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Wake County EMS Medical Director: What to do During a Heart Attack and Why

Every day Wake County EMS responds to 225 calls per day, seeing everything from nose bleeds to heart attacks.  For the most part heart attacks are the most critical calls EMS responds to each day.  There is a lot of misunderstanding when it comes to heart attacks.  Many people believe a heart attack is what you see in the movies.  Crushing pain, clutched chest and a fall to the ground.

Yes, that is one kind of heart attack, but the reality is most heart attacks are not the Hollywood movie version.  Due to this misperception, there is a chance you may wait too long at home to call 911, and in the meantime your heart will stop.

You or your family members are more likely to experience “atypical” symptoms of a heart attack, including shortness of breath, dizziness/weakness/syncope (passing out), abdominal pain or actual cardiac arrest.  If this happens take these steps immediately:

1. Call 911 preferably from a landline if available.  Landlines automatically show your physical address.  If you use a cell phone, please be prepared to provide your address to the emergency medical dispatcher twice for verification.

There are many reasons to call 911 as soon as you have any of the symptoms.  First, we can walk you through what to do at a time when you will likely not remember the contents of this blog.

Second, we have 12-lead EKGs on every single ambulance, and each ambulance is a roving hot spot.  This means EKG tests can be sent directly to the emergency department, cardiologist, and my cell phone for immediate review.  The ability to do and read this test while the patient is in their home or on the way to the hospital means we start the evaluation and treatment to get you into the cardiac cath lab faster to reopen the vessels that supply the heart muscle.

Thirdly, we can restart your heart if it stops. 

Finally, the greyhound reason; we can drive you and ensure that you are taken to a hospital that is prepared to deliver the care that you need.

2. Gather your medications so EMS can take them to the hospital.  If you have a list instead of the actual medication packages, make sure to include dosages.

3. Turn your house lights on, unlock the door and, if possible, post a person at the top of the driveway to direct emergency response personnel.

4. Chew and swallow 4 uncoated baby aspirin or 1 adult aspirin (unless you are allergic to aspirin) – aspirin will help keep your platelets from sticking together and that is what you want if you are having a heart attack

This week some of our advanced practice paramedics and myself partnered with WakeMed cardiologists to train more than 500 individuals in our community how to do CPR.  This CPR training will benefit members of our community that have the Hollywood version of a heart attack – where the heart actually stops.

Research gathered right here in our community has proven a quadruple rate of survival if CPR compressions are started within the first 8 to 10 minutes after the person collapses.  Breaths are no longer a required component of CPR because most patients that are going to survive have enough oxygen to survive the first 8 to 10 minutes, so we focus on continuous compressions. 

We have also begun controlling ventilations. EMS now administers the number of breaths a patient needs depending on their current condition – not to what their normal respiration rates are. EMS also administers cold IV fluid to cool you down to protect your brain.  Put all these elements together and we have quadrupled heart attack survival rates and quadrupled the number of heart attack victims that survive neurologically intact.

We are working toward becoming a heart safe community.  Do your part.  Learn CPR. Purchase a CPR Anytime Kit for Family and Friends by clicking here.  Your family and your community will thank you.

Dr. Brent Myers is medical director of Wake County EMS and is an Emergency Physician practicing at WakeMed.

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