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Sudden Death Denied
Note: Some of the following information was gleaned from a newsletter we received through a subscription called Alternatives, by a Dr. Williams, drdavidwilliam.com Much of this feature is a compilation of experiences and theories of our own.
Dr. Williams has been an invaluable resource for my family and I regarding health and well being and I would strongly suggest subscribing to his newsletter and products he markets.
I personally had an experience on a handball court where a player went down with a cardiac arrest. Embarrassingly there were 20 plus players including me hovering over this poor individual and no one had the slightest idea what to do to help him. Is that incredible or not?
Through good fortune an emergency nurse appeared to administer CCR Cardiac Continuous Resuscitation (Not CPR) and in a matter of minutes an emergency squad appeared with a defibrillation device to get his heart back to a normal rhythm, as we have a EMS station a block away. You talk about living under a lucky star.
Sudden Death Denied.
In fact there are instances where an individual may have a possible cardiac event in the middle of the night. I don't know what the financial expectations are in the cities for ambulance services, but in the country where we live part of the year they are billing people as much as $500.00 for ambulance trips. I am not arguing the justification for this, but there is no question that a potential heart attack victim will be very reluctant to summons an ambulance looking at the cost. They would be a lot more inclined to lets say pass it off as indigestion as so many do, let alone have the alarming red strobe lights flashing around their home and neighborhood in the middle of the night.
So what do you do? Here is one suggestion. Mom or Dad wakes up in the middle of the night with a pain in their chest, shoulder and arm. You will read below what can be done temporarily with some deep breathing and off the shelf products. At that point I would seriously consider getting in the car (If you have a driver) and head for the closest EMS station unless you are closer to a hospital. Now once you arrive you don't necessarily have to enter the facility, you can just sit in the car and see what progresses. If you are sure it is indigestion go home and go back to bed. If you are not sure or things get serious at least you have at your fingertips professional emergency services and a EMS equipped vehicle prepared to take the victim to the hospital.
Sudden Death Denied.
There are 3 parts to this feature
covering different emergencies and what you can do to save a life including the
first part in what you can do to save your own life and if this hasn't tweaked
your interest nothing will.
In all cases call 911 first or consider driving to an EMS station.
1. Apparent heart attack. Victim has the standard symptoms, hard pain in the chest, left arm and shoulder, but is conscious.
2. Apparent cardiac arrest. Victim is unconscious, no pulse, no breathing.
3. Apparent respiratory arrest. Victim is unconscious, there may be a pulse but no respiration. This problem usually occurs from drowning, something lodged in the airway, drug overdose etc. and is in the minority as most arrests are cardiac.
I carried a child out of a pool one time purple blue. I draped her over my arm and as I was carrying her she started to cough up the water she ingested and started to breath. It may have been by chance that the position I inadvertently was carrying her, probably saved her life. I was a hero and all I did was pick her up and my partner the Lord did the rest.
My guess is that little girl now a grown woman went on to lead a very productive life and it wasn't in the cards for her to succumb to my ignorance, because quite honestly I didn't know what to do to help her.
Sudden Death Denied.
You find someone on dry land unconscious without obvious trauma injuries, chances are it is cardiac. To determine what it is check the pulse first and I would suggest if there are a number of people on the scene to check the wrists and the carotids on the neck to confirm it. Two or three people checking the pulse would be smart. You don't want to start any kind of a cardiac procedure if the victim has a pulse and is breathing. They won't be breathing if they are not pumping blood by the way, although they could be pumping blood and not breathing as in something stuck in their airway.
It is important that you know not only whether there is a pulse but also if the victim is breathing. Just placing your wet finger under the nose and looking carefully whether the chest is expanding even so slightly up and down is pretty straight forward.
We had a fellow get a candy stuck in his throat a few years back and the worst thing anyone can do in these situations is mouth the mouth resuscitation. Unfortunately the victim was alone and didn't make it. After they found him they gave him the Heimlich maneuver and the candy actually popped out of his mouth and rolled across the floor.
Sudden Death Denied.
Lets take them one at a time.
Apparent heart attack.
"The life you save could be your own"
Preparation. You need to have within your reach at all times two items. I keep them in my both vehicles and in the house. A sealed bottle of 325 mg aspirin. Sealed because the aspirin in an open bottle loses its pop after awhile. 1- 325 mg Aspirin chewed by a conscious victim followed with a little water gets into the system rapidly and reduces platelet adhesiveness within minutes. This will open up blocked vessels that have triggered the attack.
A stroke victim should be handled differently as aspirin is a blood thinner and where it can be a lifesaver in Heart attacks it could be a problem in
You should familiarize
yourself with differences and approaches and of course check with your Doctor before applying them.
If a victim is showing clear signs
of a stroke and you will read this in the link and feature above, I personally
would play it safe and administer a low dose aspirin in the 81 mg range.
If you have only 325's break it in half even if you have to do it with your
teeth. Having this information on hand to the EMS station or
arriving ambulance is critical and they have means to check for the possibility
of a heart attack, a hemorrhagic strokes or even a ischemic stroke
where aspirin could be recommended.
