Heart attacks, acute myocardial infarction, will likely challenge us at some point when our society collapses. Not only will societal collapse include a collapse of the medical system and advanced treatment, it will also include a lot of stress associated with the aftermath. And that stress will have a damaging effect on the heart for some individuals. While a heart attack will be fatal for many, it doesn’t have to be for everybody. There is a lot we can do to prepare and prevent, and there are also some treatment options, even in austere circumstances.
Let’s begin with basic information from The Ship’s Medicine Chest and Medical Aid at Sea:
Acute Myocardial Infarction (Heart Attack, Coronary Occlusion)
The patient frequently is a heavy cigarette smoker over 40 years of age. A history of hypertension, diabetes, angina pectoris, or a previous myocardial infarction will help confirm the diagnosis of a heart attack. The pain usually is centered behind the breastbone and is not intermittent or pulsating. Generally it is described as a pressure or squeezing sensation. The pain builds in intensity over the first minutes and lasts from a half hour to several hours. Pain may travel to the left shoulder or left arm, the lower jaw, or upper abdomen. Less often, it radiates to the right shoulder or right arm. Sweating, nausea, and a feeling of impending death often are associated features. The pain is not relieved by changes in body position nor affected appreciably by breathing. If the patient goes into shock or acute heart failure, he may not survive.
Some patients with acute myocardial infarction do not have chest pain. They may have fainting, shortness of breath, or palpitations. Because belching and vomiting are common with heart attacks, one should not be misled and attribute the chest pain to “indigestion.”
Treatment
The conscious patient suspected of having a myocardial infarction should be put to bed in a half-sitting position.
For severe pain, morphine sulfate 10 mg by intramuscular injection should be given. If additional doses of morphine sulfate are required, medical advice by radio should be obtained before continuing the medication. If the patient’s skin or mucous membranes show a bluish tinge in color (cyanosis), reduced oxygen in the blood or lungs is indicated. If oxygen is available, it should be administered. (See p. 123.)
Medical advice by radio always should be obtained. Evacuation should be arranged as soon as possible.
This concludes the entry in The Ship’s Medicine Chest. Following is further information from off-grid medicine guides and other medical research to prepare, prevent, and treat heart attacks in our family members.
PREVENTION
Every book and article and every doctor will advise people to do the following to reduce the risk of heart attacks:
- Eat well
- Exercise regularly
- Avoid cigarettes and alcohol
- Lose weight
- Off-grid medicine guides suggest one baby aspirin (81 mg) per day in individuals for whom it is indicated and if you have sufficient supplies:
- Men over 40
- Women past menopause
- Anyone with a family history of heart disease[0]
Almost nobody ever mentions the importance of being a nice person (now there’s something to cause me stress) and maintaining healthy family relationships and a positive outlook on life. Research published a few decades back on the difference in rabbits between those which were just given the basics of food and water and those that were also petted and cuddled showed “what affects our health in the most meaningful ways has as much to do with how we treat one another, how we live, and how we think about what it means to be human.”[1] To summarize, other practices that will reduce the risk of heart attack include:
- Being a nice person
- Maintaining hope and faith
- Having a supportive family
Of course, there are still going to be some heart attacks despite our best efforts. Unfortunately, without a laboratory and diagnostic equipment, even physicians will have to make a diagnosis based on the history alone. We won’t be absolutely certain.
SYMPTOMS
- Crushing sensation in chest
- Pain radiating down the left arm
- Pain in the jaw area
- Weakness
- Fatigue
- Sweating
- Pale skin
TREATMENT
Precordial thump. “If a patient who has been having chest pain collapses in front of you, a precordial thump (a firm—but not excessive—blow with a closed fist delivered to the lower third of the breast bone) may be useful and can sometimes reverse a lethal heart rhythm—it delivers the equivalent of 5-10 joules of energy to the heart—compared with 200-300 with a defibrillator.”[2]
Aspirin. Administer aspirin immediately. As the aspirin will get into the bloodstream faster if it is chewed, chewable are desirable. Coated aspirin will not work as quickly, and time is of the essence. The aspirin will do little for pain. Its job here is to thin the blood and hopefully limit further damage.[3]
Oxygen. If you have oxygen available, administer 2-3 liters per minute. Some of the pain experienced is due to low levels of oxygen within the heart muscle, so increasing oxygenation may reduce the pain.
Lie down. Have the patient lie down, preferably in a bed, with the upper body propped up on pillows at a 45° angle and loosen constrictive clothing. This reduces the demand on the heart muscle for oxygen and to work and thus also relieves pain to some extent.
