Signs & Symptoms

A heart attack may have warning signs. (See below). It can occur without signs, too. This is called a “silent” heart attack.

Causes

1. The most common cause is one or more blood clots that block an artery in the heart. Often, a blood clot forms in an artery already narrowed by plaque.
2. Having a heart attack in the past increases the risk for another one.
3. Spasms occur in the large coronary artery. This can be triggered by: Heavy physical exertion, such as shoveling snow; exposure to cold; severe emotional stress; and having a heavy meal. These triggers are more likely to affect persons who are not active.
4. Cocaine or amphetamine abuse can cause a sudden heart attack. This can happen in persons with no signs of heart disease.

Common Warning Signs

Feeling of pain (may spread to or be felt in the arm, neck, tooth, jaw, or back), tightness, burning, squeezing, or heaviness in the chest. This lasts more than a few minutes or goes away and comes back.

Chest discomfort with:

• Fainting
• Feeling lightheaded
• NauseaShortness of breath
• Sweating

Other Warning Signs:

• Unusual chest, abdominal, or stomach pain
• Dizziness; nausea; trouble breathing; jaw or arm pain without chest pain
• Fast or uneven heartbeat or pulse
• Sweating for no reason, pale, gray, or clammy skin.

Signs More Likely in Women Than Men:

• An uneasy feeling in the chest with:
• Unexplained or extreme anxiety
• Unusual fatigue or weakness
• Fluttering heartbeats
• Severe indigestion that doesn’t go away with an antacid.

Note: If any of these signs occur, call 9-1-1. Then, give “First Aid for a Heart Attack Before Emergency Care” listed below.

First Aid for a Heart Attack Before Emergency Care

• Check for a response. Do CPR, as needed.
• If the person uses and has nitroglycerin, place one tablet under the tongue. Give as many as 3 tablets in 10 minutes.
• Give the person a regular (325 mg.) aspirin or 4 children’s chewable aspirins (81 mg. each) to chew on. Give the aspirin after calling 9-1-1. Ask the 9-1-1 dispatcher if aspirin should be taken. {Note: Don’t use aspirin if the person is allergic to it or has a condition that makes using it risky.}
• If you can’t call 9-1-1, drive the person to the hospital right away. If you are having heart attack signs, don’t drive yourself unless you have no other choice.
• Loosen clothing around the neck, chest, and waist. Don’t let the person lie down, especially if he or she has breathing problems. A half-sitting position is better. Put the legs up. Bend them at the knees. Put a pillow or rolled towel under the knees. Support the back.
• Reassure the person that you have called for medical help and will stay with him or her until it arrives.
• After a heart attack, follow the doctor’s treatment plan.

Signs & Symptoms

For Severe Dehydration

• Severe thirst (sometimes).
• Sunken and dry eyes. Tearless eyes. (Infants may not show this sign.)
• Dry mouth, tongue, and lips.
• No urine or a low amount of urine that is dark yellow.
• Sunken fontanelle (the soft spot on an infant’s head).
• Feeling lightheaded, especially when getting up quickly.
• Dry skin that doesn’t spring back when pinched.
• Feeling dizzy. Confusion. Severe weakness.
• Increase in breathing and heart rate.

 Causes

• The body does not get enough fluids for its needs.
• Too much water or other body fluids and electrolytes, such as sodium and potassium, are lost. This can result from: Repeated episodes of diarrhea and/or vomiting; heavy sweating; heat exhaustion; or heat stroke.

Treatment

Fluids and electrolytes must be replaced. If this cannot be done by mouth, they are given through an IV solution.

Do any of these problems occur?

• Signs of severe dehydration listed above.
• A child or person has been left in a hot car or other hot, enclosed place and has any of the signs listed at left.
• After being in hot conditions, 2 or more signs of heat exhaustion

Self-Care / First Aid

• If vomiting isn’t present, adults and children over age 12 should drink about 2 cups of fluid per hour. Fluids of choice are: Sports drinks; flat cola; clear sodas; broths; popsicles; and gelatin.
• If you have high blood pressure, heart disease, kidney disease, diabetes, or a history of stroke, you should find out what fluids your doctor prefers you take when you need to replace lost fluids.
• For children under 2 years old, consult your child’s doctor about the amount and type of fluid to give. Ask your child’s doctor about using over-the-counter products that give fluid and electrolytes. Examples are Pedialyte and Infalyte.
• For children over 2 years old, give up to 1-1/2 quarts of fluid per day.

