Tuesday, April 17, 2012

How to Survive a Heart Attack When Alone: Cough CPR, is it safe?

Cough CPR has been the subject of a series of chain email campaigns. These emails are typically of the following format:
Since many people are alone when they suffer a heart attack, this article seemed in order. Without help the person whose heart stops beating properly and who begins to feel Faint, has only about 10 seconds left before losing consciousness. However, these victims can help themselves by coughing repeatedly and very vigorously. A deep breath should be taken before each cough, and the cough must be deep and prolonged, as when producing sputum from deep inside the chest. A breath and a cough must be repeated about every two seconds without let up until help arrives, or until the heart is felt to be beating normally again. Deep breaths get oxygen into the lungs and coughing movements squeeze the heart and keep the blood circulating.

This technique is NOT recommended by the AMA, here are the reasons:  

Cough CPR is a fake resuscitation technique described in an email that began circulating around 1999, in which by coughing and deep breathing every 2 seconds a person suffering a cardiac dysrhythmia immediately before cardiac arrest can supposedly keep conscious until help arrives (or until the person can get to the nearest hospital). Cough CPR is most likely a lay interpretation of a "Vagal Maneuver". A vagal maneuver is a technique where a person bears down (as if trying to forcefully pass wind) to stimulate the vagus nerve. This is helpful in cases when a person experiences a dysrhythmia such as Supraventricular Tachycardia (SVT). The vagal nerve stimulation sometimes can slow down the rapid heart rate and convert SVT back to a normal sinus rhythm.
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Although the vagal maneuver is in fact taught to doctors, nurses and paramedics, this widely-circulated email confuses the difference between a "heart attack" and a "cardiac arrest" and cardiac dysrhythmia. Cough CPR is supposedly intended only for imminent cardiac arrest, yet it would be impossible for anyone to know if cardiac arrest was imminent. Neither the American Heart Association nor the American Red Cross endorses cough CPR during a heart attack.
This confusion appears to revolve primarily over the public's failure to discriminate between a heart attack and cardiac arrest and cardiac dysrhythmias.

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