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“Early Heart Attack Care” EHAC. Heart Attacks Have Beginnings!. Heart Attack: A Community Problem. With a Community Solution. Course Outline. 1. Anatomy and Physiology 101: Your Heart 2. A Heart Attack in Progress 3. Concepts of Early Heart Attack Care

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early heart attack care ehac

“Early Heart Attack Care”EHAC

Heart Attacks Have Beginnings!

heart attack a community problem
Heart Attack: A Community Problem

With a

Community Solution

course outline
Course Outline

1. Anatomy and Physiology 101: Your Heart

2. A Heart Attack in Progress

3. Concepts of Early Heart Attack Care

4. Recognition and Intervention

5. Delay and Denial

6. You: The Early Heart Attack Care Giver

part 1

Part 1

Anatomy and Physiology 101:

Your Heart

the human heart
The Human Heart
  • Location: Middle of the chest
  • Size: That of a fist
  • Purpose: Pumps blood throughout the body
  • Weight: 7 - 12 ounces
  • Capacity: Pumps 1,800 gallons of blood & beats over 100,000 times daily
the human heart and coronary arteries
The Human Heartand Coronary Arteries

SUPERIOR VENA CAVAL BRANCH (NODAL ARTERY)

ANTERIOR R. ATRIAL BRANCH OF R. CORONARY ARTERY

L. CORONARY ARTERY

CIRCUMFLEX BRANCH OF L. CORONARY ARTERY

RIGHT CORONARY ARTERY

GREAT CARDIAC VEIN

ANTERIOR INTERVENTRICULAR (ANTERIOR DESCENDING) BRANCH OF L. CORONARY ARTERY

ANTERIOR CARDIAC VEINS

SMALL CARDIAC VEIN

the human heart and coronary arteries1
The Human Heartand Coronary Arteries

SUPERIOR VENA CAVAL BRANCH (NODAL ARTERY)

OBLIQUE VEIN OF L. ATRIUM

GREAT CARDIAC VEIN

SINOATRIAL (S-A) NODE

CIRCUMFLEX BRANCH OF L. CORONARY ARTERY

SMALL CARDIAC VEIN

CORONARY SINUS

POSTERIOR VEIN OF L. VENTRICLE

R. CORONARY ARTERY

MIDDLE CARDIAC VEIN

POSTERIOR INTERVENTRICULAR (POSTERIOR DESCENDING) BRANCH OF R. CORONARY ARTERY

part 2

Part 2

A Heart Attack in Progress

heart attack facts
Heart Attack Facts
  • #1 Killer of Adults
  • 4,100 Heart Attacks every day
  • 600,000 Heart Attack deaths each year
  • Hundreds of thousands survive but are left with a damaged heart
three presentations of a heart attack
Three Presentations of aHeart Attack
  • Sudden, severe pain that stops you in your tracks.
  • Gradual increasing pain with damage occurring over a period of hours.
  • Very early presentation with mild symptoms over hours or days.
ischemia angina pectoris
Ischemia & Angina Pectoris

Partial block producing chest pain

Area of decreased blood supply

part 3

Part 3

Concepts of EHAC

progress heart attack treatment
Progress: Heart Attack Treatment
  • Thrombolytic Therapy (clot busters)
  • Angioplasty
  • Prehospital Cardiac Care
  • Decrease in hospital time to treatment  saved heart muscle  improvement in quality of life
too little progress heart attack recognition
Too Little Progress: Heart Attack Recognition
  • Only 25% of heart attack victims receive thrombolytic therapy
  • Only 10% receive therapy within the first critical hour
  • Most heart attack patients do not benefit from optimal medical advances because of ………………………………….
delay
DELAY
  • in recognizing and responding to the early warning signs of a heart attack
why e h a c
Why E.H.A.C.?
  • Early Care: Recognize & Respond
    • often mild symptoms, usually normal activity
  • Late Care: Obvious Emergency & Respond
    • incapacitating pain, diminished activity
  • Too Late Care: Critical Emergency & Respond
    • unconscious, CPR, defibrillation, probable death
  • 85% of the heart damage takes place within the first two hours.
part 4