Nitroglycerin. Administer nitroglycerin if you have it.
Pain relief. Morphine is what physicians normally administer for pain relief. Other options:
- Vicodin
- Percocet
- Tramadol
Nausea. If the patient also has nausea, an anti-emetic may need to be given to permit the patient to keep the pain meds down.[4]
- Meclizine
- Phenergan
- Zofran (ondansetron)
The patient must rest for 48-72 hours to prevent stressing the heart muscle.
Now, you might be wondering about CPR. Remember, CPR is only for dead people. If you patient is alive, you don’t do CPR. Dr. Alton, in his off-grid medicine book notes that CPR is much more useful when the patient will have modern medical facilities for treatment.[5] Dr. Steve indicated that he would not recommend CPR for patients with a history of heart disease; those individuals will need advanced medical care, which will be unavailable. There won’t be the maintenance medications to keep them alive. (CPR in austere situations is only indicated in those patients who do not have a history of heart disease—those whose hearts have stopped due to hypothermia, lightning strike, or anaphylaxis.)
Medically, from a western medicine standpoint, that’s about it.
Herbal treatment
Cayenne pepper tincture, 2 droppersful under the tongue, even if the patient is unconscious (anecdotal reports indicate that this may even work if the patient appears to be dead—you have nothing to lose). The tincture is much more effective than plain cayenne pepper. Of course, you will need to have this prepared in advance and have it at hand.[6]
Cayenne pepper, 90,000 Scoville heat units, one teaspoon mixed in a glass of warm water. The patient must be conscious and able to swallow.[7]
Psychologically, the following may be helpful:
- Keep anxious or disturbing individuals out of the room[8]
- Let a calm family member comfort the patient by holding his hand or rubbing his neck[9]
Links to related posts:
References:
The Ship’s Medicine Chest and Medical Aid at Sea, 1978, 136.
[0] Joseph Alton, The Survival Medicine Handbook, 2013, 380.
[1] Kelli Harding, The Rabbit Effect (2019), 23-24.
[2] Survival and Austere Medicine, 3rd Edition, 2017, 134.
[3] Cynthia Koelker, Armageddon Medicine, 2012, 249.
[4] Cynthia Koelker, Armageddon Medicine, 2012, 250.
[5] Joseph Alton, Survival Medicine Handbook, 2013, 379.
[6] Joseph Alton, Survival Medicine Handbook, 2013, 379.
[7] Joseph Alton, Survival Medicine Handbook, 2013, 379.
[8] Cynthia Koelker, Armageddon Medicine, 2012, 250.
[9] Cynthia Koelker, Armageddon Medicine, 2012, 250.
15 december 2021
That's a great article, Jennifer. If society ever turns all Mad Max, we will probably find out quickly just how many of our brethren have been sustained by modern pharmacology. Whatever means we can take to save those we hold dear will be critical in preventing the loss of life.
ReplyDeleteEven in normal times, everyone should be carrying aspirin or two in our wallets and purses to help someone survive a heart attack. Total cost? Maybe 10 cents?
BTW, how would you suggest that the cayenne tincture be prepared?
ReplyDeletehttps://prepschooldaily.blogspot.com/2023/05/making-cayenne-tincture.html
DeleteAgain...the best treatment is prevention. Meaning living a healthy lifestyle to prevent heart disease. But if no medical help is available and someone may be having an MI give them half an aspirin...two to three times a day to help prevent clot formation in the coronary arteries which is a major cause of MI and coronary infarction. It's a low risk treatment for most people unless they are already being treated with anticoagulants. Generally most people who have an MI will live or die. Medical treatment can improve survival odds but if you live long enough to get to an ER your odds of surviving are already pretty good. Most people who succumb do so regardless of treatment. Once you survive an MI follow up care can determine if/when you have another MI. But once the cardiac tissue dies the damage is done. Even surviving an MI can have future sequelae. If enough tissue dies you can develop cardiac failure where the heart can't pump enough blood to oxygenate your body. Modern medicine can make an MI survivable but the damage will be done. So do your best to prevent heart disease by eating right ad exercising.
ReplyDeletePlease check your sources on amount of aspirin! Most recent I saw is to CHEW a single aspirin, about 300 mg, unless recent hx of a GI bleed. Morphine helps with blood flow as well as pain, which is why they recommend it specifically (and helpful if considering how to use limited meds).
ReplyDeleteWhat specifically is your question? My husband has been taking a single baby aspirin, 81 mg, every day for years as a prophylactic. It's a common practice. If a person is suspected of having a heart attack, more aspirin should be administered. Morphine is going to be really hard for most people to obtain.
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