Heart attack: how to perform emergency first aid

A guide to the emergency help that can be given in the event of a heart attack or cardiac arrest before the arrival of emergency services.

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If someone has a heart attack, there may be only a few minutes to act before it's too late, so it's vital to know what to do beforehand. Cardiologist Joep Perk offers his expert advice:

❗️This is a brief guide to the emergency help that can be given in the event of a heart attack or cardiac arrest before the arrival of emergency services. It is not intended as a replacement for a first aid or resuscitation course.

Heart attack symptoms

There are several symptoms of a heart attack to look out for, as outlined by the NHS:

  • Chest pain
  • Feeling dizzy
  • Nausea
  • Sweating
  • Shortness of breath
  • Panic attack
  • Wheezing or coughing
  • Travelling pain sensation - as though the pain is moving from the chest to the arms, neck, back, jaw or abdomen
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    Heart attack emergency response

    If someone is experiencing heart attack symptoms, call 999 immediately. If they lose consciousness, here's what to do:

    ➡️ If the person is unconscious and breathing: look at the patient's chest to see if it is rising and falling. If they are breathing, place them in the recovery position, and then call for help from the emergency services.

        ➡️ If the person is unconscious and not breathing: call for help immediately, stating that the casualty is not breathing. You should also provide resuscitation (see below) until the patient begins to breathe or the paramedics arrive.



            How to perform CPR

                CPR is the combination of both chest compressions, to support the heart, and artificial respiration, to support the lungs. The recommended guidelines are that CPR should begin with 30 compressions and then two rescue breaths and then continued at 30 compressions to two breaths.

                To perform CPR (cardiopulmonary resuscitation) and artificial respiration (mouth-to-mouth resuscitation) effectively, training and frequent practice on resuscitation dummies are essential. We highly recommend that you do one of these courses. They are most helpful, and it's only by learning what to do in the calm environment of a course that you can reliably deliver care in the highly charged situation of a cardiac arrest.

                ❗️ First aid courses are offered all over the country at night schools or by voluntary organisations such as St John Ambulance or British Red Cross.

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                How to perform chest compressions

                If you believe someone is having a heart attack, always call emergency services. While you are waiting for help to arrive, this is how to perform chest compressions:

                🔹 Kneel by the side of the victim.

                🔹 Place the heel of one hand in the centre of the victim's chest (the lower half of the sternum, or breastbone).

                🔹 Now place the heel of your other hand on top of the first. Interlock your fingers together.

                🔹 Keep your elbows straight and bring your bodyweight over your hands to make it easier to press down vertically.

                🔹 Press down firmly and quickly to achieve a downwards movement of 4 to 5cm, then relax and repeat the compression. After each compression, release all the pressure on the chest without losing contact between the hands and the sternum.

                🔹 Aim for a rate of compression of about 100 per minute. You can help your timing and counting by saying out loud 'one and two and three and four...' etc.

                🔹 Do this 30 times, then give artificial respiration twice, and continue this 30:2 procedure until help arrives.



                How to give artificial respiration

                If the patient is no longer breathing, this is how to perform artificial respiration:

                ✔️ Tilt the head back and lift up the chin.

                ✔️ Pinch the nostrils shut with two fingers to prevent leakage of air.

                ✔️ Take a deep breath and seal your own mouth over the person's mouth.

                ✔️ Breathe slowly into the person's mouth – it should take about two seconds to adequately inflate the chest. Do this twice.

                ✔️ Check to see if the chest rises as you breathe into the patient.

                ✔️ If it does, enough air is being blown in.

                ✔️ If there is resistance, try to hold the head back further and lift the chin again.

                ✔️ Repeat this procedure until help arrives or the person starts breathing again.


                How to look after a heart attack patient

                If you succeed in resuscitating the person who has been taken ill, he or she may be confused and alarmed by all the commotion. Keep the patient warm and calm by quietly, but clearly, telling them what has happened. Make sure the patient continues breathing and has a pulse until the ambulance arrives

                    ❗️ It needs to be emphasised that the only way to provide proper first aid and resuscitation is through learning the technique, then regular practice and guidance.



                    Cardiologist
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