Part 4

Recognition and Intervention

early symptoms of a heart attack prodromal angina
Non-Specific Heart Attack Symptoms:

weakness/fatigue

clammy/sweating

nausea/indigestion

dizziness/nervousness

shortness of breath

neck/back/jaw pain

feeling of doom

Specific Heart Attack Symptoms:

chest discomfort

chest pressure

chest ache

chest burning

chest fullness

Early Symptoms of a Heart Attack(Prodromal Angina)
early signs of heart attack prodromal symptoms
Early Signs of Heart Attack(Prodromal Symptoms)
  • Present in up to half of heart attacks.
  • Suddenly accelerate preceding the heart attack.
  • Usually appear within 24 hours before the acute attack but can begin two to three weeks before.
  • Duration varies from a few minutes to several hours.
  • Usually intermittent with a pain free period before the onset of acute occlusion.
part 5

Part 5

Delay and Denial

why do we delay
Why Do We Delay ?

Denial and Procrastination = Our Heart’s Enemy!

1 it s nothing really serious
1. It’s Nothing Really Serious

I’ll just rest a bit

2 i m too busy right now
2. I’m Too Busy Right Now

I don’t have time to be sick

3 i don t want to be a problem
3. I Don’t Want to be a Problem

If it turns out to be nothing I’ll be embarrassed by the fuss made.

4 paramedics beware
4. Paramedics Beware!

First responders can easily swayed by patient rationalizations and denials

6 i m strong
6. I’m Strong

“Just walk it off, grin and bear it”

7 i m healthy
7. I’m Healthy

I have no serious medical problems

I exercise

8 i ll just wait it out
8. I’ll Just Wait It Out

Everything will be OK

part 6

Part 6

You: The Early Heart Attack Care Giver

the e h a c caregiver
The E.H.A.C. Caregiver
  • Spouse
  • Children
  • Parent
  • Co-worker
  • Friend
  • Exercise partner

Anyone who cares about you!

what to ask and look for
What To Ask and Look For
  • Do you have any chest discomfort?
  • Is it tightness, pressure, pain in the center of your chest?
  • Is the discomfort also in your arms or jaw or neck or throat or back?
  • Are you sick to your stomach?
  • Is the person sweaty or clammy?
  • What were you doing when the symptoms started?
  • Do the symptoms go away with rest?
  • Are you having any shortness of breath?
overcoming reluctance
Overcoming Reluctance
  • Suggest he or she check out early symptoms, better safe than sorry.
  • Find out the most critical issue on the persons mind.
  • Call 9-1-1. Paramedics have excellent evaluation tools.
  • Offer to call spouse or family members if he or she is anxious.
  • If he or she refuses to seek help, enlist friends or family members to help you convince them.
  • Be personal and persistent. Sit, talk, try to relieve any tension anddon’t go away.
  • When he or she agrees, congratulate them on their good judgement.
  • If all else fails, take charge and be aggressive about getting the patient to the hospital.
a c t w i s e l y
A

C

T

W

I

S

E

L

Y

Acknowledge the problem

Be Calm

Be Tenacious and do not give in.

Be Willing to spend the time

Be Influential

Keep it Simple

BeEmpathetic

Link the patient with early symptoms to medical care

Say Yes - I’ll pay attention

A C T W I S E L Y
listen to your heart and be a winner
Listen to your Heart  and be a Winner!
  • Be aware of pressure, not necessarily pain, in your chest.
  • Be aware if it increases with activity and subsides with rest.
  • Don’t try to rationalize it away. Be honest with yourself and others.
  • Call 9-1-1 or have someone drive you to the nearest emergency room.
  • Don’t go to your doctors office or wait for an appointment.
  • EHAC is knowing the subtle danger signs and acting on them before damage occurs.
slide41

With gratitude for their assistance:

Raymond D. Bahr, MD and Jane Strong, RN

St. Agnes Hospital, Baltimore, MD

Terence D. Valenzuela, MD

University of Arizona

Captain Richard Hardman, EMT-P

Clark County Fire Department, Las Vegas, NV

In Memory Of

Sally Ann Spackman

1943 - 1998

Designed & developed by: Lani Clark

Tucson, Arizona 1998

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