Most adults can donate a pint of blood without harmful side effects. Losing a quart of blood, quickly, though, can lead to shock and even death. In a child, losing a pint (or less depending on the child’s size) can put the child in extreme danger.

For External Bleeding

• A skin wound.
• Dark red blood gushes or flows from veins.
• Bright red blood spurts from arteries.
• Blood oozes from capillaries. The bleeding usually clots off by itself.

For Internal Bleeding

• Vomiting or coughing up true, red blood. This includes blood-tinged sputum.
• A bruise on the skin of the chest or abdomen, especially if it is in a place where no blow was struck.
• Fractured ribs.
• Fainting. Weakness.
• Excessive sleepiness. Mental status changes. These can occur with trauma to the head, even if it is mild.
• Fast pulse. Cold, moist skin.
• Stools contain bright red blood or are black (not due to taking iron).

Causes

For External Bleeding

• Abrasions (scraped skin). Lacerations (cut skin with jagged edges). Punctures. (See Skin Injuries / Wounds.)
• Knife, gunshot, or other wounds can graze or penetrate the skin. These can damage internal blood vessels and body organs.
• Injury wounds.

For Internal Bleeding

• A bruise. This is bleeding from and damage to tissues beneath the skin.
• Damage to blood vessels and/or internal structures. This includes a blunt injury that does not break the skin, a bleeding ulcer, and an aneurysm.
• Bleeding disorders. Taking blood-thinning drugs can result in both internal and external bleeding.

Treatment

When bleeding occurs, the goal is to find the source, stop or lessen the bleeding, and help the body cope with the loss of blood.

• For severe bleeding, treatment includes first aid measures and emergency medical care.
• For minor bleeding, treatment depends on the cause and other medical conditions present.
• Bleeding disorders need to be treated by a doctor.

Self-Care / First Aid

For Severe Bleeding

• Without delay, apply direct pressure to the wound using a sterile dressing or clean cloths. {Note: If the cut is large and the edges of it gape open, pinch the edges of the wound while you apply pressure.}
• Call 9-1-1 or take the person to nearest hospital emergency department.
• Do not remove an object that is stuck in a wound. Pack it in place with padding. Put tape around the padding so it doesn’t move.
• If bleeding continues before getting medical help, put extra cloths, etc. on top of existing ones. Keep putting pressure on the wound until bleeding stops or until medical help takes over.
• The most important thing to do is to apply direct pressure on the bleeding site. Some health experts advise to do these things, too, if needed:
• Elevate the wounded area higher than heart level while applying pressure. Do this if no bone is broken.
• Apply pressure to a pressure point; if bleeding still continues after 15 to 20 minutes of direct pressure, Use the pressure point closest to the bleeding site that is between the wound and the heart. (See Pressure Points at right.)
• Don’t apply a tourniquet except to save a life.
• While giving first aid for bleeding, keep looking for signs of shock.

A fishhook can nick or cut the skin, get stuck in the skin near its surface, or get deeply embedded in the skin.

Self-Care / First Aid

For a Fishhook Deeply Embedded in the Skin

• Put ice or cold water on the wound area to numb it. Push on the shaft of the hook until the barb protrudes. With wire cutters, snip the hook at either the shank or the barb. Pull the hook out.
• Wash the wound area well with soap and water. Treat for a puncture wound.

For a Fishhook Stuck Near the Surface of the Skin

• Put ice or cold water on the wound area.
• Take a piece of fishing line. Loop one end and tie it to the hook near the surface of the skin. Grasp the shaft end of the hook with one hand and press down about 1/8th inch to disengage the barb.
• Keep pressing the hook down and jerk the fishing line in a motion parallel to the skin’s surface to make the shaft of the hook lead the barb out of the skin. Treat for a puncture wound.

Note: For nicks or surface cuts to the skin, treat for a cut.