Medical Emergency Tips

Many of the incident calls the Fire District responds to are either medical in origin, or are precipitated by safety and health issues.

While we as a Fire District cannot prescribe or recommend medical advice for our community members, we do find there is a need for providing safety and health-related information and suggestions for further resources, in the interests of reducing avoidable medical-related calls and potential personal tragedies, as well as assisting our community members in maintaining personal health, well-being, and safety.

Disclaimer: The information presented here is for educational purposes only, and is not intended to replace professional medical advise or treatment. If you have medical or health-related problems or questions, see a licensed medical or health professional for proper diagnosis and/or treatment.

The Colestin Rural Fire District cannot be held accountable or liable for the application or misapplication of this information to any person involved in a medical emergency or health crisis.

Below: Summertime Beat-the-Heat Safety Tips

 

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Medical Emergency Tips for Cardiovascular Crises:

 

This is what a normal heartbeat looks like.

But in the event of a medical emergency, the heart can experience fibrillation, with its regular beat becoming arrhythmic, or irregular, causing cardiac arrest.

Such situations require immediate medical attention. Time is of the essence: rapid response is paramount to providing the best chance for survival and recovery.

Yet those of us living in rural areas are often miles away from a hospital or medical center with emergency services.

Because of this, a year and a half ago the Colestin Rural Fire District purchased a portable cardiac AED (Automated External Defibrillator) for our Medical Emergency Response Unit. (The $ 3,520 cost for a defibrillator was not available in our annual budget, so we realized this goal by fundraising.)

While this doesn't guarantee saving lives, this piece of equipment has saved countless lives when other emergency resources have been unavailable or insufficient.

Colestin RFD's ability to provide service at this level means that Colestin and Mt. Ashland area residents are between a few minutes to 20 minutes away from cardiac medical emergency response services, rather than 40 to 45 minutes away.

This effectively cuts emergency response time with an AED to as little as one-eighth of what it might be if transport to Ashland or Yreka were required, or the arrival of ambulance services from these towns were required.

While we are proud and pleased to be able to offer our community residents medical emergency response services that include the benefits of an AED, however, there are still a few significant problems.

Firstly, if it is sudden, cardiac arrest crises can result in fatalities within minutes, which is under the time it can take our response units to reach some residences within our district. This means that, under certain circumstances, even our best initial response efforts may not be adequate.

Secondly, in order for us to be able to attempt to reach a medical emergency victim in time to successfully respond, we need to receive your call informing us of a problem. This means that you need to be able to recognize a problem.

While we can all recognize a full-scale medical emergency by the time it has developed into a life-threatening situation, when a person has already fainted or stopped breathing, how many of us can recognize the early warning signs of stroke, cardiac arrest or heart attack?

Utilizing the interim time period between the first signs or symptoms of an upcoming emergency, and the time of its actual onset, can mean the difference between survival or death.

 

This time window is crucial, particularly for those of us who are not accessible by emergency response units within just a few minutes.

 

Cardiac Arrest

The AHA (American Heart Association) urges the public to be prepared for cardiac emergencies: Know the warning signs of cardiac arrest.

During cardiac arrest,

a victim loses consciousness

stops normal breathing, and

loses pulse and blood pressure.

 

Emergency Action Response:

Call 9-1-1 immediately to access the emergency medical system if you see any cardiac arrest warning signs.

Give cardiopulmonary resuscitation (CPR) to help keep the cardiac arrest victim alive until emergency help arrives. CPR keeps blood and oxygen flowing to the heart and brain until defibrillation can be administered.

Defibrillation is a process in which an electronic device (AED, or Automated External Defibrillator) gives an electric shock to the heart.

This helps reestablish normal contraction rhythms in a heart having dangerous arrhythmia or in cardiac arrest.

What is cardiac arrest?

Cardiac arrest is the sudden, abrupt loss of heart function. The victim may or may not have diagnosed heart disease. It's also called sudden cardiac arrest or unexpected cardiac arrest.

Sudden death (also called sudden cardiac death) occurs within minutes after symptoms appear.

What causes cardiac arrest?

