left Heart Syndrome (HLHS) are addressed through staged surgical repairs, including the Norwood procedure, Glenn procedure, and eventually, the Fontan procedure. These surgeries have varying success rates, with some patients potentially requiring further interventions like heart transplants.<br /><br />EMS providers are advised to approach such cases with a thorough assessment of the airway, breathing, and circulation, maintaining vigilance for signs of distress. Real empathy and effective communication with caregivers are crucial due to the complexities and stress involved in managing CHDs.<br /><br />Key considerations for EMS include understanding the child's baseline conditions, the impact of surgeries, medication regimes, and employing cautious interventions like administering oxygen or fluids. Transport to tertiary care is often essential for specialized treatment. Ensuring the EMS is prepared with relevant quick-reference questions can enhance care delivery during emergencies.

Keywords

Congenital Heart Defects

CHDs

emergency medical services

EMS

cyanotic lesions

acyanotic lesions

Tetralogy of Fallot

Hypoplastic Left Heart Syndrome

ductal-dependent lesions

pediatric cardiac care