Continuing our First Aid column, Aiden Thompson of Donegal Safety Training Solutions discusses and gives practical advice on heart attacks and chest pains.
In last week’s article, we discussed what a cardiac arrest is and how to perform “Hands-Only” CPR while we wait for the arrival of a defibrillator or the emergency services.
If you are interested in or have missed this article please click on the link below to read the article. https://www.donegaldaily.com/2021/09/04/dd-first-aid-how-to-do-hands-only-cpr/
In today’s article, we will discuss what a heart attack is, how we can recognize it and what we can do for the individual during a suspected heart attack.
Our heart is an incredible muscle that beats 100,000 times per day or 35 million times per year. Your heart is about the size of your clenched fist and beats on average 60-100 times per minute. With each heartbeat, oxygen-rich blood is pumped throughout the body to feed our organs, tissue, and cells. For this to happen, the heart must also have its supply of blood to stay healthy, so we have two coronary arteries which transport blood to the heart muscle itself.
So, what is a heart attack?
As we age, we will begin to develop a build-up of plaque inside our arteries. It is true to say that some individuals who seem fit and healthy and are known to live a “clean life” can have heart attacks and that some individuals can be prone to cardiac conditions due to hereditary features, but in general, individuals who have poor diets, smoke, carry excess weight, have high cholesterol or have high blood pressure are more at risk of heart attacks.
A heart attack is caused by the sudden blockage of a coronary artery. Wherever this blockage occurs will often determine whether the casualty will survive or not because once the heart muscle is starved of the oxygen-rich blood it needs, the muscle begins to die. If a large portion of the muscle is affected then the chances of surviving this incident decrease.
Sometimes individuals will ignore the warning signs of a heart attack and dismiss it as indigestion, a pulled muscle or delay going to their GP or calling the emergency services. This is dangerous and should be avoided, the longer we ignore the warning signs of cardiac distress, the greater the risk of cardiac arrest and death.
What are the warning signs of a heart attack?
The first thing to note is that contrary to popular belief, both men and women are equally as likely to have a heart attack.
The classic signs and symptoms of a heart attack are as follows:
• Chest pain. This pain may radiate down either arm or up into the neck, shoulders, or jaw. The casualty will often describe this pain as a weight sitting on or crushing their chest. It must also be noted that this symptom is often absent in ladies. Ladies will often describe nausea as opposed to intense pain.
• Shortness of breath.
• Cold clammy skin.
• Lightheadedness or dizzy
What can we do?
If you suspect a heart attack, call 999 or 112 straight away and inform the dispatcher of your concerns. Often a casualty will ask you not to do this or delay calling to see if the pain subsides but please do not delay. If calling for help irritates or aggravates the casualty, simply go to another room and make that call! Once the ambulance crews arrive, they will perform some important medical checks on the casualty and advise transport to the nearest hospital if required.
While we wait for help to arrive we can follow the dispatchers’ instructions. They will advise the following.
* Wherever we find the casualty, that is where we treat them. Do not ask the casualty to place any demand on their heart muscle by moving or walking.
* Help them into a comfortable position, which is often sitting down and leaning forward supporting their body weight. Laying down is not a preferred option.
* Loosen any tight clothing that may be restricting their breathing. Allow plenty of fresh air.
* Reassure the casualty that help is on its way and that they are safe with you.
* Keep the casualty warm.
* Be prepared to administer CPR if the casualty goes into cardiac arrest.
Some people may have a know cardiac history and already be on medication such as blood thinners or Aspirin. Others may have a condition known as Angina, a narrowing of the coronary arteries, and have a spray they administer under their tongue. If a casualty has any of these medications inform the emergency dispatcher and ask for advice on administering this medication.
When we suspect a heart attack you will be advised to give the casualty 1x 300mg Aspirin tablet. This drug prevents platelets from binding together and allowing clots to form in the blood. You will be advised to dissolve the Aspirin in a little water and give it to the person or ask them to chew the Aspirin. If the casualty swallows the Aspirin whole, give them another one but this time insist they chew it.
Some people are already on a daily dose of Aspirin because of a know cardiac problem, however, if we suspect a heart attack is occurring you will be advised to give 1x 300mg Aspirin despite them having taken their daily dose previously.
Like every drug, there are reasons we give them called indications, and reasons we cannot give a drug called contraindications.
We do not give Aspirin if:
* The casualty has a known allergy to the drug. Before we give it, ask them or a relative.
* The casualty is under 16 years of age.
* The casualty has a know bleeding disorder such as hemophilia.
* The casualty has bleeding ulcers.
In cases of chest pain or discomfort, it is always better to call the emergency services as soon as possible. Listen to your heart, not your head!
In next weeks article, we will discuss what a stroke is, the signs and symptoms of a stroke and what we can do to help a casualty while we wait for help to arrive.
Aiden Thompson is a PHECC registered paramedic and former Search And Rescue winchman with the Irish Coastguard helicopter, R118, based in Sligo. As a PHECC registered first aid instructor and an Irish Heart Foundation training site coordinator Aiden delivers the highest standard of training to members of the public.
If you would like any further information on courses available in your area, please contact Aiden on 0863111661 or visit his website www.dsts.ie for further details.