Baby Boomers and cardiac incidents

As more hikers are in the "over 50" category and many in their 60s and 70s we are seeing more cardiac arrests and/or survived heart attacks on the trail. I personally know of three regional Sierra Club trail incidents in the past 5 years.

As this becomes more prevalent it behoves us to:
1. have a thorough cardio-vascular checkup yearly or at least semi-annually.
2. be trained in CPR EVERY year if possible

Plus, there is a new Bayer aspirin, crystals in an 850 mg. dose in a small foil tube. I now carry this in my 1st aid kit and recommend it because it's THE fastest acting aspirin compound available and it's a LARGE dose of aspirin. Both factors are critical in heart attack patients.

For someone having cardiac infarc symptoms (you?) on the trail it could be a life saver. As the Toiyabe Chapter (all of Nevada) Outings Chair I'm recommending this form of aspirin to all four of my regional Group Outings Chairs to tell their outings leaders to carry. It's that important.

Now, guys, we need to learn women's cardiac problem symptoms. They differ from men's symptoms as a rule, and their seriousness can be overlooked, even by physicians.

Eric

Thanks for the good info - I'm in that "over 50" group. Although I currently have no problems, as I continue to age I find that I am sticking to the less strenuous, more traveled trails as a response to whatever heightened risk I might have. And, I'm finding that I still enjoy it just as much.

My own CPR instructor made it plain to us, his students, that CPR is only an emergency stopgap measure to be employed while awaiting EMT assistance.

Anyone who is in cardiac arrest is, to all intents, a dead person already and even poorly administered CPR cannot possibly do any more damage than has already taken place. So it is worth trying in any case.

However, doing CPR is exhausting. Even running a team of people at the victim can only buy you so much time while waiting. If assistance is too remote, the victim dies.

Coming away from that class, I realized that, although I might suvive a mild to moderate cardiac infarction in the backcountry, if I suffered a cardiac arrest I would not survive under any imaginable circumstances.

And, macabre as it might sound, there are probably worse ways and worse places to die.

Glenn,

As I typed my new post I felt I'd leave out the dismal success rate of CPR. Four of the five hikers on Club hikes did not survive, despite CPR, administered for one hour in one case. But if a person is having a SURVIVABLE cardiac infarc the aspirin could be a livesaver in thinning the blood enough to get enough past a mild blockage to reduce muscle damage.

In fact the aspirin may just prevent the pending complete blockage. It is a recommended treatment in wilderness settings where paramedics and their equipment and meds are distant, as is rapid evacuation.

The bottom line is do whatever you can to help the patient - and then pray a lot as you assist them.

Eric

The aspirin is a good idea. I would check with the group and see if anyone were allergic to it. It would be a good thing to know.
As a crew leader, I usually have a medical briefing before the trip to make sure I am aware of all possibilities.

T

I also was told in a recent first aid class that without very prompt EMS and hospital ER followup and the presence of one of those automatic external defibrillator devices, that CPR is only a stopgap and not very successful in case of heart attack--something like a 5% success rate. The AED is not exactly something any backpacker would want to buy or carry, although it certainly should be in every public building!

On the other hand, CPR can be a true lifesaver in cases of drowning or lightning strike--both accidents that could easily happen to any hiker of any age. In other words, CPR is still very definitely a useful skill to know.

As for me, don't bother--take good care of my dog and let me go in peace!

OM is correct, there are cases where CPR will save lives. For cardiac arrest caused by heart disease, however, it has very low success rate out of hospital.

I have seen many many active Myocardial Infarctions walk into the ER, go for cardiac catheterization, and walk out of the hospital a few days to weeks later (depending on whether they required by-pass surgery). Usually they present to me as having vague chest pain that radiates to the left jaw and arm. Sometimes they say it came on suddenly or kept them up all night. Sometimes they say it lasted for 15 minutes a week ago with no pain since, but their doctor wanted them to be checked out anyway. Sometimes there's nausea, cold sweats, very pale skin. Sometimes the symptoms are so mild that when you tell the patient they are having an MI they look at you in disbelief.

Women do have different symptoms. Often they will have chest pressure, nausea, body aches and shortness of breath, but nothing that says "cardiac" right off the bat. Often they will tell me they just don't feel well, and the onset was sudden.

For many cases of sudden cardiac arrest, the person will have had underlying cardiac disease whose symptoms were either so mild they didn't notice it, or present but ignored or written off as "heartburn" or "getting old". Any cardiac symptoms, no matter how mild or transient, should be reported to your physician. A simple CT can show the degree of blockage present in the 7 coronary arteries.

