Peforming Self-CPR

My Uncle Fred & I have been having a discussion about an email he received instructing you how to save yourself in the event you begin experiencing chest pain and are by yourself or not close to a hospital.  In the email it instructs you to cough deep and as often as you can while you drive yourself to an ER or can call for help, perferrably 911.  The following is our conversation:

Opinion?    ‑fad‑
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This does work to some extent.  We have conscious patients do this all the time for the exact reasons stated.  Increasing cardiac output or to change an arrhythmia.  It doesn't always work and we are always busy doing other things at the same time.  But if you were alone, it is certainly worth the "effort".  But you better be pretty damn close to an ER and/or call 911.   Another potentially life saving step could be if your heart was beating regularly, but super fast (meaning greater than 150 or so a minute, usually around 200).  This is called SVT (super ventricular tachycardia) and is considered a "lethal" rhythm as it can progress into ventricular tachycardia (slower) and then into ventricular fibrillation (arrest).  One thing we have patients do while we are starting IVs and preparing medication is to do a carotid massage or a val salve maneuver (holding your breath and bearing down as if you were having a BM).  Both of these things could be done if by yourself and far from a hospital and have been known to "spontaneously convert" SVT back to normal sinus rhythm.   Did that help?   D   I could've used a few heart attacks last night at work instead of the bucket load of crazy people.  I swear, they were out in force!  ________________________________________________ 

Better to do something besides just wait, I suppose.  We have a friend here who claims to have hit himself on the chest until help arrived!    ‑fad‑
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Well...I've beat on a few chests before, but never my own.   Funniest story about beating on chests ever...   I had just been working in the ER for about 6months and I was in triage.  I went out and called the next name on the list that had an "urgent" complaint of "spells", but the person didn't answer.  So I called the name again...no answer.  Finally I hear this lady go "That's my husband and he's in the bathroom."    So I walk over to her and say "What kind of spells does your husband have?"   "Oh I don't know...he just kind of rolls his eyes in the back of head for a minute or two and then comes back".   "Well, is he shaking at all during these spells?"   "Oh no, just the thing with the eyes."   At this point I become a little concerned because what she is describing could be either seizures or a stroke so I say "How long has he been in the bathroom, do you think I should go check on him?"   "Oh no, here he comes now"   Normal enough looking guy.  No obvious distress.  No shortness of breath.  Not diaphoretic.  Ambulating without assistance or difficulty.  Good color.  Looks damn good to me.  Oh well, I get a wheelchair and take him into triage.  Ask him a bunch of questions and basically get the same response from him except he doesn't know about the eye rolling thing.  He just says "I get all tingly before the spell comes on and then I don't remember anything".  Sounds like a seizure right?   So I take him right back to a monitor bed and hook him up.  Just as I finish the patient goes "I feel one coming on..."  So I watch him and nothing.  He goes "oh no..."  I'm looking at him, right?  Eyes roll back into head, but no seizure.  So I glance up at the cardiac monitor...FLAT LINE!  Holy crap!  "Dr Brown come into Rm10 RIGHT NOW!"  It only takes a second for David to get into to the room and I've lowered the bed to a flat position and am about to initiate CPR when David pushes me back and pounds on the patient's chest with a big "THUMP" once, twice, three times.  Sinus rhythm.  Whew!   So then the guy wakes up a minute later and goes "What happened?  Oh man, I feel like someone just beat on my chest!"   "That is because we just did!"   The man had a complete heart block and been have periodic episodes of asystole.  So............tell your friend to beat away!  Can't hurt!  But if he can keep on beating on his chest he probably doesn't need to!   D