Self-help during a heart attack

[verytalldave]

I would have posted this elsewhere, but feel its own thread might be perhaps best.
Due to recent, very tragic and sad events, I feel its worth reminding members of this simple yet effective method of self-help in dealing with a minor heart attack.

Unfortunately, statistically, you are likely to be on your own when suffering a heart attack. So its important to recognise the symptoms and what you can PRACTICALLY do in the period between the attack starting and being in medical hands.

The classic symptoms of a heart attack is an intense, sometimes squeezing, pressure or pain in or around the chest, often radiating to the jaw or left arm, and sometimes accompanied by profuse sweating, or a nearly overwhelming sense of fear or impending doom. Unfortunately, you can't count on having this classic pattern. Sometimes the discomfort may be relatively mild, and may be felt in the back, abdomen, shoulders, or either or both arms. Unexplained sudden shortness of breath, nausea and vomiting, or merely a feeling of heartburn, may be the only symptoms. These "atypical" symptoms may not make you think of a heart problem, and may keep you from seeking medical help. Women appear to experience "atypical" symptoms more often than men


In practice, if you think you are experiencing the beginnings of a heart attack, start to cough continuously and loudly. Don't stop. You are working your heart and "keeping it going".
It doesn't matter where you are, or what you are doing, keep up the loud, deep intense coughing until paramedics reach you.


Remember this....................


It could save your life one day.

 

[JumboBeef]

In practice, if you think you are experiencing the beginnings of a heart attack, start to cough continuously and loudly. Don't stop. You are working your heart and "keeping it going".
It doesn't matter where you are, or what you are doing, keep up the loud, deep intense coughing until paramedics reach you.

Coughing may excite the vagus nerve, which may suppress the heart rate via the parasympathetic nervous system, thus slowing the heart rate. Fine if your heart is racing (tachycardic) but not so good if it is going too slow (bradicardic).

Here is my input regarding what to do if someone else is having a heart attack, as promised in the other thread.

Here is a bit of background:

The Heart:

The heart is a pump: two pumps in one actually. One side pumps blood to and from the lungs, so the blood can collect oxygen. The other side pumps this blood with oxygen to and from organs and tissues throughout the body, including the brain. Think of a figure of 8.

What happens during a heart attack:

A heart attack is a term used to describe many different conditions, and the correct medical term is a myocardium infarction (MI). Typically, a clot blocks an artery in the heart mussel which leads to the death of that part of the mussel and this gives the classic crushing chest pains which people associate with having a heart attack. Not all heart attacks have pain though, and women tend to have less pain than men.

Without treatment, the heart can do one of two main things which will make the patient collapse. It can either stop totally (asystole, or ‘flatline’) or it can go into spasms (VF: ventricular fibrillation or Pluseless VT: ventricular tachycardia). Exactly what the heart is doing is irrelevant from a bystander's point of view: the only thing which matters is the heart has stopped pumping blood around the body.

CPR (Cardio Pulmonary Resuscitation).

CPR is the method of manually operating the heart by compressing the chest. This keeps the blood circulating around the organs and tissues and most importantly the brain. Without oxygen the brain will die very quickly.

Exactly the best way to perform CPR is always subject to debate, even between top professionals. The current line of thinking is this (if you are on your own):

If you find someone collapsed, this is what you should do:

1/ Safety. Before doing anything, consider your own safety. Why has the patient collapsed? The two most common reasons for a collapse which might put you at risk are electrocution or gas intoxication. On the first point, check the patient is not touching live mains, and remove or switch off the mains before doing anything. If you consider it is gas, either move the patient out of the area or at the very least open all windows and doors.

2/ Responsive? Is the patient responsive? As you walk towards them, say ‘hello, can you hear me?’ If they don’t respond, say the same thing again whilst shaking them (quite roughly) by the shoulder. If they respond to either of these, then CPR is not required.

If they are unresponsive, next you need to check ABC.

Airway
Breathing
Circulation

Airway:

Lie the patient on their back, tilt their head back slightly. Remove false teeth or any other object (such as food).

Breathing and circulation.

With your right hand, check for a pulse in the patient’s neck (this is called the carotid pulse and is found on the side of the neck). I would suggest you try finding this pulse point now, before you actually need to in an emergency.

While doing this, lean over the patient with your face close to their mouth. This is so you will feel their breath if they are breathing. At the same time, watch their chest to see if it is rising and falling (open/remove bulky clothes if you need to). With your left hand, place it flat on the chest (or on it’s side between the breasts on a woman) to see if you can feel the chest rise and fall.