MNS

My wife is certified to teach CPR, 1st Aid (adult & pedi), AED, and other type courses. She estimates that some of the current AED's weigh about 7lbs.
As with other electronic instruments, could they be eventually be made in the 3-5lb range?

If so, you might find them being required for certain group expeditions (such as BSA high adventure treks).

All three of our crews were trained in 1st Aid/CPR/AED and at least two members from every crew were trained in Wilderness 1st Aid.

Having an AED might mean the difference between life and death for some (even apparently healthy young people).
But I agree with OM, I wouldn't want to carry one at this time.

Tango

You ask me, I'm back to the same thing I posted to the topic of a snake bite kit that works:



If you're in full on cardiac arrest in the backcountry, as mentioned, there are worse places to die. Failing that, press the button, take an asprin, stay calm and wait for professional help to fly in.

No I'm not condoning hiking back into the boonies if you are at high risk. but in all seriousness you're probably better off with that than you are just about anything else you can carry.

I agree with you.

I carry a PLB when alone. It may save my life but at a minimum it will save my wife the heart ache of not being able to find the body.

In addition to the weight of an AED, they cost a couple thousand bucks. The cost alone, in addition to the weight, makes them impractical for backpacking.

If I code out there on the trail, PLEASE don't do CPR. When you get back, you can tell someone where to recover the body. Thanks!

I can personally vouch for this. I didn't have a heart attack, but had mild discomfort walking up a long hill. After putting it off for quite a while, I went to the doctor. After a few other tests, he sent me for an echo stress test, which showed up some blocked coronary arteries. They did an angiogram that afternoon and inserted two stents in the arteries. This is an amazing procedure, by the way. I spent exactly one night in the hospital and suffered very little discomfort.
"Get it checked" is good advice. I was on my way to a heart attack. BTW, I passed my follow-up stress test with flying colors, and am anxious to get out in the mountains again.

Bill K...

Glad to hear you "got it checked out" and got the medical care you needed! Thanks for sharing your experience.

MNS

Good to see ya on the board MNS03. Hope all is well and you are enjoying the long days (of sun that is - not work).

Well, so far May has been pretty insane for me, but the trails are finally starting to firm up and I'm trying to get some hiking in when I can. Only local trails... nothing extended. It may be some time before I will have an opportunity for anything longer than a quick trot around a loop trail. The long days sure are nice though... it is getting light already at 4:45am, and it will stay light until well after 10pm tonight. I just wish it were a wee bit warmer.

Just spent 2 weeks in an EMT-3 class (adding a cardiac component to my EMT-B plus IV/Intubate skills), and now I'm looking at maybe going back to school starting this summer. I've got some stuff in the works but won't know for sure for a little while yet. One thing is for sure... it won't be in AK!

MNS

Im a newbe I apriciate the in formation here. Im 64 years old wit heart problems. I want to thank you all for helping.
I will take erics advice on the bayor aspirn thanks much Jim

Please talk to your physician about the aspirin. It's not for everyone! It turned out that my blood is already too thin, which is why I was getting retinal bleeds every time I took aspirin.

I also found out that it's vitally important to let all physicians and dentists you encounter know if you're taking aspirin or ibuprofen (which also thins the blood). They will probably want you to stop taking it a couple of weeks before surgery (including dental surgery), but they don't always ask! We also tend to forget about over-the-counter stuff when they ask if we're taking any drugs. My ex ended up in the hospital with severe bleeding after a tooth extraction.

You say your EX ended up in the hospital with severe bleeding after a tooth extraction...

How exactly were you extracting the tooth?

(Sorry, OM, couldn't resist.)

It was his dentist, not me!

That's your story and you're sticking to it!

Sorry to be late chiming in on this one. First I have high blood pressure and cholesterol. I started backpacking again partially due to this senario. I have been on blood pressure medicine since age 36 or 37.I started because I was having chest pain.I i have had numerous stress and stress eco test! However,since started walking and hiking again a year and a half ago, My bp meds have been cut in half as have my cholesterol. I am 47 now! The crystal aspirin dose intriged me so I mentioned it to my wife. My wife is in the medical field and she said just put a asprin or two under your tounge to disolve. This is apparently the most direct route to the blood stream via topical. I will not mention the other! Anyway, I though this ifo may help someone who could need it

Hi,
Thank you all for sharing this info as this is really good to know!