First Response: What to Do in a Cardiac Emergency

In moments when a heart ceases to function normally, prompt and informed action can be the key to survival. A cardiac emergency, such as a heart attack or sudden cardiac arrest, presents an immediate threat to life, requiring immediate response. Knowing the signs and having the courage to act can transform bystanders into lifesavers.

Understanding cardiac emergencies and learning how to respond not only increases the chance of survival for the victim but also serves as a fundamental aspect of community health and safety. In these situations, time is of the essence. Quick recognition of symptoms, calling for help, and initiating CPR or using an AED are actions that can sustain life and improve outcomes prior to the arrival of emergency medical services.

Recognizing the critical role individuals play in these scenarios, this introduction sets the stage for a discussion on the crucial steps one should take when faced with a cardiac emergency.

Identifying a Cardiac Emergency

Recognizing the signs of a cardiac emergency is the crucial first step in providing effective first aid. Heart attacks and cardiac arrests are the most common cardiac events and demand immediate attention.

Heart Attack Symptoms

A heart attack occurs when the blood flow to a part of the heart is blocked. The symptoms can vary but often include:

Chest Pain or Discomfort: Usually in the center or left side of the chest, which might feel like pressure, squeezing, fullness, or pain.
Shortness of Breath: This can occur with or without chest discomfort.
Other Discomforts: Including pain or discomfort in one or both arms, the back, neck, jaw, or stomach.
Additional Symptoms: Such as breaking out in a cold sweat, nausea, lightheadedness, or feeling faint.

Cardiac Arrest Symptoms

Cardiac arrest is an electrical malfunction in the heart that causes an irregular heartbeat (arrhythmia) and disrupts the flow of blood to the brain, lungs, and other organs. Symptoms include:

Sudden Collapse: The person becomes unresponsive and falls to the ground.
No Pulse or Breathing: There’s no normal breathing, coughing, or movement.
Loss of Consciousness: The person doesn’t respond to being tapped on the shoulder or spoken to.

Differences from Other Conditions

Sometimes, symptoms of other conditions can be mistaken for a heart attack. For example, heartburn or panic attacks may cause similar discomfort, but there are differences:

Onset: Heart attack symptoms tend to develop gradually and persist or worsen over minutes, whereas heartburn usually comes on after eating and might be relieved by antacids.
Type of Discomfort: The pain from non-cardiac issues often differs in quality from the deep pressure associated with heart attacks.
Action Steps

If you suspect someone is experiencing a heart attack or cardiac arrest:

Call for Emergency Help: Dial the local emergency number immediately.
Assess Responsiveness: Gently tap the person and ask if they’re okay.
Check for Breathing and Pulse: Look for normal breathing and check for a pulse.
Begin CPR if Necessary: If there is no breathing or pulse, start CPR immediately, provided you are trained.
Use an AED if Available: Follow the device’s spoken instructions for analyzing heart rhythm and delivering a shock if advised.

Recognizing and acting upon these signs without delay can give someone the best chance of survival until emergency responders take over. In the next sections, we’ll delve into the specifics of performing CPR and using an AED, as well as other vital actions to take during a cardiac emergency.

Initial Steps to Take

In the face of a cardiac emergency, every second counts. Here’s how to assess the situation and act swiftly to provide the best chance of survival for the individual in distress.

Assessing the Situation

First, ensure that the environment is safe for both the rescuer and the victim. Then, follow these steps:

Check Responsiveness: Gently shake the person’s shoulders and ask loudly, “Are you okay?”
Call for Help: If there is no response, instruct someone to call the local emergency number immediately. If you’re alone, make the call yourself.
Look for Normal Breathing: Watch their chest for regular breathing movement for no more than 5-10 seconds.
Check for a Pulse: If trained, check for a pulse simultaneously while assessing breathing.

Immediate Actions

If the person is unresponsive, not breathing, or only gasping, take the following actions:

Call or Ask Someone to Call Emergency Services: Provide clear information about your location and the condition of the person in need.
Begin CPR: If you are trained in cardiopulmonary resuscitation, start immediately. Push hard and fast in the center of the chest at a rate of 100 to 120 compressions per minute.
Retrieve an AED: If an automated external defibrillator is available, ask a bystander to bring it to you while you continue CPR.
Continuous Monitoring

While waiting for emergency medical services to arrive:

Keep performing CPR, only stopping to check for breathing and a pulse if the person shows signs of life.

