NTI 2016: Sudden Cardiac Death: When its Not Good To Buy a Cadillac!
Risk assessment puts us ahead of the game when it comes to sudden cardiac death and the Cadillac Risk Score is important.
Why do we do what we do?
For many reasons: we are professionals with a job to do and we've gone to school to learn what we do. Most of all...we do what we do because we care!
And..in an effort to improve ourselves, we come to NTI to learn more, to network, and to immerse ourselves in the latest technology and research.
So...to that end...we are going to talk about sudden cardiac death. Not the most fashionable topic at hand, but one most of us have experienced.
What kind of car do you drive? A sturdy 4-door sedan that has 243,000 miles on it but still runs? A pick-up truck with full bed? A convertible? A mini-van? What brand do you drive? Ford, Chevy, Toyota, Kia, Subaru, BMW or a Cadillac? Some cars are synonymous with certain images: a mini-van with a family, a convertible with a free spirit and a Cadillac with someone who likes the finer things in life.
Aw...but in this article, being a Caddy is not what you should aspire to be and I'll tell you why.
What is sudden cardiac death?
From the National Institutes of Health, "sudden cardiac death is a condition in which the heart suddenly and unexpectedly stops beating. If this happens, blood stops flowing to the brain and other vital organs".
That sounds simple enough, right? However, the "why" behind it is not always so simple.
Sudden cardiac death (SCD) is thought to arise from an arrhythmia. However, it has been documented to happen in previously healthy individuals as well.
SCD strikes more than 500,000 people per year. It is the third leading cause of death in the US. In-hospital cardiac arrest accounts for 209,000 pts per year. Survivability of these in-hospital cardiac arrests is 24%. Overall, a shockable rhythm was only present in 17% of these cases! You can't shock what you don't have...
It's important that we have a scorecard to risk stratify patients who might have an SCD while on our watch.
The Cadillac Risk Score
The components of the Cadillac Risk Assessment Score include:
Age >65 years 2 points
Killip class ⅔ 3 points
Baseline LVEF <40% 4 points
Anemia 2 points
Renal insufficiency 3 points
Triple vessel disease 2 points
Thrombolysis in MI 2 points
Low risk score 0 to 2
Intermediate risk score 3 to 5
High risk score ≥6)
The Killip Classes are:
Killip classes: I no evidence of HF II findings consistent with mild to moderate heart failure [S3, lung rales less than one-half way up the posterior lung fields, or jugular venous distension] III overt pulmonary edema IV cardiogenic shock
Some risk factors are modifiable:
- High blood pressure
And some...unfortunately are not:
- Family history
As nurses, we like to use scorecards and the Cadillac Risk Score is one we should be familiar with as it can alert us to impending danger!
Cadillac Risk Score
Killip Class Calculator
National Institutes of HealthLast edit by traumaRUs on Jun 15, '18
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Specialty: 25 year(s) of experience in Nephrology, Cardiology, ER, ICU
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