EMERGENCY MEDICAL RESPONSE

• Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
• Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
• Shortness of breath. This feeling often comes along with chest discomfort. But it can occur before the chest discomfort.
• Other signs: These may include breaking out in a cold sweat, nausea or lightheadedness.

The staff are also trained to revive someone whose heart has stopped. You'll also get treated faster in the hospital if you come by ambulance. If you can't call 9-1-1, have someone drive you to the hospital right away. If you're the one having symptoms, don't drive yourself, unless you have absolutely no other option.

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• Sudden numbness or weakness of the 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

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1. Check the victim for a response:

• Gently shake the victim's shoulders and ask loudly, "Are you all right?"

• Do not move the victim (unless he or she is in further danger), check the victim's condition, and get help if needed.
• Reassess the victim's condition regularly.

• Shout for help, send someone for help, or if you are on your own, consider leaving the victim and going for help.
• Open the victim's airway by tilting the head and lifting the chin:
  • If possible, without moving the victim from his or her original position, place your hand on the victim's forehead and gently tilt the head back, keeping your thumb and index finger free to close the victim's nose if rescue breathing is required.
  • At the same time, with your fingertip(s) under the point of the victim's chin, lift the chin to open the airway.
  • If you have any difficulty, turn the victim onto his or her back and then open the airway as described.
    Avoid head tilt if trauma (injury) to the neck is suspected.

• Look for chest movements.
• Listen at the victim's mouth for breath sounds.
• Feel for air on your cheek.
• Look, listen, and feel for up to 10 seconds before deciding that breathing is absent.

• Place the victim in the recovery position.
• Check for continued breathing.

• If you have not already done so, send someone for help, or if you are on your own, leave the victim and go for help; return and start rescue breathing as below.
• Turn the victim onto his or her back if the victim is not already in this position.
• Remove any visible obstruction from the victim's mouth, including dislodged dentures, but leave well-fitting dentures in place.
• Give 2 effective rescue breaths, each of which makes the chest rise and fall.
  • Ensure head tilt and chin lift.
  • Pinch the soft part of the victim's nose closed with the index finger and thumb of your hand on the forehead.
  • Open the victim's mouth a little, but maintain chin lift.
  • Take a breath and place your lips around the victim's mouth, making sure that you have a good seal.
  • Blow steadily into the victim's mouth over about 1.5 to 2.0 seconds, watching for the chest to rise.
  • Maintaining head tilt and chin lift, remove your mouth from the victim's mouth, and watch for the victim's chest to fall as air comes out.
• Take another breath and repeat the sequence as above to give 2 effective rescue breaths in all.
• If you have difficulty achieving an effective breath:
  • Recheck the victim's mouth and remove any obstruction.
  • Recheck that there is adequate head tilt and chin lift.
  • Make up to 5 attempts in all to achieve 2 effective breaths.
  • Even if unsuccessful, move on to assessment of circulation.

• This includes
  • Looking for any movement, including swallowing or breathing (more than an occasional gasp)
  • Checking if the carotid pulse is present.
• Take no more than 10 seconds to do this.

• Continue rescue breathing, if necessary, until the victim starts breathing on his or her own.
• About every minute, recheck for signs of circulation; take no more than 10 seconds each time.
• If the victim starts to breathe on his or her own but remains unconscious, place the victim in the recovery position. Check the victim's condition and be ready to turn the victim onto his or her back and restart rescue breathing if breathing stops.

• Start chest compression:
  • Locate the lower half of the sternum (breastbone), and place the heel of one hand there, with the other hand on top of the first.
  • Interlock the fingers of both hands and lift them to ensure that pressure is not applied over the victim's ribs. Do not apply any pressure over the upper abdomen or bottom tip of the sternum.
  • Position yourself vertically above the victim's chest, and with your arms straight, press down on the sternum to depress it between 4 and 5 cm (1.5 to 2.0 inches).
  • Release the pressure, then repeat at a rate of about 100 times a minute (a little less than 2 compressions per second). Compression and release should take an equal amount of time.
• Combine rescue breathing and compression:
  • After 15 compressions, tilt the head, lift the chin, and give 2 effective breaths.
  • Return your hands immediately to the correct position on the sternum and give 15 further compressions, continuing compressions and breaths in a ratio of 15:2.

• The victim shows signs of life.
• Qualified help arrives.
• You become exhausted.

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AUTOMATED EXTERNAL DEFIBRILLATOR

During the December 2000 Graduation ceremony Chief Pete Sturner used the new AED to revive a man who was suffering ventricular fibrillation. The Department had just taken delivery of the apparatus a few days earlier. Chief Sturner was awarded the American Heart Association, Heart Saver Award for his actions in reviving the victim.

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