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CALLING 911 TRUMPS COUGH CPR

From Washington University Physicians, posted September 8, 2009, written by Mary Jo Blackwood, RN, MPH

We’ve all received forwarded emails telling us to do a particular treatment to save our lives. They usually end with the dire warning to tell everyone you love. Too often we don’t bother to check them out before we send them on. They just seem so compelling. 

One great example is the PowerPoint email that has been circulating since 2004 about cough CPR. The email advises you if you are driving alone in your car and start experiencing symptoms of a heart attack, to start coughing forcefully. The email implies that it will buy you time to drive yourself to the hospital.

The American Heart Association says don’t do it. Pull over to the side of the road and call 911 or get someone else phone for you. Andrew M. Kates, M.D., Medical Director for the Heart Disease Prevention Program at Washington University, explains the origins of cough CPR, as it is called.

“Rhythm problems can cause you to pass out. The idea with “cough CPR” is that if you cough hard enough, you may be able to increase blood flow to your brain, and maintain consciousness a few seconds longer. Coughing may help get rid of certain types of heart rhythm irregularities such as supraventricular tachycardia (SVT) which originate in the upper chambers of the heart.   The problem is that with heart attacks and other true cardiac emergencies, we are more concerned with ventricular rhythm disorders that do not respond in this way.

“Cough CPR is not taught to lay people because it would distract from the ABCs of resuscitation:

Airway
Breathing
Circulation

In some cases, coughing could make it worse. Coughing is not the right approach.” Kates says every moment you spend coughing is time taken away from getting the right help. “Most importantly, call 911. The delay and the hazards of trying to drive yourself to the hospital aren’t worth the risk. If you lose consciousness while driving, not only can you hurt yourself, but other people on the road.”

Calling 911 and getting skilled responders have far more advantages than coughing:

Trained rescuers can do an EKG on the spot to verify a cardiac emergency.
They can initiate therapy immediately, right there on the spot, including defibrillation for a potentially fatal ventricular heart rhythm. 
Getting to the Emergency Room through traffic by ambulance is quicker; and ambulance patients are evaluated more quickly than if you try to check yourself in and have to wait. 

“Prevention is the best way to keep this sort of scenario from happening. Be aware of the symptoms of a heart attack. Know your risk factors and work with your doctor about controlling them. High blood pressure, high cholesterol, diabetes, smoking, physical inactivity, and family history all come into play. Smoking and physical inactivity are the most treatable risk factors. If you do have heart attack symptoms, pull over, call 911, and chew an aspirin (if you have one) while you wait for help to arrive.”

Symptoms of a Heart Attack:

Chest pain or pressure that doesn’t go away in a couple of minutes
Heaviness in the chest like an elephant sitting on it.
Sweating
Shortness of breath
Nausea
Lightheadedness
Radiation of pain down either arm

Women are more likely than men have atypical symptoms, such as nausea, but also have the usual symptoms. Unlike angina symptoma (or chest pain from a partial blockage) that tends to occur with activity, heart attack symptoms often occur at rest.

About those Emails:

Before you pass on emails that claim lifesaving properties of certain actions or therapies, make sure you check them out with a reputable source.

For cardiac emergencies, talk to your doctor, check with the American Heart Association (http://www.americanheart.org), WebMD, or other peer-reviewed sites. 
For cancer cures, check with the American Cancer Society. Did you read the one about asparagus curing cancer? Not true. 

Many of the warnings out there may have a basis in truth, but to follow their advice can be life-threatening. 

A website  good for debunking these myths is www.Snopes.com. It often has the exact wording of the email and will refer you to reputable sites like the ones above. Be informed before you email.


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Copyright 2009 Washington University School of Medicine
Copyright 2009 Washington University School of Medicine