First emergency aid for acute myocardial infarction
Author Ольга Кияница
Myocardial infarction is a pathological condition that is an acute consequence of coronary heart disease, in which the blood supply of the heart muscle is broken up to the complete absence of blood flow through the affected vessel.
The severity of a heart attack depends on how much the coronary circulation is disturbed. If a cholesteric plaque or thrombus completely blocks blood flow, an acute condition develops. In such cases, the person remains between 20 and 40 minutes, after which the heart cells begin to die because of a critical lack of oxygen.
The process of necrosis of the heart cells is irreversible. There are no magic pills capable of restoring dead cardiomyocytes, so the affected area of the heart remains a weak spot, contributing to the occurrence of repeated heart attacks in the future. So, if you have the first symptoms of the disease (most often chest pain), you should immediately seek medical help or take the first-aid measures.
Video: Myocardial infarction. First Aid and Action Algorithm
First aid for suspected heart attack
First of all you need to take care of calling an ambulance or, if possible, to help the patient to get to the hospital as soon as possible, offering his or using the associated transport.
The paramedic when calling the "first aid" should always specify that the patient with suspicion of myocardial infarction was taking out medications and what manifestations are observed. In this case, usually sent a special team from the cardiology or intensive care unit.
If the victim is on the street, the escort should indicate his exact location and wait for the medical vehicle.
It is worth recalling that with deadly pathology, which is a myocardial infarction, time goes not for hours, but for minutes and seconds, which means that the patient can not wait for the car without assistance. It is necessary to take all measures available to all, to save human life.
It is necessary to begin with the fact that the patient should be conveniently located. To do this, he is laid on his back and put something under his head. In this case, the head should be slightly thrown back, and the legs - raised and bent at the knees. It is desirable that the surface on which the patient lies is flat and firm. This position of the patient with myocardial infarction will help reduce the burden on the heart and will additionally get valuable time.
With myocardial infarction, a symptom such as the fear of death is extremely pronounced, which causes incredible anxiety in patients, which makes it difficult to find them in a calm state. To cope with excessive anxiety, it is recommended to calm the patient with words or give a soothing remedy. Usually in such cases, "Valocordin", "Barbovale", valerian and other medicines with the same effect are used. Sometimes you even need to use physical strength to keep the patient from active movements that are dangerous for him in this state.
A frequent symptom of myocardial infarction is shortness of breath caused by oxygen starvation, therefore it is necessary to take measures to facilitate access of oxygen to the victim. If a crowd of curious people gathered around, we must ask them to disperse. In the event that a heart attack occurred in the room, it is necessary, if possible, to turn on the air conditioner or fan, open the windows wide open, and do not interfere with the access of air to the bed of the patient.
It is necessary to try to free the neck and chest of the patient from the tightening clothes, unfasten the buttons or untie the laces on the clothes.
To expand the vessels and stop the severe pain syndrome, which in itself sometimes causes premature death, you can use nitroglycerin. The tablet of the drug should be placed under the patient's tongue, if necessary keeping the lower jaw, so that the medicine does not fall out of the mouth. The next tablet can be given to the patient not earlier than in a quarter of an hour. Strengthen the analgesic effect of nitroglycerin can be with the help of analgin, as well as other analgesics or NSAIDs.
In addition, it is recommended to give the patient acetylsalicylic acid (just over half the tablet) or an aspirin tablet. This drug dilutes the blood and facilitates its flow through the coronary vessels affected by thrombosis.
Using nitroglycerin and aspirin in most cases, you can slightly improve blood circulation and slow the process of necrotic tissue of the heart. Nevertheless, the patient still needs the help of a cardiologist or a cardiac surgeon.
If the pathological process develops too quickly, and the measures taken do not give the expected result, it is necessary to closely monitor the patient's condition before the arrival of an ambulance, check the pulse, breathing, palpitation. If possible, it is also necessary to check blood pressure, which is significantly reduced when the heart is broken.
If a person has lost consciousness, his pulse became weak and intermittent, and breathing and palpitation are not determined, there is a high probability that, despite everything
action, the patient's heart stopped. This is the most important moment during first aid in myocardial infarction. Here, in no case should one become confused and panic or fall into a stupor, because human life now hangs in the balance.
Video: Heart Attack || How to recognize and provide first aid in a heart attack? || +1 project
Help with cardiac arrest
The first thing to do is to make a precordial stroke. This procedure, despite the seeming cruelty and the possibility of injury in the form of fracture of the ribs, in many cases helps to start the heart and save the life of the patient. The blow should be done with the fist, once in the sternum, closer to the heart. It is necessary to beat quickly and quite strongly.
If this procedure does not work, then artificial respiration and indirect heart massage are performed. Usually these manipulations are taught at school and at the institute, but information without practice is quickly forgotten, and not everyone is able during the excitement to act quickly and perform the necessary manipulations, which in fact are not particularly complex.
Indication for cardiopulmonary resuscitation is the absence of two of the three vital signs: breathing, pulse, consciousness. In the absence of all three signs of life for 2-3 minutes. biological death sets in, so there is no need for resuscitation.
Basic principles of prehospital resuscitation:
- To conduct an indirect heart massage, the hands must be assembled together, the fingers crossed with each other, while the palms begin to rhythmically and quickly push the patient's chest in the area of two thirds of the sternum. The pressure frequency is approximately 2 times per second. Hands during a massage from the chest can not be torn off to prevent their shifting to the side.
