Heart Attacks

hellonotarealdr
Jun 9
2 min read

Updated: Jun 23

Heart attacks are some of the most common emergencies that bystanders have to assist with — they come on suddenly and often lead to a quick loss of consciousness.

Early symptoms

Chest pain (central or on the left side)
Pain radiating to the jaw and/or left arm
Pressure/squeezing/tightening of chest
Shortness of breath
Nausea
Dizziness
Pale/clammy skin.

Many of these symptoms are signs of other problems too — such as dizziness and nausea coming before a faint. However, it is important to remember some “Quick Red Flags” — if any of these occur, you should contact emergency services as soon as possible.

Quick red flags:

Pain lasts more than a few minutes
Doesn’t improve with rest
Comes with breathlessness or collapse
The person becomes unconscious — doesn’t respond to voice or pain stimuli

As always — first conduct a primary survey.

If the person is conscious, they have not gone into cardiac arrest. It is important that emergency services are still called, because cardiac arrest can still occur (delayed onset).

You should ask them if they are allergic to aspirin. If they are not, give them one 300mg tablet to chew slowly. This thins the blood, limiting the damage.

Stretch!

Aspirin works by stopping platelets (particles in the blood that clot wounds) gathering together, helping prevent further clot formation during a heart attack. However, it should only be given if the casualty is conscious and not allergic.

Then, help them to sit in a comfortable position — ideally semi-reclined, with their back supported and knees drawn up, as this reduces strain to the heart.

Monitor the casualty* continuously; if they become unconscious, notify emergency services and begin cardiac arrest protocol immediately.

Cardiac Arrest

A cardiac arrest can be caused by a heart attack. It is where there is a complete blockage of blood flow to the heart, and leads to abnormal/absent breathing.

If you detect a cardiac arrest (unresponsive/unconscious and absent/irregular breathing), immediately call emergency services and begin CPR. Fetch a defibrillator* if possible, as they greatly increase survival rates if used early.

Remember:

In adults, the rhythm of CPR is 30 compressions to 2 rescue breaths. In children older than 1 year, it is the same, except preceded by 2 rescue breaths (so 2–30–2–30… etc).

Summary:

People having heart attacks have chest pain, breathlessness, and dizziness. Heart attacks can quickly progress to cardiac arrest. Key red flags include persistent pain, no relief with rest, or collapse — emergency services must be called immediately. If conscious, give aspirin (if not allergic) and keep them calm and reclined. If they become unconscious, begin CPR and use a defibrillator if available.

Glossary:

Casualty: the person that's hurt in a first aid scenario.

Defibrillator: an electrical device that restarts the heart by giving it an electric shock.

For Older Learners:

Use these questions to challenge yourself!

How can a bystander’s actions in the first 3–5 minutes of cardiac arrest be more important than waiting for paramedics?
Why is it important not to give an aspirin to an unconscious casualty?
How could you maintain a stranger's dignity if you had to give them CPR/use a defibrillator on them in public?