If the person starts breathing normally, roll them onto their side into a recovery position, keeping their airway clear.

If an AED is available, prepare to use it following its instructions as soon as possible.

Clear and Concise Communication

When emergency services arrive, provide them with a clear, concise summary of the events and actions taken.

If you have been able to take a pulse or measure breaths, provide that information as well.

By taking these initial steps with urgency and precision, you can provide the critical care needed in the precious minutes before professional help arrives. These actions can significantly increase the chances of survival and recovery for the person experiencing a cardiac emergency.

CPR: A Life-Saving Skill

Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in many emergencies, including heart attack or near drowning, in which someone’s breathing or heartbeat has stopped. Here’s what you should know about performing CPR:

The Basics of CPR

CPR involves chest compressions and, if trained, rescue breaths that help circulate blood and oxygen in the body, keeping vital organs alive.

Performing CPR

Ensure Safety: Confirm the area is safe for you and the victim.
Chest Compressions: Place the heel of one hand on the center of the person’s chest, with the other hand on top. Press down firmly and smoothly, compressing the chest at least 2 inches in depth. Aim for a rate of 100 to 120 compressions per minute.
Rescue Breaths: If trained, after 30 compressions, give two rescue breaths by tilting the person’s head back slightly and lifting the chin. Pinch the nose shut, take a normal breath, cover the person’s mouth with yours to create an airtight seal, and blow in for about one second to make the chest rise.
Continue CPR: Repeat the cycle of 30 compressions and two rescue breaths. If you’re not trained to perform rescue breaths, continue chest compressions only.

Automated External Defibrillators (AED)

If an AED is available, it should be used as soon as possible. After one round of CPR:

Power on the AED: Follow the voiced prompts precisely.
Attach Pads: Apply the AED pads to the person’s chest as indicated in the device’s instructions.
Analyze and Shock: Stand clear and allow the AED to analyze the heart’s rhythm. If a shock is necessary, ensure no one is touching the person and press the shock button if the machine is not automatic.
Resume CPR: After the shock, or if no shock is advised, immediately resume CPR for two minutes before the AED reanalyzes.

CPR for Infants and Children

For infants and children, the CPR technique is modified:

Infants (under 1 year old): Use two fingers to deliver compressions about 1.5 inches deep at a rate of 100-120 per minute. After every 30 compressions, give two gentle breaths.

Children (1 to puberty): Use one or two hands, as needed, to achieve the proper depth of about 2 inches.

Importance of Training

While instructions can provide an overview, hands-on CPR training is invaluable. Courses offered by local health organizations, community centers, or the Red Cross can prepare you to perform CPR confidently.

By understanding the principles of CPR, you can be ready to give someone the highest chance of survival in a cardiac emergency. Always remember, in such situations, doing something is better than doing nothing. The actions you take could save a life.

Using an Automated External Defibrillator (AED)

In the case of sudden cardiac arrest, an automated external defibrillator (AED) can be the difference between life and death. It’s a portable device that checks the heart rhythm and can send an electric shock to the heart to try to restore a normal rhythm.

What Is an AED?

An AED is designed to be simple to use for the layperson. It uses voice prompts, lights, and text messages to tell the rescuer the steps to take.

Locating an AED

AEDs are often found in public places like schools, gyms, airports, and shopping centers. They are usually placed in areas where they can be easily accessed in an emergency.

Steps for Using an AED

Turn on the AED: As soon as you have access to an AED, turn it on. It will immediately start to provide instructions.
Expose the Chest: If the person is wearing any clothing that covers the chest, remove it to expose bare skin.
Attach AED Pads: Peel the backing off the pads and attach them to the person’s chest as indicated by the pictures on the pads.
Stand Clear: Ensure that no one, including yourself, is touching the person. The AED will then analyze the heart’s rhythm.
Deliver the Shock: If the AED determines a shock is needed, it will tell you to press the shock button. Some AEDs will automatically provide a shock without pressing a button.
Continue CPR: After the shock, or if no shock was administered, continue with CPR for about two minutes. Follow the AED’s prompts; it will re-analyze the heart rhythm and advise if an additional shock is needed.