Stay like that for five to ten seconds. If there is breathing and a pulse, then CPR is not required.

If you cannot feel a pulse or breathing, and the chest is not falling or rising, then CPR is required.

Speed is of the essence. Start CPR immediately! Do not wait for someone else to do it. You do it. Every second without oxygen means the brain is dying.

Call 999 or (ideally) get someone else to call. Make sure you tell them it is a suspected cardiac arrest with CPR ongoing.

Ensure the patient is lying flat on a hard surface. If the patient is on a bed, get them on the floor. Quickly expose the chest (ideally it should be bare, but thin clothes are fine to be left).

Put one hand flat on the chest, roughly midway in between the nipples. Place your other hand on the first hand. Keep your arms straight and push down, leaning your whole body forward. Relax, allowing the chest to rise. These are called chest compressions. You may feel ribs breaking (particularly on older people): keep going! Ribs can heal. Aim to administer 60-100 chest compressions per minutes (so, just over one per second).

Mouth to mouth (rescue breaths).

If you are on your own, do not give rescue breaths. Continuous chest compressions are much more important, however make sure the airway remains open (always remember ABC). If there are two of you, the second person can give rescue breaths if they wish (however, I would never give a stranger rescue breaths). If you do give rescue breaths, give them in the ration of 30:2 (30 chest compressions then 2 rescue breaths).

The most important thing to remember is to keep the chest compressions going: do NOT stop, even for a few seconds. If you do stop, the blood will thicken making recovery much less likely. As it is said, you cannot restart a blue heart. Keep that CPR going!

Do not stop until the ambulance arrives (and even then, you may well be asked to help out by continuing).

I will just add that trauma can sometimes cause cardiac arrests, even down to suffering a fall during sport. A rough rugby tackle can stop the heart, if the chest is hit just at the wrong point during the heart’s cardiac cycle. What you should do is the same as described above, just be aware of the possibility of other injuries that the patient might have suffered.

If you suffer chest pain, and you can’t explain them, then please call 999 without delay ~ do not wait for the pain to go away. If you are having a heart attack, then it is very important for certain treatments to begin in the first hour. A heart attack will not ‘go away’, it is the pain of some of your heart muscle dying. Once the muscle is dead, it can never be recovered and you may well be disabled for the rest of your life (if it doesn’t kill you). All this can be avoided if you act quickly! If you don’t want to call 999, then call NHS Direct (who will most probably send an ambulance anyway). Just call someone!

I have adapted this from the professional protocol I follow, to allow for lack of equipment and training a bystander will have. I have not included other processes which we use, including using a precordial thump for witnessed arrests for example, because use of these other processes without training can make matters worse rather than better.

Finally, if you live in a rural area, consider becoming a Community First Responder: Community first responder - Wikipedia, the free encyclopedia CFRs are volunteers and are trained in CPR and use of (basic) defibs and are despatched by ambulance control to suspected arrests in their area. They will normally arrive before the ambulance and so they have a very important role of starting CPR as required until the ambulance arrives. CFRs are fab people!

I have written this article to try to help people if they are ever faced with a cardiac arrest: I hope you are never in this position. It is written in good faith in the hope it helps, but anything you do is at your own risk and I cannot be held responsible for what happens. I strongly recommend that you under take a First Aid course before undertaking CPR.

I wish more people would learn basic First Aid, including CPR. If someone has a heart attack outside of hospital, their chance are not very good anyway, however if no one does anything before the ambulance arrives, then the patient will almost certainly die.

 

[petermansell]

I'm afriad it's too late for some of us - I had a series of heart attacks in 2003 and didn't know what they were even though had all the classic symptons when looking back.... Now I have a titanium aortic valve that I can hear clicking away when its very quiet....

 

[kth286]

will taking an asprin help thin the blood and therefore ease the situation ?

 

[JumboBeef]

will taking an asprin help thin the blood and therefore ease the situation ?

Short answer: Yes

Longer answer: but only if you are not:
allergic to it
already taking anti-coagulant medication
suffering from haemophilia

Boring answer: asprin doesn't thin the blood, it reduces platelet aggression (which is, in short, the clotting process) which, sort of, has the same effect. But is different.

Clotting is one of the most complex subjects there is! Enjoy!

Coagulation - Wikipedia, the free encyclopedia

 

[JumboBeef]

mussel

Of course I meant 'muscle' (can't edit it now). Damn that spell checker!

