Washington Ambulance Association Newsletter
Post Office Box 294, Washington Depot, CT  06794
In This Issue
Heart Attack Symptoms
What Can You Expect from Us?
A Cardiac Pilot Program
We Won't Give You This
Heart attack symptoms: Know what's a medical emergency

Heartburn or chest pain: When is it heart attack?

Women & Heart Attack

Symptom Presentation of Women with Acute Coronary Syndromes
In Previous Issues of our Newsletter

Learn to Recognize These Three Stroke Symptoms

Don't Fall Victim to Carbon Monoxide Poisoning

Join Our List

Join Our Mailing List
Issue # 5April 2013


Dear Neighbor:


Over the last twenty years, there have been phenomenal advances in caring for people with cardiac problems.  However, there is one critical area that has not improved at all.  Here it is:  On average, people who have symptoms of a heart attack wait two to four hours from the time that they begin experiencing symptoms to the time that they seek care.  The reasons for delay range from confusion to denial to fear of looking silly if they aren't having a heart attack. 


There's a saying in cardiology that "time is muscle."  Every minute that a heart attack goes unrecognized and untreated means that more heart muscle dies.  The more the heart muscle is compromised, the greater the decrease in the person's quality of life forever after.  Think of it as a clock that is running out on living a normal life - on the ability to walk up stairs, to play with grandchildren, to simply do the things you want to do.    


When someone is having a heart attack, delay in treatment may lead to a bigger heart attack and worse prognosis. That's why we are focusing this issue of our newsletter on recognizing heart attack signs and symptoms. By learning to recognize these signs and symptoms, and by seeking emergency care without delay, you might make an enormous and positive difference in the quality of your life for the rest of your life.  You might save your own life.  Or, you might do that same good thing for someone you love, or for a perfect stranger.  How cool is that?  


Recognize and Respond to Heart Attack Symptoms


Tip #1:  Risk Factors are Red Flags


When Washington Ambulance Emergency Medical Technicians (EMTs) and Emergency Medical Responders (EMRs) begin our assessment of a 

patient, we are always attuned to cardiac risk factors.  If a patient has any of these risk factors, it heightens our level of suspicion that the call may be cardiac, even if it was not originally dispatched as a cardiac call. The specific risk factors that raise red flags for us are:

  1. A patient who is over 65 years old
  2. A family or personal history of heart disease
  3. Smoking
  4. Hypertension
  5. Diabetes
  6. High cholesterol
  7. A sedentary lifestyle

If you have any of these risk factors, then it is especially important for you to know and recognize heart attack symptoms.


Tip #2:  Know the Most Common Heart Attack Symptoms 


The most common symptoms of a heart attack are chest pain (sometimes radiating to the upper arm or jaw), nausea, vomiting, shortness of breath, sudden, heavy sweating, and lightheadedness.  Some people also experience a feeling of anxiety or a sense of impending doom.  


If you have these symptoms, call 911 immediately.  Do NOT try to drive yourself to the hospital!  It could put you or others on the road in danger. When you call 911, the responding ambulance crew will begin assessment and treatment right on scene, will continue that assessment and treatment in the ambulance on the way to the hospital, will take you to the most appropriate hospital, and will fast track you to the right setting within that hospital.   


Tip #3:  Know the Atypical Symptoms of a Heart Attack  


37% of women and 27% of men who are having heart attacks do not have chest pain.  That's why it's important to be attuned to the total constellation of symptoms, which may include:

  • Pain or discomfort in other parts of the body, such as the arm, shoulder, middle back or jaw
  • Indigestion, heartburn, nausea or vomiting
  • Clammy skin or sweating
  • Feeling dizzy or light-headed or actually fainting
  • Unusual or unexplained fatigue or generalized weakness
  • Heart palpitations
  • Strokelike symptoms such as numbness or unexplained confusion

Tip #4:  A Special Tip for Women (and those who love them)


Coronary heart disease is the leading cause of death for women in the United States.  Women are 5.5 times more likely to die from heart disease than from breast cancer.  Women, do not ignore heart attack symptoms!


