Know Your Heart Attack First Aid

By Anthony Cascio, MS, MICP, Virtua Paramedic and Director of Quality and Education  

If you’re near someone who you suspect is having a heart attack, first call 911. After making the call, you’ll probably have about 8 minutes to offer help before emergency medical services (EMS) arrive.

Knowing the signs of a heart attack and following this guide for basic heart attack first aid can help save a person’s life.

Signs of a Heart Attack—When to Call for Help

A heart attack occurs when a blockage cuts off the heart’s blood supply. The heart muscle then becomes starved for oxygen, and a variety of symptoms can occur, including:

• Chest pain
• Shortness of breath
• Dizziness
• A sudden and drenching sweat
• Fainting (syncope)
• A feeling of doom or that “something’s just not right”

Too many people ignore the early signs of a heart attack. As a bystander, call 911 if you’re with anyone experiencing these feelings.

If the Person is Awake and Responsive

After calling 911, there are several ways you can help a heart attack victim who is still awake and responsive.

• If he or she is allowed to take aspirin, offer 324 mg of baby aspirin or 325 mg of adult aspirin if the baby version is not available. (Baby aspirin is preferred because it doesn’t have the extra coating that’s added to adult aspirin, so it can be absorbed more quickly.)
• Also, if the person has a history of heart problems, he or she may have nitroglycerin tablets on hand. Help the person get and take the nitroglycerin, but avoid touching it, as the medicine is easily absorbed into the bloodstream.
• Don’t offer the person water or food.
• Make a list of his or her medications and dosages if possible.
• Keep the person comfortable and offer reassurance with your words and actions.

If the Person Loses Consciousness

As long as the person is still breathing normally, his heart is still beating. At this point, you can provide several basic first aid procedures before EMS arrives.

• Try to lower the person to the ground, if you can.
• From there, roll the person onto his side, and help to keep the airway clear by ensuring the head remains in a relaxed, yet erect, position (not bent at the neck too far forward or backward). This helps prevent choking by letting saliva drain from the mouth.

If the Person Loses a Pulse

You don’t need to be an expert at pulse-taking to know if a person is experiencing cardiac arrest (when the heart stops beating). An unconscious person without a heartbeat will “look dead,” meaning they are either not breathing or not breathing “normally.”

Even without a heartbeat, a person can experience a ragged, intermittent form of “breathing,” which is an indicator of serious trouble.

If the heart stops beating, follow the steps for CPR (cardiopulmonary resuscitation):

Bystander CPR
Bystander CPR is no different than traditional CPR, except the person administering it (you) may or may not have formal CPR training. You do NOT need formal CPR training to perform life-saving CPR (though classes can help with technique and confidence).

Standards for CPR have changed in recent years, and mouth-to-mouth resuscitation is no longer recommended. For a person in cardiac arrest, chest compressions can significantly increase the chances that he will leave the hospital with heart and brain function intact. 

To perform chest compressions:

• Find the best spot to compress, at the center of the chest at the nipple line, place one hand over the other and push hard and fast.
• Try for 100-120 compressions per minute (the beat of the 70s song “Stayin’ Alive” provides a good rhythm to follow).
• Don’t let fear stop you from performing these compressions. You CAN do it. Studies have shown that we all have the ability to save a heart attack victim’s life.

Defibrillation
More and more, public places have automatic external defibrillators (AED). AEDs are used to deliver an electric shock to the heart to restore normal rhythm.

From the time you turn on an AED, the device provides computerized, step-by-step voice guidance to help you operate the machine. If you are near a heart attack victim whose heart has stopped, use the AED with confidence because these machines save lives. Once you’ve discharged the defibrillator, return to chest compressions as previously discussed.

Remember, bystanders make all the difference in the survival rates and quality-of-life factors for people who have heart attacks.

Recovery after a heart attack

You can be healthy again after a heart attack. Virtua's cardiac rehabilitation program experts work with patients in a medically supervised environment to help them recover safely and effectively. Call 1-888-VIRTUA-3 for more information. 

Updated April 11, 2017