Second, for a definite heart attack victim, (without stroke symptoms) a sealed bottle of Tabasco sauce with a tablespoon. I would wait about 5 minutes between the aspirin and a tablespoon of Tabasco sauce. Tabasco sauce is an immediate stimulant to both the nervous system and vascular system. It will dilate your blood vessels. Make sure you have a little knife or some devise to open up these sealed containers at each station.
Place the victim in a sitting up laid back position in the shade and if it is very warm have some bystanders get some towels and lightly fan the person. Keep in mind many problems are heat related. The difference between a heart attack and heat prostration is pain with a heart attack.
Before you administer the aspirin and Tabasco sauce you must try to alleviate the heart attack symptoms though a breathing in and coughing operation. The breathing and coughing should alleviate the problem temporarily. In any event even if the pain persists for lets say 5 minutes, I would administer the aspirin and Tabasco sauce still continuing the breathing and coughing efforts until help arrives as described below.
The first process in a victim showing the standard signs of a heart attack are to have them breath in to a full chest expansion and then coughing twice and continue to repeat this with a few seconds in between each cycle. The theory is the breathing in naturally fills your lungs with oxygen and the cough contracts the diaphragm, compressing the heart and helping to keep it pumping the oxygenated blood to the tissues. Incidentally you won't hurt yourself one bit if you did about 5 full breathing operations each day without heart problems. It is just a dam good thing to do. It also moves lymphatic fluids in the very important chest area that is tied into the thoracic network.
Apparent Cardiac Arrest
Although we see what they refer to as CPR on TV in most cases if an emergency vehicle does not arrive within a 5 minute period to do automatic defibrillation, anytime after that could be useless we have read, although my guess is the EMS people will most likely do the automatic defibrillation upon arrival regardless of the time down. In fact if CPR is started by someone, along with the standard mouth to mouth procedure for a cardiac arrest it is rarely successful, in fact only in 15% of the time. Actually it is reported that increasing the air pressure with unnecessary mouth to mouth can actually deprive the heart of needed oxygen. Taking the time for mouth to mouth ventilations and not concentrating and continuously pumping blood without interruption leads to these poor statistics. Pumping blood with chest compressions described below and doing it at a rate of 100 per minute which is the equivalent of counting at a 1 and 2 and 3 and 4 pace. Not 1 thousand 1 and etc, but 1 and 2 and 3 and 4.
The less interruptions you have for the first 4 minutes or 400 compressions of CCR (Continuous cardiac resuscitation) the better chance of success. Just a short interruption drops the vitally needed blood pressure to the brain down to nothing. After 400 compressions you can fit in two mouth to mouth ventilations, followed by 100 more compressions, followed by 2 mouth to mouth and so on. After 15 minutes of compressions which would be over 1000 compressions, ventilation is probably mandatory only if the patient is not gasping. At this point something in the neighborhood of the standard CPR or 30 to 50 compressions at the 100 per minute pace, followed by 2 breathings.
Continue chest compressions if the patient is gasping is recommended as gasping does provide some oxygenation, although even without gasping the patient can survive.
Basic principles of the CCR technique
1. Place victim on his/her back This is different than a conscious heart attack victim that should be sitting a little laid back preferably in the shade if it is hot.
2. Kneel besides the chest and place the heel of your hand in the middle of the chest. Cover it with your other hand. Lock your elbows and press firmly on the chest, using your hips as the pivot point so that your full upper body weight can be used to compress the victim's chest. You have to use some discretion here as you certainly cannot apply the same pressure to a frail old man or woman that you would to a burly 225 lb. linebacker. You could actually break someone's ribs with too much pressure. If you are compressing adequately, you will feel it, just don't over do it.
3. Compression 100 times a minute, the 1 and 2 and 3 and 4 cadence count.
4. Make sure that the heel of your hand breaks contact with the chest during the relaxation phase, and that you do not maintain any pressure on the chest between compressions. This release allows the chest to passively recoil fully, and it will aid in returning blood to the heart.
5. Take a breath for yourself and get ready to trade off to someone or a little group of people who are willing to kneel right across from you and pick up from you. You may have to provide a little hands on training session as you are performing the first efforts. In another words as soon as you start, enlist some help, you might need it unless you are a marathon runner or you may have other important things to do. You may have the aspirin and Tabasco sauce in a sports bag or in a vehicle that has to be retrieved. You may have ventilation equipment to put together and prepare to use it after the first 1000 compressions. Keep in mind that most victims have a generous amount of oxygen in their system for awhile, but it is the blood that needs to be artificially pumped to move the oxygen where it is needed. It would be a plus to have someone take over for a bit. Again as stated above any interruption in the process of pumping blood could be curtains for the victim.
6. Try to arouse the victim from the start with light taps on their face or a little shake here and there.
If you have an automatic defibrillation unit use it only after at least 200 compressions
Sudden Death Denied.