- The pressure should be such that the compression of the chest is not less than 5 cm. To stop the indirect cardiac massage is possible only during the artificial respiration and checking the pulse in the region of the carotid artery.
- In between the cycles of indirect heart massage, artificial mouth-to-mouth breathing is performed. The ratio of these two procedures is 30: 2, i.е. within 30 strokes on the chest, 2 inhalations-exhalations are done. Thus, there is ongoing monitoring of whether the patient's pulse has appeared, indicating a restoration of cardiac activity. In this case, the resuscitation procedure as part of the first prehospital care for myocardial infarction ceases.
- If the pulse does not appear, it is recommended to continue the manipulations until the ambulance arrives, however, no more than 10 minutes, after which irreversible processes in the body that are incompatible with life will begin. In such cases, even after bringing the patient to their senses, there is no guarantee that during the resuscitation there were no critical changes in the work of the brain, nervous system and other important organs.
Indicators of the patient's return to life - the determination of the pulse on the carotid artery, the change in skin color from grayish to pale pink and the appearance of pupillary responses to light.
First aid to oneself with a heart attack
No one is immune from myocardial infarction, therefore sooner or later one can experience such horror on oneself and you need to know what to do in such cases. First of all, you need to learn how to effectively help yourself, if necessary, and if there is not anyone around who can help.
It's not always close to relatives who can help, or there are neighbors on the site who can call an ambulance, so it's very desirable, especially for elderly single people, to know how to act when symptoms of myocardial infarction appear.
If a heart attack has arisen at home and no one is around, the main thing is not to panic. It is important to immediately collect the strength of the spirit and call an ambulance (and, if possible, call your relatives) at. Thus it is necessary to take care of that doctors of "first aid" could enter into a room, even if it happens to lose consciousness. It is necessary to open the lock on the entrance doors of the apartment and, if possible, open the door.
Then you need to open the windows or turn on the air conditioner, loosen the gates of clothes, drink the necessary medicines, of which the above was written. After that, it is most reasonable to lie on a hard surface, placing a pillow or a twisted blanket under your head, throw your head back and wait for the doctors to arrive.
Active movements during the development of acute myocardial infarction can cause irreparable harm.
If you know about the presence of heart disease, it is necessary that in the home medicine cabinet there is always a stock of suitable medications: heart drugs, analgesics, sedatives, etc. In addition, the first aid kit should be in a place where it can be easily taken if necessary.
During walks on the street, trips to work, shops or other establishments it is desirable to have the most necessary medicines with you, which may be necessary for yourself, and relatives or even strangers.
Video: First aid to oneself with a heart attack
Briefly on the treatment of myocardial infarction
Treatment of acute myocardial infarction is performed in the hospital under the supervision of medical personnel. At the same time, both medical methods and non-pharmacological therapy are used.
As an "ambulance" for acute myocardial infarction, patients take:
- Nitroglycerin in the form of tablets, capsules or solution for intravenous administration
- Thrombolytics (streptokinase, urokinase, alteplase)
- Anticoagulants (aspirin, heparin)
- Beta-blockers (metoprolol, atenolol)
- Antiarrhythmic drugs (mainly lidocaine)
- Analgesics (morphine plus neuroleptic droperidol, promedol)
- ACE inhibitors (captopril, lisinopril, ramipril).
Additionally they can appoint:
- Calcium antagonists (diltiazem, verapamil)
- Preparations of magnesium
In severe cases, when it is impossible to dilate blood vessels medically and restore blood flow, resort to transluminal percutaneous coronary angioplasty. With extensive infarctions, surgical treatment with aortocoronary shunting, intracoronary stenting, etc. is carried out.
Treatment of myocardial infarction and prevention of its relapse include diet, lifestyle changes, moderate physical activity (first under the supervision of a doctor).
Using all of the above treatment methods allows 80% of patients to return after a while to their usual activities, but they must take the medicines prescribed by the cardiologist for the rest of their lives.
Prevention of myocardial infarction
The disease is easier to prevent than to cure. For this, first of all, you need to reconsider your lifestyle and diet.Abandonment of bad habits, physical activity, outdoor walks, weight control and restriction of high cholesterol intake help many people prevent the development of cardiovascular pathologies, including atherosclerosis of vessels and coronary heart disease are the most common causes of myocardial infarction.
If there is no way to avoid heart disease, you should strictly follow the doctor's recommendations for their treatment.Most often the doctor prescribes drugs from the group of statins, which prevent the formation of atherosclerotic plaques on the walls of blood vessels. In this case, patients often ignore this appointment only because these drugs are not cardiac. If the patient has high blood pressure, it is necessary to take medications that help reduce it (ACE inhibitors).
It is necessary to fight with increased viscosity of the blood, for which anticoagulants and thrombolytics are prescribed, which prevent the formation of blood clots inside the vessels. If there is an increased heart rate and nervousness, it is recommended to take beta-blockers and sedatives.
All of the above measures will help prevent the re-development of myocardial infarction, which usually takes place much harder than a primary heart attack.
First aid for myocardial infarction - urgent measures that help save the life and health of the patient. But if you take care of your health on time and resort to preventive measures, such help will never be needed.
Video: infarction of myocardium. First aid!