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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
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.
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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 cities
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:
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Early
Access to Medical Care (calling 9-1-1 immediately)
-
-
-
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.
Here
are 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 (Nov. '99)
-
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.
The following
article, "And The Beat Goes On," comes to us through
the courtesy of Lewis Ward, 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.
"Without
HELP, the person whose heart stops beating
properly and who begins to feel faint, has about 10
seconds before losing consciousness."
"However,
these victims can help themselves by coughing repeatedly
and very vigorously." |
"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.
Complete
heart failure can occur within two hours of
the onset of any symptoms.
Response
time during heart failure is of the essence: with
ventricular fibrillation, the chance of survival
declines by 10% per minute. The average survival
rate for sudden cardiac arrest is just 5 %.
However,
the potential for survival rises to 60 - 70%
if advanced life support with an AED (Automated
External Defibrillator) and CPR is initiated
within 6 to 8 minutes of collapse (2 to 3 minutes
for sudden cardiac arrest).
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.
In
the United States alone,
sudden
cardiac arrest kills 350,000 people every year. |
For
further information about heart health and heart crises,
see:
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.
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.
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:
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.
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Dry,
pale skin (no sweating)
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-
-
- 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
911 is therefore the appropriate, and the most comprehensive,
way to ensure the most effective response.
Remember:
In the event of a medical emergency, your own awareness
of warning signs increases your chances of survival
and recovery.
Your
earliest call to 911 will help our First Responders
Unit reach you within the shortest possible time,
to provide limited life support and arrange to have
you transported to a medical facility. |
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