Note: Below there is mention of the Heimlich maneuver and in fact in great detail. There are some controversial opinions on the Internet regarding the Heimlich maneuver and especially how it applies to near drowning victims. I have personally experienced using the Heimlich maneuver on my wife who swears I saved her life. I have observed it being used on the beach with near drowning victims along with personal hands on, all with a high degree of success. I am going to continue to advocate it.
Apparent Respiratory Arrest
Respiratory arrest can result from different causes. We have copied two causes below from the website http://www.heimlichinstitute.org/maneuver.html to give you a sample of the material on the site. It is extensive with many illustrations. In most cases with someone that is not breathing it is important to do the Heimlich maneuver so that you do not complicate matters. You may want to look into the mouth and air way to see if there is a foreign object, and you may not see anything at all. Before you even attempt to remove something by hand even a small hand, do a series of Heimlich maneuvers. If you see an object and the Heimlich is not working, you have no other choice but to try to snare it and a woman with small fingers would be the ticket. If in the process she moves it without jamming it further in the airway, this may be the time to do some more Heimlich's.
The Heimlich Maneuver for CHOKING
A choking victim can't speak or breathe and needs your help immediately. Follow these steps to help a choking victim:
behind, wrap your arms around the victim's waist.
Make a fist and place the thumb side of your fist against the victim's upper abdomen, below the ribcage and above the navel.
Grasp your fist with your other hand and press into their upper abdomen with a quick upward thrust. Do not squeeze the ribcage; confine the force of the thrust to your hands.
Repeat until object is expelled.
After dislodging the blockage and the victim is not breathing this is when you have to do mouth to mouth. If you are not sure whether you have relieved a blockage, when you start mouth to mouth you will easily see the chest inflating like a balloon. If this takes place you know that you are getting air into the lungs. If you are not, either through observation or resistance in breathing you may have to resume Heimlich's (Don't forget to make sure the nostrils are kept shut with either a device or you pinching the nostrils)
There is also a means to do a self Heimlich on yourself. Essentially you would use your own arms and hands to do what someone else would do for you and is demonstrated on the right. You may not be able to generate the same leverage, but if you are alone, you have no alternative unless you know someone is close by and knew the procedure. If you can find someone close by and they are not familiar with the Heimlich, do your best with animated gestures and lip movements to alert them of your problem, then turn your back to them, grab their arms, bring them around your body, position their hands as above and actually guide them as best you can with the position and thrust upward, even to the point of effecting the thrust from above your navel and toward the rib cage.
There is another method in a self Heimlich using a chair where you are using the back of the chair as a thrusting device. In this example you stand in back and thrust your chest into the top part of the chair. You would of course use both hands to enhance the process in sort of a pull motion. You could give this a quick try, but you can't beat the leverage of someone in back of you executing it. Don't stay in the house, get out in the street, you can always try self Heimlich's out on the street hoping for a passerby to stop, let alone run into a barber shop or a saloon for that matter.
Sudden Death Denied.
Unconscious victim or when rescuer can't reach around victim
Place the victim on back. Facing the victim, kneel astride the victim's hips. With one of your hands on top of the other, place the heel of your bottom hand on the upper abdomen below the rib cage and above the navel. Use your body weight to press into the victim's upper abdomen with a quick upward thrust. Repeat until object is expelled. This is similar to the drowning procedure as described below and in fact I would duplicate the process with the head placed to the side as in the drowning procedure.
If the victim has not recovered, proceed with CPR.
The victim should see a physician immediately after rescue.
Don't slap the victim's back. (This could make matters worse.)
Sudden Death Denied.
The Heimlich Maneuver for
"You can't get air into the lungs until you get the water out!"
Place victim on back.
Turn face to one side to allow water to drain from mouth.
Facing victim, kneel astride victim's hips.
With one of your hands on top of the other, place the heel of your bottom hand on the upper abdomen below the rib cage and above the navel.
Use your body weight to press into the victim's upper abdomen with a quick upward thrust.
Repeat until water no longer flows from the mouth.
After water or an object has been expelled using the Heimlich maneuver, then and only then can you start CPR. There are more people killed each year from not purging the lungs and or dislodging a foreign object FIRST.
(Pardon the repeat, it is important) After dislodging the blockage and the victim in not breathing this is when you have do mouth to mouth along with CPR. If you are not sure whether you have relieved a blockage, when you start mouth to mouth you will easily see the chest inflating like a balloon. If this takes place you know that you are getting air into the lungs. If you are not, either through observation or resistance in breathing, you should go back to more Heimlich's (Don't forget to make sure the nostrils are kept shut with either a device or you pinching the nostrils)
Sudden Death Denied.
For those who are skittish of mouth to mouth there are plastic devices (As shown in the picture to the left) that separates your mouth from a victim and like myself who has obtained these devices feel uncomfortable without one. You could be working with someone with AIDS.
Sudden Death Denied
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This information is intended to heighten awareness of potential health care alternatives and should not be considered as medical advice. See your qualified health-care professional for medical attention, advice, diagnosis, and treatments.
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