Heart Attack First Aid Tips: You Should Never Ignore in Emergencies

Recognise the Signs

A heart attack may begin gradually, with mild discomfort, or suddenly. Look for:

• Pressure, tightness, squeezing or heaviness in the centre of the chest, lasting more than a few minutes or coming and going.
• Pain or discomfort spreading to the shoulders, arms, back, neck, jaw or upper abdomen.
• Shortness of breath, with or without chest discomfort.
• Cold sweat, nausea, vomiting or light-headedness.
• Unusual, extreme tiredness, especially in women, older adults and people with diabetes.
• A sense of anxiety or impending doom.

If you are not sure, treat it as a heart attack. It is better to be wrong than to wait.

Step-by-Step First Aid for a Conscious Person

Step 1: Call for Emergency Help Immediately

Dial 112 or your hospital's ambulance number. Say that you suspect a heart attack, give the exact location, and stay on the line. Do not wait to see if the pain goes away. Ask someone else to bring an AED if there is one nearby.

Step 2: Keep the Person Calm and Still

Help them sit down in a comfortable position, such as half-sitting with knees bent and back supported, which eases the heart's workload and breathing. Do not let them walk, climb stairs or exert themselves.

Step 3: Loosen Tight Clothing

Open collars, belts and anything restricting the chest and neck.

Step 4: Give Aspirin If Appropriate

If the person is awake, able to swallow and is not allergic to aspirin, has no known bleeding disorder, stomach ulcer or recent bleeding, and has not been told by a doctor to avoid it, give a regular 300 mg aspirin tablet to chew slowly, or two low-dose (75 to 81 mg) tablets. Chewing allows faster absorption and helps prevent the clot from growing. If you are unsure, follow the emergency operator's advice. Do not give aspirin to a person who is unconscious.

Step 5: Help With Prescribed Medicines

If the person has been prescribed nitroglycerin (a sublingual tablet or spray), help them take it as directed, usually one dose under the tongue while sitting, and repeat as instructed if pain persists, up to the dose their doctor allows. Do not give it if their blood pressure is very low, if they have taken certain erectile dysfunction medicines recently, or if it is someone else's tablet.

Step 6: Stay With Them and Monitor

Reassure and observe breathing, responsiveness and colour. Note when symptoms started, what they were doing, their medicines and medical conditions, so that you can tell the ambulance team. Send someone to the gate or road to guide the ambulance.

Step 7: Be Ready for Cardiac Arrest

If the person becomes unresponsive and is not breathing normally (gasping does not count), begin CPR immediately.

CPR for an Adult: What to Do

CPR keeps oxygenated blood flowing to the brain and organs until a defibrillator or paramedics arrive.

1. 1Check for response. Tap the shoulders firmly and shout, "Are you all right?"
2. 2Call for help and get an AED. If you are alone and have a phone, put it on speaker and place the call.
3. 3Open the airway and check breathing for no more than 10 seconds. If the person is not breathing normally, start compressions.
4. 4Position your hands. Kneel beside the person on a firm surface. Place the heel of one hand on the centre of the chest (the lower half of the breastbone), and place the other hand on top, interlacing your fingers.
5. 5Compress hard and fast. Keep your arms straight, shoulders over your hands, and push down at least 5 centimetres (2 inches) but not more than 6 centimetres, at a rate of 100 to 120 compressions per minute. A helpful rhythm is the beat of a fast song.
6. 6Allow full chest recoil after each compression, and minimise interruptions.
7. 7If you are trained and willing, give two rescue breaths after every 30 compressions: tilt the head, lift the chin, pinch the nose, give a breath lasting one second and watch the chest rise. If you are untrained or unwilling, give hands-only CPR, which is effective for adults who collapse suddenly.
8. 8Keep going until the person starts breathing normally, an emergency team takes over, an AED is ready or you are too exhausted to continue. If others are present, change over every two minutes to avoid fatigue.

Do not worry about breaking ribs. This can happen and is not a reason to stop, since the alternative is death.

Using an AED

Automated external defibrillators are found in airports, malls, offices and some housing societies. They analyse the heart rhythm and give a shock if needed. They are designed for use by anyone.

1. 1Turn on the AED and follow the voice instructions.
2. 2Expose the chest and dry it if wet. Shave excess hair if needed to ensure contact.
3. 3Attach the pads as shown in the pictures: one on the upper right chest, below the collarbone, and one on the left side, below the armpit.
4. 4Let the AED analyse the rhythm. Do not touch the person.
5. 5If a shock is advised, make sure everyone is clear and press the shock button, if prompted.
6. 6Resume CPR immediately after the shock, or if no shock is advised, and follow the AED's prompts.
7. 7Continue until help arrives.

What Not to Do

• Do not wait. Do not tell the person to rest and see if it passes, and do not delay calling for help.
• Do not let them drive themselves or be taken in a private vehicle if an ambulance can arrive quickly.
• Do not give food or drink other than aspirin with a sip of water if appropriate.
• Do not give someone else's medicine, or pain tablets such as ibuprofen or diclofenac, which may worsen outcomes.
• Do not rely on home remedies, such as giving ghee, pressing the chest or giving a "cough CPR" instruction.
• Do not leave them alone, even if they say they feel better.
• Do not panic or crowd the person. Ask bystanders to give space.

Special Situations

Women, Older Adults and People With Diabetes

Symptoms may be subtle, such as breathlessness, extreme fatigue, nausea or back and jaw pain. Take these seriously and give the same care.

Children and Infants

Heart attacks are rare in children, but cardiac arrest can occur. Pediatric CPR differs: for infants, use two fingers on the centre of the chest, compress about one-third the depth of the chest, and give rescue breaths because arrests are often due to breathing problems. Learn paediatric CPR if you care for young children.

At Home Alone

If you suspect you are having a heart attack and are alone, call for an ambulance immediately, unlock the door, sit down, chew aspirin if appropriate and try to alert a neighbour. Do not drive yourself. Avoid "cough CPR," which is not recommended as a general measure.

After the Ambulance Arrives

Tell the paramedics what happened, when symptoms began, medicines given (including aspirin), and the person's medical history. Hand over any medicine lists and reports. If CPR was done, tell them how long and whether an AED was used. Then step back and let them take over.

Prepare in Advance

1. 1Learn CPR and AED use. Hospitals, the Red Cross and other organisations offer short courses. Practise on a manikin if you can.
2. 2Save emergency numbers in your phone: 112 and your hospital.
3. 3Know where AEDs are in your workplace, society or mall.
4. 4Keep aspirin at home, and know whether family members can take it safely.
5. 5Share a family emergency plan: who calls, who unlocks the door, who gets the medicine list.
6. 6Encourage family members with risk factors to have regular check-ups.
7. 7Teach teenagers and domestic staff the basics.

Reducing the Chance It Happens

Prevention is the best first aid. Controlling blood pressure, cholesterol and diabetes, quitting tobacco, eating well, exercising and managing stress all lower the risk of a heart attack. Know your family history and have regular check-ups.

Care at Trustmed Hospital

Trustmed Hospital in Badshahpur, Gurugram, provides 24-hour emergency care with an ambulance service and ICU for patients with heart attacks. In an emergency, call +91-8700232311. For heart risk assessment and prevention, book an appointment.

Frequently Asked Questions