The most common underlying reason for patients to die suddenly from cardiac arrest is coronary heart disease.

Most cardiac arrests that lead to sudden death occur when the electrical impulses in the diseased heart become rapid (ventricular tachycardia) or chaotic (ventricular fibrillation) or both.

This irregular heart rhythm (arrhythmia) causes the heart to suddenly stop beating. Some cardiac arrests are due to extreme slowing of the heart. This is called bradycardia.

Other factors besides heart disease and heart attack can cause cardiac arrest. They include respiratory arrest, electrocution, drowning, choking and trauma. Cardiac arrest can also occur without any known cause.

Can cardiac arrest be reversed?

Brain death and permanent death start to occur in just 4 to 6 minutes after someone experiences cardiac arrest. Cardiac arrest can be reversed if it's treated within a few minutes with an electric shock to the heart to restore a normal heartbeat. This process is called defibrillation. A victim's chances of survival are reduced by 7 to 10 percent with every minute that passes without defibrillation. Few attempts at resuscitation succeed after 10 minutes.

How many people survive cardiac arrest?

No statistics are available for the exact number of cardiac arrests that occur each year. It's estimated that more than 95 percent of cardiac arrest victims die before reaching the hospital. In locations where defibrillation is provided within 5 to 7 minutes, the survival rate from sudden cardiac arrest is as high as 49 percent.

What can be done to increase the survival rate?

Early CPR and rapid defibrillation combined with early advanced care can result in high long-term survival rates for witnessed cardiac arrest. For instance, in June 1999, automated external defibrillators (AEDs) were mounted 1 minute apart in plain view at Chicago's O'Hare and Midway airports. In the first 10 months, 14 cardiac arrests occurred, with 12 of the 14 victims in ventricular fibrillation. Nine of the 14 victims (64 percent) were revived with an AED and had no brain damage.

If bystander CPR was initiated more consistently, if AEDs were more widely available, and if every community could achieve a 20 percent cardiac arrest survival rate, an estimated 40,000 lives could be saved each year. Death from sudden cardiac arrest is not inevitable. If more people react quickly by calling 9-1-1 and performing CPR, more lives can be saved.

 

Sudden Cardiac Death

AHA Scientific Position: Sudden death from cardiac arrest is a major health problem that's received much less publicity than heart attack. The American Heart Association supports implementing the "chain of survival" to rescue people who suffer cardiac arrest in the community. The adult chain consists of:

Early Access to Medical Care (calling 9-1-1 immediately)

Early CPR

Early Defibrillation

Early Advanced Care

 

What is sudden cardiac death?

Sudden cardiac death (also called sudden arrest) is death resulting from an abrupt loss of heart function (cardiac arrest). The victim may or may not have diagnosed heart disease. The time and mode of death are unexpected. It occurs within minutes after symptoms appear. The most common underlying reason for patients to die suddenly from cardiac arrest is coronary heart disease.

About 250,000 people a year die of coronary heart disease without being hospitalized. That's about half of all deaths from CHD -- more than 680 Americans each day. Most of these are sudden deaths caused by cardiac arrest.

What causes sudden cardiac death?

All known heart diseases can lead to cardiac arrest and sudden cardiac death. Most of the cardiac arrests that lead to sudden death occur when the electrical impulses in the diseased heart become rapid (ventricular tachycardia) or chaotic (ventricular fibrillation) or both. This irregular heart rhythm (arrhythmia) causes the heart to suddenly stop beating. Some cardiac arrests are due to extreme slowing of the heart. This is called bradycardia.

In 90 percent of adult victims of sudden cardiac death, two or more major coronary arteries are narrowed by fatty buildups. Scarring from a prior heart attack is found in two-thirds of victims. When sudden death occurs in young adults, other heart abnormalities are more likely causes. Adrenaline released during intense physical or athletic activity often acts as a trigger for sudden death when these abnormalities are present. Under certain conditions, various heart medications and other drugs -- as well as illegal drug abuse -- can lead to abnormal heart rhythms that cause sudden death.

