You will notice that we include “chewable” ASA (acetyl salicylate acid), which is better known by its trade name Aspirin in our “Dave” line of kits. Why is this, you may ask.
Remember that our kits are designed for backcountry or remote use, where help may be very delayed, or evacuation to a medical facility quite an extended affair. There is rarely anything the first aider can do for newly occurring first-time medical events. To deal with these situations a higher level of training and the correct medical equipment or drugs is usually required.
One of our deadliest first-time medical events is the possibility of a heart attack, or medically speaking an MI (myocardial infarction… death of the heart muscle). These cardiac events are still a leading cause of death in Canada and across the western world, many being caused by preventable behaviours. One of the main predictors of heart attack is age and as we mature as a population, we cannot change or reverse the age factor. The older we get the more chance of being struck by a heart attack.
Like it or not our population is aging, and we are seeing more and more of this aging population remaining or becoming active. Ask any guide or outdoor leader who works with the general population and they will tell you that they are seeing the demographic of their client base move toward an older age group. This inevitably will lead to the day that a guide may have a group member experience a “first-time” cardiac event. Be ready and be prepared.
A quick review of signs and symptoms of a suspected heart attack can include:
- Chest pain, described as crushing; squeezing; discomfort; restrictive
- A sweeping of the hand as they try to indicate where exactly the pain is located
- The sensation of pain or numbness in their arm; jaw or neck
- A feeling of shortness of breath
- A sense of “impending doom” and anxiety
- Nausea and or vomiting
- Sudden weakness
- Grey, ashen skin colour and profuse sweating
Women may show the above signs or have more “atypical” signs that can include:
- Back pain
- Abdominal pain
- A sudden onset of feeling like they are exhausted
If we suspect that someone is experiencing a heart attack, then we must act quickly. The longer the heart attack continues the more extensive the heart muscle damage can be and the higher the possibility of cardiac arrest. In a remote setting reversing cardiac arrest is rarely achieved.
Our goal then is to prevent the muscle damage from getting worse and to evacuate the individual as quickly as possible. What steps can be taken to ensure the best possible outcome? Do remember that sometimes these events are sudden, dramatic and do not have good outcomes.
- Alert rescue / emergency services ASAP
- Stop all physical activity… this means they are NOT walking out!
- Allow the person to find their position of comfort (usually the “lazy-boy recliner” position)
- Keep them comfortable in the environment (protect from the elements)
- Stay calm as the rescuer and keep them calm as the patient
- Give them 2 low dose ASA and have them chew and swallow ASAP
- If you are in a facility with access to an AED (Automated External Defibrillator) make sure that it is brought close to the patient. DO NOT place it directly in view of the patient and DO NOT place pads on a conscious and alert patient’s chest! This will increase anxiety levels and potentially cause more heart damage or potentiate a cardiac arrest.
Why the ASA you ask?
- It is not to take the pain away!
- If the problem is being caused by a clot that is growing in a coronary artery (classic and most common type of heart attack) it will help to prevent that clot from growing into a complete blockage and causing massive heart muscle damage
- Yes, it must be ASA (Aspirin)! It cannot be one of the other over-the-counter pain meds
- It should be chewable for the fastest onset
- ASA has proven to be lifesaving. Studies have shown that when ASA is given early at the onset of a heart attack it can save 23% of those who would have gone into arrest (died).
Can I give ASA?
Yes. Provision is made for the carrying and administration of medications under OH&S guidelines. A hazard assessment must first be completed that indicates the potential need for ‘over the counter’ medication, based on the distance from and potential travel time to advanced care.
If you are not sure about conducting a specific ERP (Emergency Response Plan) our sister company Emergency Response Planning and Consulting, Canada (ERTC-C) can consult and build this plan on your behalf.
After due diligence you decide to put ASA into your kit which you can order from RMAM complete with a S&S reminder card and instructions.
Check how well you understand Heart Attacks and their S&S and treatment with our short online quiz.