(Rescuer) Sir are you okay. (Patient) I have this pain that hurts in my chest.
(Patient) I just feel awful. (Rescuer) Has it been going on a long time?
(Patient) Its almost been about an hour and a half now, almost 2 hours.
(Rescuer) Do you have heart problems normally? (Patient) Well, the doctor says I have a little bit of something,
but I think I'm okay. I've been fine.
(Rescuer) Can you describe what it feels like right now?
(Patient) It feels like someone is grabbing me and squeezing.
(Rescuer) Okay, alright. Do you have any allergies to any medications at all? (Patient) Not that I know of? No.
(Rescuer) Have you taken an aspirin yet? (Patient) No, no aspirin.
(Rescuer) I'll tell you what. Why don't I get one of these adult aspirins. Have you had any gastrointestinal bleeding.
(Patient) No. I don't have any history of that. I've never had that problem.
(Rescuer) You can go ahead and chew that up. Now this is the first time this has happened? No history?
(Patient) No, it just started. It just came on me all of the sudden. (Rescuer) Have you called an ambulance yet.
(Patient) No. I don't want an ambulance. (Rescuer) I'm going to go ahead and call the ambulance.
(Patient) I'll be just fine I think, if I just sit up for a minute. (Rescuer) I understand,
but this looks an awful lot like something that could be a heart attack
and I think it would be wise if we make sure we get you checked out. If its nothing,
we don't have to worry about it. But if it was a heart attack, time is really important. Is it okay if I call? (Patient) It's alright.
(Rescuer) You just relax there. (Patient) I'm trying. (Rescuer) Are you comfortable the way you're sitting?
(Victim) Sort of. Oh...this hurts. (Rescuer on phone) 911, I think we have a gentleman who's having a heart attack.
Now let's talk about cardiovascular disease and heart attacks.
When we talk about cardiovascular disease, I think its important that we realize that there are controllable
risk factors and uncontrollable risk factors.
Some of the controllable risk factors have to do with diet, exercise, stress, smoking, blood pressure,
and diabetes. Blood pressure and diabetes especially, if you could control it through exercise and diet
and medication but refuse to do so. The uncontrollable aspects of cardiovascular disease would be gender.
Males have a higher risk factor than females genetically. That's being changed because of stress.
Women are in the workplace as much or more than males. And so those are starting to make up for what
women naturally had going for them in the genetic aspect. We know that age is an uncontrollable factor.
As we get older we have these other debilitating problems like arthritis, back injuries, knee injuries...
If we didn't prepare ourselves through a nice active younger area of our lives
we're going to pay for it as we're older because we won't be able to maintain a healthful lifestyle.
and that is only going to complicate cardiovascular disease. Race, we know from statistics that hispanics
and black people are more prone to cardiovascular disease. There's some different things behind
that which we could philosophize about. Is it diet, is it traditions? Is it part of the aspect of our culture?
Are we eating fried foods versus non-fried foods? Is it that we eat fattier foods than others and so on and so forth?
But, we do know based on statistics that the race piece of this does have some aspects that tilt the scale
towards cardiovascular disease, and we need to be aware of that. Let's just say
that those predisposing factors have caught up and a person actually develops the symptoms of a heart attack.
Well, what are they? The classic symptoms of a heart attack for a male are profuse sweating, pressure in the chest,
difficulty breathing, dizziness, weakness, pain under the breastbone..sternum, up into the neck,
or radiating down the left arm or right arm, nausea, vomiting, this impending doom feeling
I think I'm going to die. It is such a terrible thing to suffer through.
These individuals usually cannot ignore it for long, not when it gets that bad.
I said that males have these signs and symptoms. Females might be a little bit different.
In my background and history as a paramedic on the street. What I noticed about females
is that the pain is a little less classic. It can be more of a back pain. They tend to think it's muscular in nature.
It does not seem to be as crushing. We know that females do not usually sweat as profusely as males, anyways.
And because of that, they don't have this pouring sweat response. They tend to think it's indigestion
or just tightness. They can tend to put it off a lot longer and cause more heart damage from that.
And therefore when I've responded to the heart attack patients that were females, many times they were
already in congestive heart failure, and the reason for the call was difficulty breathing because they
had heart failure. You're going to want to bring the person into the position of comfort.
Whatever they feel most comfortable in. Maybe it's sitting down, maybe it's leaning up against a wall.
Maybe it's standing up. Whatever makes them feel comfortable, that's the position we want them to be in.
We can loosen up tight clothing if it's around the neck. If they have a tie on, you can loosen the tie.
If the shirt is tucked in or their belt is tight, you can loosen that up as well.
Whatever makes them feel more comfortable and less anxious. A lot of what you say to the person
can bring down the anxiety factor. Remember with anxiety, we build fight or flight mechanisms
and that response can increase heart rate, it can increase blood pressure, it can cause vasoconstriction,
and all of those things we don't need. We want the person to relax. So, telling them
that they're in good hands...that help is on the way...that we're going to take good care of them
that we're not going to leave them and that we're going to be by their side, helping them through this
helps to reduce that anxiety. Beyond that, per the 2010 guidelines, we now will
encourage the person, if they do not have an allergy to aspirin, or do not have a history of gastrointestinal bleeding,
we can actually encourage them to take one adult dose of aspirin, or two baby aspirin.
As long as they're not coated, they can chew them up and swallow them.
The aspirin helps to make the platelets slipperier so that they will pass by each other
and not continue to get stuck and create a bigger clot. It's not like coumadin or a blood thinner persay
but aspirin has been known scientifically to help prevent further build up of blood clots and help protect the person.
If this person has had a history of angina and they have nitroglycerin tabs or spray,
we can assist them by getting it for them so they don't have to stress themselves out and go get the
medication, but bring it to them and help them by taking it out of the bottle and giving it to them.
These things will be assistive to them while we wait for the ambulance to arrive.
Monitor this patient because if this person goes unconscious or unresponsive and stops breathing
we're going to begin CPR immediately. If we have access to an AED, we're going to bare the chest,
dry if off, and follow the guidelines for AED usage. And, time is of the essence to treat this person.
Getting the ambulance on the way, getting emergency medical services on the way,
and getting this person to final treatment so we can resolve the problem is key.
So, don't delay your treatment and don't delay calling emergency medical services.