Graceful Health: Time is of the essence during a heart attack

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What is the difference between a heart attack and sudden cardiac arrest? One of the biggest differences is time. A person having a heart attack may have time to get help.

One out of four deaths in the U.S. is caused by heart disease. It is the leading cause of death for both men and women. The term "heart disease" actually refers to a variety of conditions. The most common one is coronary heart disease, when plaque builds up in the arteries, narrows them, and restricts the flow of blood. A heart attack occurs when an artery becomes blocked, restricting blood flow and oxygen to an area of the heart. Without blood and oxygen, that area of the heart becomes ischemic and dies.

Time is of the essence during a heart attack, but depending on how severely the blood flow is compromised, the person having a heart attack may have enough time to get help, as long as early warning signs are heeded.

In some cases, the symptoms are sudden and intense. Most often they are intermittent, progressing over several hours, sometimes even days. Symptoms can include chest pain or discomfort, sweating, shortness of breath, arm pain, and back pain. Despite these symptoms, you are still conscious and breathing, but you need to act quickly. If you think you are having a heart attack, it is important to call 911 right away, or go to the closest emergency department.

With cardiac arrest, however, every second counts. Sudden cardiac arrest occurs when there is a disruption in the electrical activity or rhythm of the heart. Without proper medical treatment, a heart attack can lead to sudden cardiac arrest.

Cardiac arrest occurs without warning. When the electrical activity in the heart is disrupted, the heart stops pumping. Within seconds, the person becomes unconscious. Without rapid medical treatment, death soon follows. It is estimated that over 400,000 sudden cardiac arrests occur outside of hospitals in the U.S. each year. Without immediate intervention, it is unlikely a person will survive.

So, what exactly is "early intervention," you ask? Defibrillation and Cardiopulmonary Resuscitation (CPR) are the two types of early intervention that must be used to stop sudden cardiac arrest if a person is to have any chance of surviving. These must happen immediately. With every minute that passes, the chances of surviving diminishes by 7-10 percent, according to the American Heart Association.

An Automated External Defibrillator is small portable device found in all hospitals and ambulances, and increasingly in many public places. When applied to a person suffering sudden cardiac arrest, it senses the abnormal heart rhythm, and is capable of "shocking" or interrupting that abnormal rhythm, restoring cardiac function. Defibrillation has been used in the hospital setting since the late 1960s. In the 1990s, AED use by lay personnel was approved by the FDA. The Red Cross added AED training to its basic CPR course in March of 1999. In 2003, New York State became the first state to mandate AEDs in all of its schools and health clubs or fitness centers. The next year, the Federal Aviation Administration mandated that all large passenger-carrying U.S. airlines must carry AEDS and have personnel trained in their use.

Currently, Vermont does not require schools and fitness centers to have an AED on-site. You might ask why. The answer is public policy and cost. Still, some places have AEDs even though they are not required. For example, the elementary schools in towns around Grace Cottage all have AEDs and the staff is CPR trained. Leland and Gray Middle-High School also has AEDs and trained staff, and seniors graduate with CPR certifications.

What's the best thing you can do after reading this article? One thing is to ask your legislators about enacting a law so that AEDs would be more widely available. Also, ask about AEDs at your own local schools and sports centers.

The other thing you can do is to learn CPR, including AED use.

Grace Cottage Hospital has three staff members trained to teach CPR and AED skills. Currently, they provide instruction only to staff, but that could change. Right now, the closest location for most of us is Rescue, Inc. The next training is on March 24 (there is a charge for the class). Call 802-257-7679 or visit train.rescueinc.org for more information. With this important training, and an AED near at hand, you could be a life-saver!

Lisa May received her Associate's in Nursing at Castleton University, and her Bachelor's from The University of North Carolina. She is the Clinical Nurse Educator at Grace Cottage Hospital and is a Certified Advanced Cardiac Life Support Instructor.

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