The first and most important thing to do is to call 911 if you think a spouse or close friend may be having a heart attack. The quicker the EMS technicians arrive and begin treatment, the better the prognosis. Sometimes people hesitate to call 911 because they are not sure it’s really a heart attack. But 85% of the damage to the heart muscle occurs within the first 60 minutes after a heart attack. So even if your loved one tells you to wait, make the call—fast!
Watch for the signs of a possible heart attack:
- Chest discomfort, pressure, or pain
- Pain and discomfort that travels to your arms, back, neck, teeth, and jaw
- Shortness of breath
- Sweating, nausea, vomiting, indigestion, and fatigue
Be aware that frequently women and people with diabetes may experience little or no chest pain. Therefore, if the person has diabetes, pay particular attention to pain and discomfort in the back or jaw, shortness of breath, and extreme fatigue.
Gather the documents you’ll need at the hospital:
Ask your loved one to sit or lie down, and remind him/her that it is best to remain as quiet and calm as possible. Then gather up everything you will need to present at the hospital: the person’s medications, health insurance card, doctor’s name and contact information, list of allergies, health care proxy, and living will.
(Note: A heart attack can happen to anyone, so even if you’re young or fit, it’s a good idea to collect this information in one place and keep it with you. What I do is use my smartphone to take pictures of my medication vials, my doctor’s business card, health care proxy, and other documents. That way, it’s easy to carry the information at all times.)
While you wait for the ambulance to come, you can take the following steps to help reduce the risk of irreparable damage to the heart tissue, or even death of your loved one. And remember, try your best to remain calm, and reassure the person that help is on the way. Remind your loved one that the odds of surviving a heart attack today are far better than even 25 years ago.
Do
Don't
Do
Do keep your loved one still and quiet
Often, and particularly if the pain isn’t acute, people suffering a heart attack may want to fetch their information, find a bottle of aspirin, and walk downstairs to wait for the ambulance. Let them know that any exertion puts additional strain on the heart, and it’s better for them if they sit and wait quietly. Excessive conversation and fretting also can strain the heart, so discourage individuals from giving a lot of instructions and worrying. Keep assuring them that everything is under control.
Do give the person an aspirin to chew (if not allergic)
If the stricken person is not allergic to aspirin, grab one and ask him or her to chew and swallow it, with a small sip of water if necessary. If you can, opt for a standard aspirin tablet of 325 mg; if not, give the person a baby aspirin (81 mg), which is also effective. Aspirin helps because aspirin inhibits platelets, which are the building blocks of blood clots. Heart attacks are caused when blood clots clog an artery. Ingesting aspirin will keep the clot from growing bigger.
Note: It is better to chew an aspirin than to swallow it because it enters the bloodstream faster.
Do note the time symptoms began
Emergency room doctors will want to know when the heart attack symptoms began. Knowing what time the symptoms started helps them assess how much damage has been done to the heart muscle.
Do reduce choking risk from vomit by keeping the airway open
Nausea is a common byproduct of a heart attack. If someone begins to vomit when he or she is not fully conscious, the person can choke. So be alert to any possible choking hazards. If your loved one is lying down, turn his or her head to the side to keep the airway open.
Do be prepared to perform CPR if necessary
A heart attack can cause cardiac arrest. (Note: a heart attack and cardiac arrest are not the same thing. Heart attacks occur when the heart is deprived of oxygen because of a blocked artery. Sudden cardiac arrest happens when the heart beats erratically or stops altogether.) If someone stops breathing or is not breathing normally, it is essential that you push hard and fast on the center of the person’s chest. Don’t hesitate to call 911 again to have them walk you through it.
Don't
Do not drive to the hospital yourself
You may think it’s faster to drive your friend to the hospital – or even worse, allow your loved one to drive – but there are three important reasons to wait for the ambulance:
- The EMS crew can begin administering life-saving care en route to the hospital. They can provide oxygen, start an IV, monitor heart rhythm and treat the patient’s pain and nausea, if necessary;
- The ambulance will take you to a hospital that operates a cardiac receiving center, which has the expertise and technology to treat heart attacks effectively. Most people would head to the nearest hospital, whether or not that hospital is equipped to handle heart attacks;
- When you walk into ER, precious time is wasted at the admitting desk. Patients who arrive by ambulance get immediate attention. What’s more, at White Plains Hospital, we ask to receive EKGs transmitted directly from ambulances en route. That allows us to know ahead of time whether the patient will benefit from a cardiac catheterization procedure. If so, we will get the cath lab up and running to treat patients as soon as they arrive. Our track record from patient pick-up to cath lab is 55 minutes on average, much faster than the 90-minute gold standard set by the AHA.
Do not give your loved one food or water
There are two reasons why you should not give your loved one anything more than a few sips of water or other clear liquid. First, until you get to the hospital, you won’t know if your friend will require anesthesia for a procedure. Second, nausea is a common symptom of heart attacks. Undigested food could become a choking risk.
Do not leave the person alone for a long time
While you may have to step away to call 911 and gather medications and insurance information, stay by your friend’s side as much as possible. Not only will this help calm the person, it also allows you to react quickly if your friend stops breathing or begins to vomit.
Do not ask EMS to write down the list of medications
The EMS crew will have their hands full. They may not have time to write down the medications or they may write it down wrong in the rush. Take your own list (double-checked, of course) or the pill vials to the hospital.
Do not allow your loved one to go to the hospital alone
It will be easier for both your friend and the hospital staff if you go, too. There will be many questions for you to answer. If you are not sure you will be able to get a ride home, drive yourself rather than go in the ambulance.
Summary
Emotions run high at times of emergency, and it may be hard to think clearly if you believe your loved one has been stricken by a heart attack. Learn these do’s and don’ts before they are needed, and keep them handy for quick reference—just in case.
More expert advice about Heart Attacks and Strokes
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