Who Best At Your Side During Major Heart Attack?

[JasperC]

Anestesiologists probably have the skill set of all the others combined.

It's an anestesiologist who keeps you alive during surgery, and when complications arise in the OR it's usually their fault, so they know how to revive someone.

[Buccaneer]

[ QUOTE ]
Who Best At Your Side During Major Heart Attack?

[/ QUOTE ] Skalansky as usual you forgot one.
GOD

[Buccaneer]

[ QUOTE ]
have the person chew an aspirin or Goody's or BC powder (Tylenol and Advil are useless),

[/ QUOTE ] So, so, so wrong.

You need to stick to poker advice.

Someone else mentioned MONA. A Goody's or BC has a huge dose of caffeine. Caffeine is sort of an anti-MONA. It increases anxiety which increases the heart rate which is one of the reasons morphine is given. Oxygen, we want to decrease the oxygen needs of the heart while increasing the oxygen that is available. Heart rate increases from caffeine increase the oxygen needs of the heart and atrial arrhythmias from caffeine decrease the oxygen available to the heart. Nitro dialates blood vessels of the heart and guess what caffine does. Aspirin is in "powders" but that does not make it a cardiac medication.

Please don't anyone substitute "powders" for an aspirin in an emergency. Just call 911 and wait.

Don't give medical advice and non poker pros won't advise anyone to cap 27 from the blinds.

[Piemaster]

[ QUOTE ]
[ QUOTE ]
Who Best At Your Side During Major Heart Attack?

[/ QUOTE ] Skalansky as usual you forgot one.
GOD

[/ QUOTE ]

Yeah, that's just what you need. An overhaul of your entire belief system when you're already in the middle of a heart attack [img]/images/graemlins/wink.gif[/img]

[MM_red33]

paramedic.

i work in a hospital and thts what i would pick. DRs call the shots rarely do the grunt work like compressions.

[Matt Flynn]

[ QUOTE ]
[ QUOTE ]
have the person chew an aspirin or Goody's or BC powder (Tylenol and Advil are useless),

[/ QUOTE ] So, so, so wrong.

You need to stick to poker advice.

Someone else mentioned MONA. A Goody's or BC has a huge dose of caffeine. Caffeine is sort of an anti-MONA. It increases anxiety which increases the heart rate which is one of the reasons morphine is given. Oxygen, we want to decrease the oxygen needs of the heart while increasing the oxygen that is available. Heart rate increases from caffeine increase the oxygen needs of the heart and atrial arrhythmias from caffeine decrease the oxygen available to the heart. Nitro dialates blood vessels of the heart and guess what caffine does. Aspirin is in "powders" but that does not make it a cardiac medication.

Please don't anyone substitute "powders" for an aspirin in an emergency. Just call 911 and wait.

Don't give medical advice and non poker pros won't advise anyone to cap 27 from the blinds.

[/ QUOTE ]



You are saying that because of the caffeine in a Goody's or BC powder that it is better to delay aspirin therapy for 20-30 minutes than to give that? I find that stunning. Do you have data in heart attack patients to support your claim?

In the my area of South where powders are common, people often do not have aspirin available but they do have Goody's and BC powders. If you want to get more specific and say aspirin is better or wait for the EMR if response time is expected to be very rapid, that's fine. Otherwise, educate me. I'm listening.

Also, please specify your level of training. It sounds from the way you are talking -- specifically your reliance on physiology instead of outcomes data in heart attack patients -- that you are yourself a medical student.

Matt

[Matt Flynn]

Edit function appears not to be working:


First, I strongly suspect based on his post that I outrank Buccaneer medically by several years of training.

Physiology is often misleading or wrong. Only outcome data matter. For example, the nitrates Buccaneer refers to are a coronary vasodilator (good), but giving nitrates has no effect on mortality in a heart attack patient. Physiology says it should work very well for heart attacks. Outcomes data says it doesn't really matter.


Here are some outcomes data on the subject:

http://www.ncbi.nlm.nih.gov/entrez/query...bmed_docsum

1: Am Heart J. 2004 Jun;147(6):999-1004.Click here to read Links
Caffeinated coffee consumption and mortality after acute myocardial infarction.

* Mukamal KJ,
* Maclure M,
* Muller JE,
* Sherwood JB,
* Mittleman MA.

Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Mass 02215, USA. kmukamal@bidmc.harvard.edu

BACKGROUND: Previous studies have generally suggested no effect of coffee consumption on the risk of acute myocardial infarction. The effect of coffee consumption on prognosis after acute myocardial infarction is uncertain. METHODS: In an inception cohort study, we observed 1935 patients who were hospitalized with a confirmed acute myocardial infarction between 1989 and 1994 at 45 community hospitals and tertiary care centers in the United States, as part of the Determinants of Myocardial Infarction Onset Study. Trained interviewers assessed self-reported caffeinated coffee consumption before infarction with a standardized questionnaire. We analyzed survival censored at December 31, 1995, using Cox proportional hazards regression. RESULTS: Of the 1902 patients for whom we had information on coffee intake, 315 (17%) died during a median follow-up period of 3.8 years. Coffee drinkers tended to be men, younger, and free of comorbidity, and they were more likely to be current smokers. Coffee consumption was not associated with an overall change in long-term post-infarction mortality rate. However, we did observe an unexpected and unexplained variation in the association between coffee consumption and mortality with time, with an apparent inverse association in the first 90 days after infarction. CONCLUSIONS: Self-reported coffee consumption has no overall association with post-infarction mortality. The unexpected time variation in the effect of coffee intake requires evaluation in other studies.



Meanwhile, aspirin has extreme benefit for someone having a heart attack. No other drug reduces mortality from heart attacks as well as it does.

[surftheiop]

I was gonna guess this, seeing as i think people are really close to "dead" while they are having surgery

[StregaChess]

In your case the local parish priest....

[img]/images/graemlins/grin.gif[/img]

[Buccaneer]

[ QUOTE ]
I was gonna guess this, seeing as i think people are really close to "dead" while they are having surgery

[/ QUOTE ]

Not at all, this is some kind of myth probably spread by the same people that want you to "take a Goody's" for a heart attack.

Just ask Flynn, he is some kind of ambulance driver or something.