LESSONS FOR AFRICA – How Not to Die from a ‘Heart Attack’
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LESSONS FOR AFRICA – How Not to Die from a ‘Heart Attack’
‘Doctor he’s not waking up, I think he’s dead!’
This is the call I got one Saturday afternoon when I thought my work on site was over for the day. I had just finished seeing a queue of sick people in our bush clinic when I got this call from a colleague, Daniel.
A project team member, Steve, had been exercising at our makeshift outdoor ‘gym’ when he had collapsed and stopped breathing. Daniel, struggling to describe what was happening, switched to video call.
One of the guys was busy pumping Steve’s chest with both arms locked, fingers intertwined, in a frantic effort to bring him back. Another guy had placed the resuscitation mask over Steve’s mouth and was giving rescue breaths. Saliva was foaming and dripping down the side of Steve’s face. And even from the chaotic WhatsApp video lens I could see he was completely limp and lifeless.
Being 5 minutes away from the scene I started grabbing my things while giving instructions to the first aid team over the phone:
‘30 compressions – hard and fast, let the chest recoil.
2 rescue breaths – head tilted, lift the chin’.
Literally as I arrived on the scene the miraculous happened. Steve’s body started twitching and he dry heaved in an effort to open his lungs. Collapsing limp again the team carried on pumping the chest but then Steve lifted his arm to try push their arms away.
He was alive.
The team’s early intervention with good quality CPR had literally brought Steve back from the dead.
What is a ‘heart attack’ / cardiac arrest?
The term cardiac arrest literally refers to a medical emergency in which the heart stops beating / pumping blood. The heart’s failure to pump causes the patient to become unresponsive, stop breathing and lose blood flow (pulse).
Without intervention (CPR and or defibrillator) it is fatal in minutes.
Note: a ‘heart attack’ is a common cause of a cardiac arrest. Heart attacks are where blood vessels around the heart get blocked by clots. Not all heart attacks lead to a cardiac arrest.
How do I know if this is a cardiac arrest?
If someone collapses, becomes unresponsive and is not breathing normally (or at all) you must start CPR immediately. Do not wait to try figure out if there is a pulse or not.
What do I do next?
- Call for help. Immediately call emergency services or your closest medical professional for advice and assistance. But DO NOT let this delay starting CPR.
- Get an AED. Fetch the AED / Defibrillator if you have one or tell emergency services you need one.
- Start CPR. Place hands (interlock fingers) in the centre of the chest, keep arms locked and push hard and fast at a rate of 100 beats per minute. If trained give 2 rescue breaths after each 30 compressions.
What do I do when the AED arrives?
- Immediately turn it on and listen to voice prompts. With minimal interruption to chest compressions.
- Apply pads to bare chest.
- Let device analyse heart rhythm.
- Follow machine’s voice to deliver shock if needed.
- Continue CPR -leave AED pads on and listen to voice prompts.
- AED will re-analyze rhythm every 2 minutes.
What is the bottom-line?
Early, good quality CPR saves lives. Know the basics, stay calm and you have a chance of saving a life.
About the Authors:
RES Healthcare is a team of energetic and adventurous South African Doctors and Health & Safety practitioners, driven to provide quality health, safety and community services to projects and communities in Africa.
Contact: healthcare@res.co.za
Image: A RES Healthcare Medical Officer showing the correct way to do chest compressions. Image credit: RES Healthcare
DISCLAIMER:
This column provides general health information for educational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with any questions about your health. The author and publisher accept no responsibility for any outcomes resulting from the use of this information.