DEALING WITH AN EMERGENCY.

IF SOMEONE you know has a heart attack, you have only a few minutes to act before it is too late. That's why it's vital to know what to do beforehand.

1 The first thing you should do if you feel that either you or someone around you is experiencing a heart attack is to call an ambulance, move to an open area and take deep breaths. If you have a gauge at home, check blood pressure as an attack leads to a drop in B. P.

2 If you know that you are at risk of a heart attack, always keep a nitroglycerine spray within reach. " Spray twice under your tongue. Nitroglycerine dilates blood vessels, removes blockages and makes it easier for blood to flow through them. This helps the heart pump the blood," says Dr Peerzada Badruduja, emergency medical officer at Max Healthcare. If you don't have the nitroglycerine spray, chew 325 mg of aspirin. Chewing the pill pushes it faster into the bloodstream than swallowing.

Aspirin should not be taken by people who have been advised otherwise because of allergies or possible harmful interactions with other medications or known disease complications.

Painkillers can be taken to relieve chest pain.

3 If the person becomes unconscious, make sure he is lying on his back on a hard surface. Check for breathing by looking for falling and rising movement of the chest, feeling the breath on the cheek and listening to it. Also check the pulse by placing two fingers on one or the other side of the person's neck muscle adjacent to the Adam's apple to feel if he has a carotid pulse. Carotid pulse is a better indicator of a heart attack than pulse on the wrist because it's nearer to the heart.

4 If there is no breathing or pulse, the patient has had a heart attack. Provide artificial respiration in this case. Tilt the head back and lift up the chin. Pinch the nostrils shut with two fingers to prevent leakage of air. Take a deep breath and seal your own mouth over the person's mouth. Push two deep breaths inside the person's mouth for expansion of patient's lungs. Also start cardiopulmonary resuscitation ( CPR). " Once you reach 30 compressions, ask somebody else to administer two artificial breaths. The frequency of compression should be 100 times a minute. This would supply oxygen to the brain and other tissues. The latest research says just compressing for 8 minutes can pull up the body reservoir and the patient can survive the cardiac event," says Dr Badruduja.

5 At a hospital emergency, ECG is the first test to be done. Along with this, medications like aspirin, nitroglycerine, and morphine are given to treat chest pain and beta blockers to reduce the heart rate. Clopidogrel is given to check blood clotting.

Tests for cardiac enzymes which are released by heart muscles when they are damaged are also done.

Peak levels of these enzymes may vary depending upon the type of enzyme released during the event.

6 While an ECG tells you which part of the heart is affected, angiography pinpoints the artery which is blocked and the amount of blockage. Depending on this your doctor can recommend angioplasty or bypass surgery. However, if a patient can't afford to undergo surgery due to financial constraints and if the blockage is not high, thrombolytic therapy can be given. It involves injecting clot- dissolving medicines within recommended time, but it can only be given to people whose blood coagulation is normal and they have not undergone any recent major surgery otherwise profuse bleeding can take place.

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