Safety Considerations

Before using an AED, quickly check for water around the person. Move them to a dry area if necessary, as water can conduct electricity.

Remove any medication patches on the person’s chest before attaching the AED pads.

If the person has an implanted pacemaker or defibrillator, avoid placing the AED pads directly over the device.

Training and Familiarity

While AEDs are user-friendly, familiarizing yourself with their use before an emergency occurs is beneficial. Many CPR training courses include instruction on using an AED.

The timely use of an AED, especially within the first few minutes following sudden cardiac arrest, can greatly increase the chances of survival. Having the knowledge and confidence to use one can enable you to act decisively in a moment of urgent need.

Helping Until Help Arrives

Once you’ve initiated the first response measures for a cardiac emergency, such as calling emergency services, performing CPR, or using an AED, your role shifts to supporting the person until professional medical help takes over. Here are steps to ensure you provide the best possible care during these critical moments.

Keep the Person Calm

Reassure Them: If the person is conscious but distressed, reassure them that help is on the way. Speak calmly and clearly.
Maintain Comfort: Ensure they are as comfortable as possible without moving them unnecessarily, especially if there is a possibility of injury.
Monitor Vital Signs
Breathing: Keep checking their breathing and pulse. If they stop breathing or their heart stops beating, resume CPR immediately.
Consciousness: Monitor their level of consciousness. If they lose consciousness at any point and you haven’t already, begin CPR.

Relay Information to EMS

When emergency services arrive, provide them with all the information you have about the situation:

What happened and when.
The symptoms the person experienced.
Any first aid measures taken (CPR, AED use, etc.).
The person’s medical history, if known, including any medications, allergies, or known conditions.

After Emergency Care Arrives

Step Back: Once professional responders are on the scene and have taken over, step back and allow them to do their job. They may have questions for you, so remain available.

Follow Up: If you’re a family member or close contact, the medical team will likely provide instructions on where the person is being taken and how you can follow up.

Emotional Support

For the Person: Continue to offer emotional support to the person if they’re conscious. Let them know what is happening as emergency services take over.

For Yourself and Others: Witnessing or responding to a cardiac emergency can be traumatic. Don’t hesitate to seek support for yourself or suggest it to others who were involved.

By staying informed, prepared, and calm, you can make a significant difference in the outcome of a cardiac emergency. Your actions can provide the crucial care needed until the arrival of emergency medical services, potentially saving a life.

Do's and Don'ts in a Cardiac Emergency

Responding effectively to a cardiac emergency involves not just knowing what to do, but also what not to do. Here are key guidelines to ensure your actions support the person’s well-being until professional help arrives.

Do:

Do Call for Help Immediately: Time is critical in a cardiac emergency. Call emergency services right away.
Do Start CPR if Needed: If the person is unresponsive and not breathing normally, start CPR immediately, focusing on chest compressions.
Do Use an AED if Available: Don’t hesitate to use an Automated External Defibrillator. It’s designed for public use, and voice prompts will guide you through the process.
Do Ensure Safety: Make sure the environment is safe for both you and the person in distress. Move them only if they are in danger of further harm.
Do Stay Calm: Keeping calm helps you to remember your training and take appropriate actions. It also helps to reassure the person in distress.

Don’t:

Don’t Leave the Person Alone: Stay with them until emergency services arrive. If you must leave them to call for help, return immediately after the call is made.
Don’t Give Food or Drink: This can cause choking or complications if the person requires anesthesia at the hospital.
Don’t Wait to See if Symptoms Improve: Immediate action is crucial. Waiting can worsen the person’s condition.
Don’t Ignore Symptoms: Even if symptoms seem to subside, they may quickly worsen. It’s better to err on the side of caution and seek medical help.
Don’t Try to Transport the Person Yourself: Except in extremely remote areas where medical help is hours away, wait for emergency responders to arrive. They can provide care en route to the hospital.

After Emergency Care Arrives:

Cooperate with Emergency Responders: Quickly and clearly explain what happened and any actions you took.

Step Back: Allow the medical professionals to do their job. They may take over CPR, use more advanced equipment, and prepare the person for transport to the hospital.

By following these do’s and don’ts, you can ensure that your actions contribute positively to the care and potential recovery of the person experiencing a cardiac emergency. Your prompt and informed response can make a significant difference in the outcome.