 

[verytalldave]

Short answer: Yes

Longer answer: but only if you are not:
allergic to it
already taking anti-coagulant medication
suffering from haemophilia

Boring answer: asprin doesn't thin the blood, it reduces platelet aggression (which is, in short, the clotting process) which, sort of, has the same effect. But is different.

Clotting is one of the most complex subjects there is! Enjoy!

Coagulation - Wikipedia, the free encyclopedia

I was just going to say this............but you beat me to it...! !

 

[GrahamC230K]

So having (skim) read that the summary is call 999?

 

[Druk]

Thanks for taking the time Jumbobeef. I was a first-aider when I worked and was updated yearly. 4 years of retirement have made me forget most of the procedure. Good to get a reminder.
It is confusing how many times the 'breaths' have changed.

 

[JumboBeef]

Thanks for taking the time Jumbobeef. I was a first-aider when I worked and was updated yearly. 4 years of retirement have made me forget most of the procedure. Good to get a reminder.
It is confusing how many times the 'breaths' have changed.

If it helps just one person, then it was worth the time.

So having (skim) read that the summary is call 999?

Er...... the very last line is:

If someone has a heart attack outside of hospital, their chance are not very good anyway, however if no one does anything before the ambulance arrives, then the patient will almost certainly die.

With regard to the clotting issue, there is only one thing you need to know:

All bleeding stops eventually.

 

[CE230]

Timely reminder as I need to renew my FBOS training.

 

[Godot]

Don't forget, if you are a Diabetic type 1 or 2 your heart attack may arrive quite unannounced

 

[mclare]

Hey guys, I'm new to your board and on the other side of the pond and I had a Heart attack on Sept. 9th 2009 while IN boxing class at age 49.

I had weighed 407 pounds and had a Stroke in 2003 and struggled with my weight for years. I am a computer engineer and have a sedentary job. Well I was just plain lazy too. I was always active in my teens and twenties and mostly thin. In my thirties I got married, had kids, blah blah blah....

So in my forties, I got divorces and never got re-activated...

Well 2007 changed all of that. I lost my Grandmother on my birthday and my live-in GF broke up with me while she was dying. I had to move out days later from the house I built. So after a period of mourning, I decided I was not going to lay around anymore and I went and got a gym membership and started going everyday. They started a boxing program there and I was hooked. The owner is a two time Golden Glove champ and really saw my desire and helped me and motivated me.

I lost over 100 pounds! That's when I bought my Benz and started restoring them. That summer damn near gave me a heart attack. Once I got them done I started back at the gym in earnest again and continued my loss.

Then on September 9th I was in a bag class just hitting a heavy bag and I started coughing and could not catch my breath... My instructor Jeremy came over and said "Mike are you ok? You are sheet white and don't look ok, I know all of your looks and you don't look right." He had been training me for two years and knew when I would get tired. But I was hacking and trying to get my breath. I left class and went into the Yoga room where it was quite. He went and got Allen the owner and then several people came in. I assured them I was okay, just out of breath. I did have intense pressure on my chest though. I asked them to get me a drink and my pills out of the car. I had aspirin and Metroprolol in there and I took them. I also texted a girlfriend who was an ER nurse and asked her "Gwen, what are the symptoms of a heart attack?" She told me "It feels like a Elephant is sitting on your chest." I knew at that point I had had one and I went to the VA Hospital. The very next morning they put three stents in me. They released me the next day right out of ICU and I have been feeling pretty good since then. I do get tired more because of all of the meds and I am still struggling with my weight. I may have a GBP done later this year. I ma back to boxing now and watching my diet. I had been for the two years prior and that was a bit disheartening, so to speak...

But I am back on track...

 

[st4]

But I am back on track...

Glad to here it and welcome to our forum

 

[jasonyw]

Dead at 30, there is something wrong with the British food.

Cyclist's 'sudden death' on Suffolk road - East Anglian Daily Times

 

[Godot]

Ahem !...err should you erm find yourself, in a, a little country, ahem like er Switzerland...aahh do um bear this in ..er mind !

Swiss prostitutes are being trained to use defibrillators to prevent clients with heart problems from dying on them, it has emerged. On being the er operative word.
http://www.telegraph.co.uk/news/newstopi....ents-dying.html

 

[jasonyw]

Who said we got only 2 pumps?

Wrong. Sub-humans got them.

We got 4 pumps and 4 valves, I would call it 4 cylinders single valve turbo engine. We are more advanced than a car engine when one valve is better than 4 valves cylinder.

 

[JumboBeef]

Yes, but you don't want it to rev................or to stall