Your A&E Cheat Sheet

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• A&E
  Stands for Accident & Emergency, the emergency department of a hospital.
  
   
• Arrhythmia
  Arrhythmia refers to an irregular heartbeat. Basically everything that’s not a normal sinus rhythm falls under the term arrhythmia. A sinus rhythm is the distinct form of the heartbeat as you see it on an ECG.
  
   
• Arterial Catheter
  An arterial catheter or arterial line is an invasive method usually used during surgery or in intensive care to monitor blood pressure in real time. The non-invasive method to measure blood pressure would be a blood pressure cuff, but the cuff will need to cycle repeatedly (pump up and take a measurement). This results in a blood pressure that is only updated in certain intervals. An arterial catheter is used when a measurement every five or ten or fifteen minutes is not sufficient. The catheter usually goes into the radial artery (in the wrist). It is only used for taking a measurement, not for drug administration. (Drugs are administered into veins, not arteries.)
  
   
• CABG
  A coronary artery bypass graft is a surgical procedure to bypass a blocked artery leading to the heart. The graft used for that bypass is usually taken from the arm, the leg or the chest. Different versions of this procedure exist: The most common is the on-pump CABG where the heart is stopped to perform the surgery. While the heart is stopped, the patient is on a heart-lung machine which oxygenates the blood. Also available is the off-pump CABG where the heart isn’t stopped. Both of these surgeries need a sternotomy, from which recovery is quite painful and time-consuming. There is also a minimally-invasive version available but it doesn’t look like this has been widely adopted yet.
  
   
• CAD
  Computer assisted dispatch system. Used to localise and dispatch vehicles, in this case ambulances.
  
   
• Cardiac Arrest
  Cardiac arrest occurs when the heart suddenly stops beating.
  
   
• Carotid Artery
  The carotid artery is an artery in the neck.
  
   
• Cath Lab
  A catheterisation laboratory or cath lab is an examination room equipped to visualise the arteries and chambers of the heart. It is also where certain procedures like PCI or catheter ablations are performed.
  
   
• Coronary vasospasm
  Coronary vasospasm refers to a temporal occlusion of a cardiac artery. It results in chest pain, nausea, cold sweat.
  
   
• CT
  A computer tomography is an imaging technique to get detailed internal images of the body.
  
   
• CVICU
  Cardiovascular Intensive Care Unit
  
  


• Defibrillator
  Defibrillation is used to treat arrhythmia and to re-establish a normal sinus rhythm. It is also used during CPR.
  
   
• Dyspnoea
  Shortness of breath
  
   
• ECG
  An electrocardiogram is a graph that shows the electrical activity of the heart. It is used to check whether there’s any irregularity to the functionality of the heart (like, for instance, an arrhythmia). An ECG uses electrodes that are applied to different parts of the body. Depending on how many electrodes are used, it’s a 3-lead, 5-lead or 12-lead ECG with the 12-lead ECG being the standard as it provides the most information.
   


• Echo
  An echocardiography is an ultrasound to examine the heart. It is used in patients with heart diseases.
  
   
• Endotracheal Tube
  An endotracheal tube is a flexible tube inserted into the windpipe to ventilate a patient (who cannot breathe independently) or administer certain drugs, e. g. during surgery. This is referred to as intubation. Intubation can be performed on an awake patient (during an emergency) or under local anaesthesia. However, since it’s an uncomfortable and invasive method it is usually used under general anaesthesia.
   


• Fentanyl
  Fentanyl is a very powerful opioid used for pain management in cancer patients and during recovery after surgery. It can also be used to induce anaesthesia.
  
   
• Flumazenil
  Flumazenil (usually injected) works as an antagonist to benzodiazepines, especially in cases of overdose. Benzodiazepines are used, among other indications, for treating insomnia.
  
   
• Hypotension
  Low blood pressure. A normal blood pressure for an adult would be 120 (systolic) over 80 (diastolic). If the blood pressure falls under 90 (systolic) or 60 (diastolic) this would be considered hypotensive.
   


• ICU
  Intensive Care Unit
  
  
  
• Internal Thoracic Artery
  The internal thoracic artery or internal mammary artery is an artery in the chest.
   


