It’s all about time when it comes to getting lifesaving treatment for heart attack and stroke. That’s just one of the messages a panel of trauma experts from Providence Santa Memorial Hospital delivered at a Nov. 2 town hall on medical emergencies. A large crowd of Oakmonters got advice on dealing with obvious – and a lot of not so obvious – traumatic injuries, ranging from recognizing sepsis to avoiding falls.
“Time is muscle,” said Omar Ferrari, DO, chief of Emergency Medicine. “For every minute (of delay), you have heart muscle that is dying for lack of blood.”
Brian Schmidt, MD, a Providence surgeon and trauma specialist who was instrumental in establishing the hospital as the region’s Level II Trauma Center, urged not second guessing a trauma. “If you think you’re having a heart attack or stroke (or other trauma), you definitely want to call an ambulance,” he said, pointing out the potential for a deadly arrythmia (a problem with the rate or rhythm of the heartbeat), which be can treated with shock. Likewise, ischemic strokes have a window of successful treatment, and administering clot-busting drugs in that window can make a patient a candidate for follow-up advanced plaque removing technologies to restore normal blood flow and reverse a “devasting stroke. “What we are seeing is nothing short of miracles. That is the rule, rather than exception, if you can get to us quickly. That is the whole key,” Dr. Ferrari said.
While many classic symptoms of heart and brain attacks are recognizable, subtle presentations demand equal attention. Women’s heart symptoms, for example, can be as innocent as a toothache or shoulder pain. Dr. Ferrari said a man who complains of fullness or a need to “belch” is a red flag.
The physicians urged the audience to be vocal about symptoms and not be embarrassed or reluctant to seek help. “We’d rather see you and tell you everything is okay than have you suffer irreparable damage,” Dr. Ferrari said.
The warning signs of sepsis, a life-threatening emergency, can also be subtle and complicated by delay. Sepsis is an extreme response to infection that moves to the bloodstream and triggers a chain reaction in the body. The mortality rate from sepsis increases 10% for every hour it goes untreated.
Fever is one of the key warning signs of sepsis, and it doesn’t have to be high. “As we age it is harder to mount a fever,” said Dr. Ferrari. “An 80 year old can be frankly septic at 100.6 (degrees), and as you age, your bodies become less and less able to mount inflammatory response to a pathogen. … I don’t want anyone saying, I have a low-grade fever, it must be nothing. Look at the things that don’t add up when someone has a simple infection.”
The panel also had advice for bystanders of traumatic injury and emergencies. Learn CPR, know where automatic defibrillators (AED) are located, take steps to avoid falls, and make sure you or your surrogate have your medications easily available and put them in your smartphone. (See related story).
You can access a video recording of the town hall at Oakmontvillage.com/videos.