Saving Lives

I am going to combine two topics this week from prior columns I wrote last year. The two are related anyway, even though they covered seemingly different aspects of the same event. That event is chest pain, most often resulting in a heart attack.

First, a disclaimer: I am not a doctor, and I have absolutely no medical education or training. I do not pretend to be an expert on cardiac events. If you do not trust what I write below, please consult your family doctor, or better yet, a cardiologist to verify the text and the procedures.

I do consider myself an authority, since I have so far survived at least six cardiac events exactly like those I am about to describe. You don’t get any better experience than that, unless you are a treating physician who specializes in cardiac care.

Apparently my column about cough CPR must have had some effect, since I have only received one subsequent message on the subject. But, just in case you missed that column, I will briefly recap it for you.

There is an “urban legend” circulating via e-mail about what to do if you experience severe chest pain while driving alone. The recommended action is to breath heavily and cough repeatedly while you drive yourself to the nearest emergency room.

While the action above seems logical and lifesaving, the opposite is actually true. As a survivor of several cardiac events such as that described above—though not while driving alone—I can assure you that it is nearly impossible to take a deep breath while in the throes of a heart attack. I can also attest to the fact that coughing only exacerbates the condition, and can easily put you into cardiac fibrillation, the complete arrhythmia of heart muscle referred to as “a bag of worms.” Untreated for a very short time, fibrillation leads to only one conclusion: death.

If you should ever experience sudden chest pain of any kind, there is only one correct way to proceed.
1. First, if you are driving, pull over to the shoulder and put on your hazard warning lights.
2. If you have a cell phone, dial 9-1-1 and get help. If you don’t have one, then try to signal to another driver that you need help.
3. If you carry nitro pills, and most heart patients do, slip one under your tongue. If you don’t have nitro, but you have aspirin, swallow two of those. It won’t help as much as nitro, but it will help some.
4. Once you know that help is on the way, recline your seat, or lie on the ground and remain quiet. Get a blanket or coat to keep warm.
5. If you lose consciousness before help arrives, CPR is more effective if you are in the prone position on your back.

I have one other warning regarding the onset of chest pain, and I know you’ve heard it before. Don’t ignore it or go into denial as to what caused it. Get help as soon as possible. If it is gas or stomach cramps, then lucky you.

Now, suppose you are the one who comes upon someone having a heart attack, or who collapses in front of you. The question here is “What do you do?” If that person is a stranger, you might be reluctant to do anything, but if it is a friend or a relative, you definitely will want to do something to help.

Until recently, the prescribed treatment was to administer CPR, but that required that you be trained and certified in the procedure. It also meant that you were going to have to do something most of us consider gross. That is, you would have to give the kiss of life, breathing into the stricken person’s mouth. What are the chances the victim will be a knockout member of the opposite sex?

In actual experience, the stricken person tends to gasp during chest compressions, so some air is being inhaled even without mouth-to-mouth. Also, the lungs are never completely collapsed, so oxygenation of blood is not really an issue.

Hands-only CPR has now taken the place of the prior compression and mouth-to-mouth combination CPR. The hands-only CPR not only keeps a steady rhythm to the compressions, but it also removes the objectionable part of the procedure that has frequently prevented CPR from being performed. In my opinion, it will likely cause a much higher incidence of recovery from sudden cardiac events.

The new hands-only CPR requires the rescuer to perform continuous chest compressions at a rate of 100 per minute. That compares to a rate of 30-40 compressions per minute with an irregular rhythm in the former CPR technique. The survival rate is likely to go up with the new guidelines.

Hands-only CPR
If someone collapses, stops normal breathing and is unresponsive to shaking, here are the steps you should take:
· First, have someone call 911 and summon help if a phone is handy.
· Put the person on the floor or other flat and firm surface face up.
· Place one hand atop the other in the center of the person’s chest.
· Push hard and fast, 100 compressions a minute.
· If there is another person with you, take turns. It is hard work.
· Continue compressions until paramedics arrive to take over.
(Source – American Heart Association)

If the person on whom you are performing CPR regains consciousness or shows signs of a return of heartbeat and breathing, you may quit your efforts, but do not move them and stay ready to begin again. Do not allow the victim to sit up, but make them as comfortable as possible.

There is a Website where you can learn more about hands-only CPR and even get some online training. Just click on the link here for the American Heart Association. Then be sure to read the links within that page. Other links can be found at the following sites.

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2008/04/01/BAJ8VTF35.DTL

http://www.cbsnews.com/stories/2008/04/01/health/main3984803.shtml?source=RSSattr=HOME_3984803