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              CIRCULATION - HEART ATTACKS & CARDIAC ARREST
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   Sudden  interference with the normal action of the heart will have
   serious consequences. This can occur if a blood clot blocks a
   coronary artery preventing blood reaching the heart muscle ( Coronary
   Obstruction/Thrombosis ), or because the heart is stopped for another
   reason.

   Symptoms and Signs
   -------------------
  
   Sudden, crushing, vice like pain in the centre of the chest 
   ( sometimes described as severe indigestion ) which may spread to
   the arms, ( usually LEFT ARM ) throat, jaw or back.

   Sudden dizziness or giddiness causing the casualty to sit down or
   lean against a wall for support.

   Skin may ashen; lips and extremities may become blue ( Cyanosis ).

   Profuse sweating may develop. Breathlessness may occur.
 
   Fast pulse which becomes weaker and may become irregular.

   Symptoms and signs of shock. ( See previous page )

   Unconsciousness may develop. Breathing and heartbeat might stop.


   Treatment
   ---------

   1:  If conscious, gently support and place the casualty in a half-
       sitting position with head and shoulders supported and knees
       bent.

   2:  Loosen any constricting clothing around the neck, chest and 
       waist.

   3:  If the casualty becomes unconscious but is breathing normally,
       place in the Recovery Position. ( See Resusitation )

   4:  If breathing and heartbeat stop, beging Resusitation immediately.

   5:  Check breathing rate, pulse and responsiveness at 10 minute 
       intervals.

   6:  Remove to Hospital immediately. Transport as a stretcher case
       maintaining the treatment position.


   CARDIAC ARREST
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   This is a very serious condition in which the heart suddenly stops
   beating altogether. It can be the result of an extensive coronary
   obstruction.

   Symptoms & Signs
   ----------------

   The casualty becomes unconscious.     No pulse can be found at neck.
  
   Breathing and heartbeat will cease.   Skin becomes ashen.


   Aim
   ---
 
   Attempt to revive the casualty by commencing Resusitation without 
   delay. Arrange removal to Hospital, making it clear that heart
   attack is suspected.

   Treatment
   ---------

   1:  Begin Resusitation immediately.

   2:  Remove to Hospital immediately. If necessary, continue 
       Resusitation on the way to the Hospital.

  
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