• Ketamine
  Ketamine induces a kind of trance-like state. It causes dissociative anaesthesia and pain relief. It is often used in emergency settings since it doesn’t cause breathing depression (= the patient stops breathing independently and has to be intubated).
  
   
• Lidocaine
  Lidocaine is used as a local anaesthetic or to treat ventricular fibrillation. As a local anaesthetic it is injected.
  
   
• LOC
  Loss of consciousness
  
  
  
• MI
  MI or AMI = acute myocardial infarction = heart attack
  
   
• MS
  Multiple Sclerosis, an autoimmune disease that damages the central nervous system.
  
   
• Necrosis
  cell death
   


• Nurse Practitioner
  Nurse Practitioners carry out an advanced level of care, usually in emergency settings or primary care units.
  
   
• PCI
  A percutaneous coronary intervention is a minimally invasive procedure used to treat narrowed coronary arteries. Blocked arteries cause reduced blood flow to (in this case) the heart, which leads to heart disease or heart attack. During a PCI a catheter is inserted into the artery (under local anaesthesia). The catheter is then advanced towards the block in the artery to open it up again. A PCI is what people refer to as „getting a stent“ since the stent is what is used to open up the artery (and keep it open).
   


• Pericarditis
  Pericarditis is the inflammation of the sac that surrounds the heart. It results in chest pain that can radiate into the shoulders and neck.
   


• Pulmonary Artery Catheter
  A pulmonary artery catheter (also called Swan-Ganz catheter) is introduced through a large vein – usually the jugular (neck) or subclavian (chest). It can be used to administer fluids. It is also a tool to get different measurements in regards to how (well) the heart is working.
  
   
• Resus
  Short for Resuscitation. The part of A&E were people with life-threatening injuries or illnesses are treated.
  
   
• RN
  Respiratory Nurse or Respiratory Therapist (the same thing seems to have different names in different countries) is a nurse specialised in giving critical to patients with cardiac or pulmonary problems.
  
   
• Sepsis
  Sepsis occurs when an infection causes damage to organs and tissue. It can be caused by bacteria or viruses and is a life-threatening condition that needs immediate treatment.
  
   
• ST-elevation
  An ST-elevation refers to a sinus rhythm (of the heart) where the segment between S and T is elevated (instead of a flat line). The sinus rhythm as you see it during an ECG is divided into different segments and those segments use different letters (P, Q, R, S, T). If the ST segment is elevated during a heart attack, the heart attack is called STEMI (ST-Elevation MI). Heart attacks can also occur without a visible ST-elevation. They’re then called Non-STEMI.
  
   
• Sternotomy
  A sternotomy is a surgical procedure where, after a vertical incision on the chest, the sternum (breastbone) is divided using a saw. This opens the chest cavity for surgery on the lungs or the heart. After the surgery the sternum is fixed together with wire.
  
   
• Suction Chamber
  A suction chamber can be used after surgery to drain unwanted fluids (air, blood) from a surgical site. To that effect, tubes are inserted into the body and those tubes connect to the suction chamber. Due to different pressures fluids are then suctioned into the chamber.
  
   
• T5
  The spine is divided into the cervical spine (C), the thoracic spine (T), the lumbar spine (L) and the sacrum (S) and coccyx (C). The individual vertebrae are then numbered from the top down, meaning T5 is the fifth vertebrae of the thoracic spine.
  
   
• Tachycardia
  Tachycardia occurs when the heart beats too fast. Generally, a heart rate above 100 beats per minute is considered tachycardiac.
   


• Temporary Pacing Wires
  In contrast to a normal pacemaker (which is transplanted right under the skin) temporary pacing wires are not meant to stay in the body for any length of time. The wires go from the heart out of the body and are connected to the pacer (kind of the size and shape of a remote control). Once the pacing isn’t necessary anymore, the wires are retrieved by pulling them out.
   


• Troponin
  Troponin is a protein. Cardiac troponin is elevated for up to two weeks after myocardial infarction.
  
   
• Vasopressor
  A medication that raises blood pressure by constricting blood vessels.
   


• V-Fib
  Ventricular fibrillation is an abnormal heart rhythm where the ventricles (the two chambers at the bottom of the heart) quiver. Ventricular fibrillation can cause cardiac arrest.
   


• X-ray
  An imaging technique to see bone structures.