The term "massive heart attack" is often wrongly used in the media to describe sudden death. The term "heart attack" refers to death of heart muscle tissue due to the loss of blood supply, not necessarily resulting in a cardiac arrest or the death of the heart attack victim. A heart attack may cause cardiac arrest and sudden cardiac death, but the terms aren't synonymous.

Can the cardiac arrest that causes sudden death be reversed?

Brain death and permanent death start to occur in just four to six minutes after someone experiences cardiac arrest. Cardiac arrest is reversible in most victims if it's treated within a few minutes with an electric shock to the heart to restore a normal heartbeat. This process is called defibrillation. A victim's chances of survival are reduced by 7 to 10 percent with every minute that passes without defibrillation. Few attempts at resuscitation succeed after 10 minutes. If someone becomes unconscious, seek help immediately. They may be suffering from sudden cardiac arrest.

What are treatments for survivors?

If a cardiac arrest was due to ventricular tachycardia or ventricular fibrillation, survivors are at risk for another arrest, especially if they have underlying heart disease.

Survivors of cardiac arrest must have all causes corrected to prevent future episodes. Possible causes include myocardial ischemia (inadequate blood flow to the heart muscle), arrhythmia (abnormal heart rhythm), etc.

Possible tests and treatments include: cardiac catheterization, electrophysiologic tests, coronary artery bypass surgery, balloon angioplasty or PTCA, antiarrhythmic medicine, implantable cardioverter / defibrillator, implantable pacemaker, [and] heart transplant.

 

The following information is from the Americanheart.org journals link:

 

What is a heart attack?

The medical term for heart attack is myocardial infarction. A heart attack is also sometimes called a coronary thrombosis or coronary occlusion.

A heart attack occurs when the blood supply to part of the heart muscle itself -- the myocardium -- is severely reduced or stopped.

The reduction or stoppage happens when one or more of the coronary arteries supplying blood to the heart muscle is blocked.

This is usually caused by the buildup of plaque (deposits of fat-like substances), a process called atherosclerosis. The plaque can eventually burst, tear or rupture, creating a "snag" where a blood clot forms and blocks the artery. This leads to a heart attack.

If the blood supply is cut off for more than a few minutes, muscle cells suffer permanent injury and die. This can kill or disable someone, depending on how much heart muscle is damaged.

Each year, 1.1 million Americans experience a heart attack; 460 000 of them are fatal.

Of those who die, almost half do so suddenly, before they can get to a hospital.

Although a heart attack is a frightening event, if you learn the signs of a heart attack and what steps to take, you can save a life—perhaps even your own.

Some heart attacks are sudden and intense -- the "movie heart attack," where no one doubts what's happening.

But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren't sure what's wrong and wait too long before getting help.

 

Signs that can mean a heart attack is happening:

Chest discomfort. Most heart attacks involve discomfort, uncomfortable pressure, fullness, squeezing or pain in the center of the chest lasting more than a few minutes, or pain that goes but returns.

Discomfort in other areas of the upper body. Pain spreading to the shoulders, neck or arms. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.

Shortness of breath, difficulty breathing, fatigue, lightheadedness, and/or fainting. These feelings often come along with chest discomfort. But they can occur before the chest discomfort.

Women can experience symptoms differently: Nausea and vomiting are often the first signs, which may or may not be accompanied by pain or pressure in the chest, arm, or neck. (Source: the Harvard Women's Health Watch newsletter

Additional general symptoms: a rapid pulse, tightness or atypical pain in the chest or upper abdomen, radiating pain in the jaw, a feeling of impending doom or anxiety, nausea or dizziness without chest pain, palpitations, sweating or breaking out in a cold sweat (diaphoresis), or paleness.

If you or someone you're with has chest discomfort, especially with one or more of the other signs, don't wait longer than a few minutes (no more than 5) before calling for help. Call 9-1-1. Get to a hospital right away.

 

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The following article, "And The Beat Goes On," comes to us through the courtesy of the late Lewis Ward in VT, who provided a copy from the newsletter of Chapter 240, which obtained its copy, reprinted in The Mended Hearts Inc. publication Heart Response, from Rochester General Hospital's 'Health Cares.'