Tip #5:  For Patients Who Have Diagnosed Angina


Patients who have previously been diagnosed with angina should be concerned if their angina is increasing or becoming unstable - that is, if it is happening more often, being triggered by lower levels of exertion, becoming more severe, lasting longer, not responding to nitro, or continuing even after 20 minutes of rest.  A patient with diagnosed angina should have a calm, in-advance conversation with their doctor about when increasing angina should prompt a call to 911.    


Tip #6:  For People Who Are Worried About Crying Wolf


It is true that there are lots of things besides heart attacks that can cause chest pain.  These include coughing, pleurisy, direct trauma to the chest, indigestion and stress.  Our suggestion to you is that you take the time now, in a moment of calm, to read an excellent article from the Mayo Clinic called Heartburn or chest pain: When is it heart attack?     


We would like to say this: Unexplained shortness of breath is a huge red flag that you are experiencing a medical emergency. There are really no benign explanations for unexplained shortness of breath or difficulty breathing.  


Tip #7:  Keep Baby Aspirin in Your Medicine Cabinet


If you call 911 and your symptoms appear to be cardiac, one dispatcher will get the ambulance and paramedic started while the original dispatcher will stay on the phone with you and will very likely direct you to take four 81 mg tabs of baby aspirin.  Why?  Aspirin is a blood thinner that can begin working to dissolve a blood clot, if you have a blood clot obstructing the flow of blood to your heart.  Before directing you to take baby aspirin, the 911 dispatchers will ask you a few questions to see if you are a good candidate for aspirin.    

What Can You Expect from Us?
When you call 911 from Washington, your call is answered by Litchfield County Dispatch.  They will ask you a few questions (the first and most important one being "What is the address of your emergency?"), and will dispatch the appropriate emergency services through our emergency radios.  If the call appears to be cardiac, they will dispatch Washington Ambulance and a paramedic. 

Since we are a volunteer service, and our EMTs and EMRs respond from wherever they happen to be, it's very likely that the first person to show up on your doorstep will be arriving in a personal vehicle, in advance of the ambulance.  Sometimes the first person to arrive will be a police officer; all the police who work in Washington are trained at either the EMT or EMR level, and we work closely together.  

The first person to arrive on scene will begin to assess you, to gather your history, to take your vital signs, and to start you on oxygen.  

When the ambulance and the rest of the crew have arrived, we will move you to the ambulance and head to the most appropriate hospital, continuing to assess and treat you along the way.  The medic will join us on the ambulance, will assess your heart rhythms, will likely establish an IV and may administer drugs such as morphine and nitro.  All the things that we do on the ambulance are intended not simply to save your life, but also to slow down the clock on damage to your heart. 
An Exciting Pilot Program
Washington Ambulance is proud to announce that we will be participating in a an exciting new pilot program intended to improve cardiac care for our patients.

Specifically:  Within the next month, we anticipate having a 12-lead EKG on our ambulance with the ability to transmit the readings from that EKG to New Milford Hospital.  The emergency room physician on duty will read and interpret that EKG immediately. Based on what that physician sees, he or she will direct us to the most appropriate hospital.  For example, that physician may direct us to bring the patient to New Milford Hospital or to take the patient directly to the cardiac catheterization lab at Danbury Hospital.

Our new EKG cost over $7,000.  We are enormously grateful to the Lions Club of Washington and to an anonymous donor who together gave us the funds that we needed to purchase the 12-lead EKG and associated training equipment.  
We Will Not Give You This

Here is one thing that you will not get from Washington Ambulance:  You will not get a bill.  Washington Ambulance is one of a very small number of Connecticut volunteer services that still do not charge patients. We are supported entirely by contributions from our community, for which we are profoundly grateful. It is a wonderful thing to be able to simply focus on doing what is right for our patients, without worrying about insurance information and diagnostic codes and all that kind of stuff. Thank you!!!!!!!!!!!!!!!!!  You are the best.  It is our privilege to serve you.

The Volunteers of Washington Ambulance Association
Susie Wallace-Wyant, Chief