Code Blue Field Guide: Cardiac Emergencies

The cardiac patient in transport is not stable by virtue of being in a vehicle. They are in the highest-risk window of their illness, adverse events occur in 23–28% of critically ill cardiac transports, and the decisions that determine outcome often happen in the minutes before wheels up — not at the receiving facility.

This guide was built for that window.

Six chapters cover acute coronary syndromes and STEMI, acute decompensated heart failure, cardiogenic shock, life-threatening arrhythmias, aortic dissection, and mechanical complications with tamponade. Each follows the same nine-section format: red flags requiring immediate action, pathophysiology relevant to transport, key assessment findings, what to ask at patient pickup, diagnostic criteria and lab interpretation, evidence-based treatment priorities with explicit hard stops, a transport monitoring plan, complications with troubleshooting sequences, and a condition-specific SBAR handoff template formatted for bedside delivery.

The guide opens with a Quick Reference sheet designed for 60-second bedside scanning; pattern recognition and differentiation on one side, treatment triggers and hard stops on the other; and a How to Use section that maps each chapter section to the operational question it answers.

What distinguishes this from a general cardiac reference is what it doesn't include. It doesn't define basic terms. It doesn't walk through fundamental procedures. It assumes you know what SCAI staging means, why pulse pressure matters, and what a dicrotic notch tells you on an arterial waveform. What it gives you instead is the advanced layer: the three arrhythmias where standard management causes death, the inferior STEMI that is actually a Type A dissection, the ADHF patient who arrests if you diurese them, and the tamponade where pericardiocentesis accelerates hemorrhage.

Every recommendation is grounded in current evidence — 2022–2025 ACC/AHA and ESC guidelines, SOAP II, SCAI staging consensus, the 2024 AHA Scientific Statement on Interfacility Transport — and stated in the imperative.

Format: Digital download, PDF. Instant delivery. Formatted for 8.5 x 11 printing.

Audience: Flight nurses, flight paramedics, CCT/CCEMT-P, critical care transport (ground and air).