Disclaimer: We are sharing this information as potentially life-saving advice; however, neither this nor any other method or procedure for dealing with a medical crisis is fail-proof. We therefore offer this article as a suggestion only, and encourage you to consult with a medical professional or other professional resources in order to properly evaluate this information.

"And the Beat Goes On: How to Survive a Heart Attack When Alone"

"Let's say it's 6:15 PM and you're driving home (alone of course) after an unusually hard day on the job. You're really tired, upset and frustrated.

"Suddenly you start experiencing severe pain in your chest that starts to radiate out into your arm and up into your jaw.

"You are only five miles from the nearest hospital. Unfortunately, you don't know if you'll be able to make it that far.

"What can you do? You've been trained in CPR [CardioPulmonary Resuscitation] but the guy that taught the course neglected to tell you how to perform it on yourself.

"A deep breath should be taken before each cough and the cough must be deep and prolonged, as when producing sputum from deep inside the chest.

"A breath and cough must be repeated about every 2 seconds without let-up, until help arrives or until the heart is felt to be beating normally again.

"Deep breaths get oxygen into the lungs and coughing movements squeeze the heart and keep blood circulating.

"The squeezing pressure on the heart also helps it regain normal rhythm.

"In this way, heart attack victims can get to a hospital.

"Be a friend, and pass this information on to other friends! It could save a life."

 

During a life-threatening heart crisis, cardiac arrythmias (usually ventricular tachycardia or ventricular fibrillation) occur before full cardiac arrest, when the heart's pumping action completely stops, and the blood's circulation to vital organs fails, causing imminent death.

If signs of heart trouble are recognized and emergency services notified immediately, a portable AED (Automated External Defibrillator) can be used to pre-empt an impending full- scale cardiac arrest by delivering an electrical shock to the heart, which interrupts heart arrythmias by stopping the heart's irregular electrical impulses, allowing the heart to re-synchronize itself into a normal rhythm.

Cardiac arrest or heart attack? AED's are used to treat cardiac arrest, which occurs when the heart's normal electrical signals become erratic and fibrillate, diminishing the heart's ability to pump blood effectively. AED's are not used for heart attacks, when the flow of blood pumped to the heart is blocked.

 

 

How an AED works:

The operator turns on the device and places two pads on the victim's chest. The machine assesses whether the heart is fibrillating, or quivering with an erratic rhythm, instead of beating normally.

If an abnormality is detected, the AED prompts the user to push a shock button, delivering a charge to the heart.

If that doesn't restore normal rhythm, the unit repeats the process.

An AED won't deliver an electrical charge to a person who has simply fainted and does not have defibrillation.

50% of heart attack deaths occur before arrival at the hospital.

While age is a risk factor, youth does not provide immunity. A heart attack can happen to anyone.

 

 

For further information about heart health and heart crises, see:

www.americanheart.org

www.cardiacscience.com

www.survivalink.com/heart

 

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Stroke

What causes a stroke? Stroke is a cardiovascular disease. It affects the blood vessels that supply blood to the brain.

A stroke occurs when a blood vessel that brings oxygen and nutrients to the brain bursts or is clogged by a blood clot or some other mass.

Because of this rupture or blockage, part of the brain doesn't get the blood and oxygen it needs.

Deprived of oxygen, nerve cells in the affected area of the brain can't work and die within minutes. And when nerve cells can't work, the part of the body they control can't work either.

The devastating effects of a severe stroke are often permanent because dead brain cells aren't replaced.

There are two main types of stroke.

One (ischemic stroke) is caused by blood clots or other particles; the other (hemorrhagic stroke) is caused by bleeding.

Bleeding strokes have a much higher fatality rate than strokes caused by clots.

 

Stroke Warning Signs

If you notice one or more of these signs, don't wait. Stroke is a medical emergency. Call 9-1-1 or your emergency medical services. Get to a hospital right away!

The following information about stroke comes from The American Stroke Association:

The Warning Signs for Stroke:

Sudden numbness or weakness of face, arm or leg, especially on one side of the body.

Sudden confusion, trouble speaking or understanding.

Sudden trouble seeing in one or both eyes.

Sudden trouble walking, dizziness, loss of balance or coordination.

Sudden, severe headache with no known cause.

 

Take action in an emergency. Not all the warning signs occur in every stroke. Don't ignore signs of stroke, even if they go away!

Check the time. When did the first warning sign or symptom start? You'll be asked this important question later.

If you have one or more stroke symptoms that last more than a few minutes, don't delay! Immediately call 9-1-1 or the emergency medical service (EMS) number so an ambulance (ideally with advanced life support) can quickly be sent for you.

If you're with someone who may be having stroke symptoms, immediately call 9-1-1 or the EMS. Expect the person to protest -- denial is common. Don't take "no" for an answer. Insist on taking prompt action.

 

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Summertime Beat-the-Heat Safety Tips:

According to the Centers for Disease Control and Prevention, more than 400 Americans annually die from heat over 90 degrees, more than in most natural disastes.

General Tips: Stay inside, preferably where it is air-conditioned. Use the buddy system. Drink plenty of cool water or other beverages (frequent sips, or a small cup every 15-20 minutes) and sports drinks that replace minerals. Take frequent short breaks. Cool off in the pool, or take a cool shower or bath. Wear a hat and light-colored, loose-fitting layers of clothing. The layers trap the cooler air next to your body and keep the hot air away.

Avoidance: Avoid large meals, which increase metabolic heat as the body digests food. Avoid caffeine and alcoholic beverages, which can cause water loss. Do not leave pets or children unattended in parked cars, where temperatures can climb to life-threatening levels.

Early signs of sickness caused by heat are cramps during exertion.

More serious is heat exhaustion - dehydration with blood flowing more to the skin instead of vital organs. Its symptoms are cool, moist, pale or red skin, sweating, headache, nausea, vomiting, dizziness or exhaustion.

The most extreme reaction is heat stroke, with high temperature, decrease in sweating, hot, dry, red skin, loss of consciousness, rapid, weak pulse and rapid, shallow breathing. It can be fatal if not treated.

Heat Exhaustion and Heat Stroke Risks increase with heat, and can produce life-threatening conditions.The signs, symptoms and first aid remedies are:

Heat Exhaustion:

Headaches

Dizziness

Light-headedness

Weakness

Mood changes

Confusion

Upset stomach

Vomiting

Fainting

Pale, clammy skin.

Remedies:

If you feel heat exhaustion coming on, get out of the sun and rest in a cool, shady area with feet elevated 8 to 12 inches. If the symptoms worsen or last more than an hour, seek medical attention.

If someone you're with appears to be experiencing heat exhaustion, move the person to a shaded area. If dizzy, elevate legs 8 to 12 inches. If vomiting, lay person on their side. Loosen and remove heavy clothing. Give cool water - a small cup every 15 minutes if not vomiting. Cool person by fanning, a cool mist or damp cloth. If not feeling better within a few minutes, call for medical assistance.

Heat Stroke:

Dry, pale skin (no sweating)

Mood changes

Confusion

Seizures

Collapse

Unresponsive

Hot, red skin

Remedies:

Call for emergency help. Move person to shaded area. Don't leave person alone. Lay person on back if having seizures. (On side if vomiting.) Try to cool by fanning, cool spray, damp cloth or wet sheet. Ice, if available, in armpits and groin area.

The above information is provided by the American Red Cross, the Centers for Disease Control and Prevention, and by Dave Campbell of Wilson-Heirgood Associates, in The Communique, Vol. 21, Issue 5, Page 3.

If you feel that you may be experiencing any of the symptoms for cardiac arrest, heart attack, stroke or heat stroke, or if someone near you tells you they feel this way or appears to exhibit any of the above symptoms, treat the situation seriously and call 911 immediately.

We and other emergency response units would far rather respond quickly to a false alarm, than to a real one, too late.

Calling 911 is easier and faster than calling Colestin RFD's number, calling a spouse/partner, other family member or friend, and 911 automatically relays the message to the closest agency able to respond (that's Colestin RFD for local residents), and helps to arrange for any necessary backup support.

Calling 9-1-1 is therefore the appropriate, and the most comprehensive, way to ensure the most effective response.