2002 - The fall NCMIC Examiner prints case study # 4223709, "Doctor Misjudges Coronary Symptoms; Failure to Refer Results in Tragedy." Readers are reminded of unstable angina risk factors and potential risk-management implications.
2003 - The summer NCMIC Examiner contains two grateful letters to the editor from DCs who had patients with similar experiences in which tragedy was averted.
2003 - The June issue of JACA hopes to provide some life-saving advice if a DC suffers a heart attack while driving alone: Start coughing to squeeze the heart and keep blood circulating to the heart.
2003 - The July issue of JACA retracts the June advice. Although the advice came from a good source, it "turned out to be an urban legend." The July 2003 JACA revises the advice: Pull over to the side of the road and flag down another motorist for help or phone 911 on your cellular telephone.
2003 - July 2: Chiropractic leader Dr. Fred H. Barge passes suddenly from a heart attack.
What is surprising is that neither the JACA nor the Examiner (both chiropractic publications) give any advice beyond referral, even though the chiropractic literature over the years has given various examples of life-saving techniques DCs have used to help cardiac patients. In the event you have also forgotten (or missed) these techniques, they are reviewed for you from past to present:
1966 - Major Bertrand DeJarnette, DC, in his book Chiropractic First Aid1 devoted four of the book's 66 pages to heart attacks. In addition to covering the basics of CPR and the importance of prompt referral, "The Major" gave the following helpful hints:
- To help restart the heart: Place two thumbs under the left lower rib border and push up strongly.
- Pulse fast and weak: Press at the sternoclavicular junction with the thumbs, one side at a time, to slow the heart and re-establish the pulse rhythm. Thumb pressure can also be applied to the eyeballs.
- Pulse slow and weak: Strike the cervical/thoracic junction at the top of the shoulder to speed up the pulse.
1991 - John A. Amaro, DC, FIACA, and acupuncture point Ht 9. This is the tonification point of the Heart meridian, located at the inside corner of the left small finger fingernail. Dr. Amaro learned the value of stimulating this acupuncture point during a heart attack in a most unusual way. Before he studied acupuncture and chiropractic, Dr. Amaro was a paramedic on an ambulance crew. On one run, the crew found a young man who had experienced a coronary and was nonresponsive. Dr. Amaro gave CPR in the ambulance while the driver was rushing to the hospital. There was no response to CPR. In desperation Dr. Amaro stomped his shoe on the floor of the ambulance to make noise and at the same time yelled, trying to get the young man to respond. In stomping his foot, Dr, Amaro's foot inadvertently came down directly on the small finger of the patient's left hand. The patient began to respond, and by the time they reached the ER, he was breathing regularly and his pulse had returned to normal. After studying acupuncture, Dr. Amaro realized he had stimulated one of the most powerful points on the Heart meridian, which was the reason for the patient's recovery (in spite of a bruised finger).
Twenty years later, Dr. Amaro was on an airplane on his way to present an acupuncture certification program. An elderly passenger on his way to the bathroom suddenly grabbed his chest and collapsed with a massive heart attack adjacent to John's aisle seat. Again, Dr. Amaro performed CPR, but after five minutes, he realized he was losing the patient. Deja vu: Dr. Amaro remembered to press Ht 9 (with firm finger pressure this time). The patient began responding and soon wondered why he was on the floor. Remember to use Ht 9 along with CPR. Dr. Amaro ended his article on this subject2 by stating, "Be aware of the tonification point for the heart for emergency situations or when the heart is in obvious bradycardia - it just may save a life."
1999 - What about a stroke emergency? Brian Sutton, DC, in a "DC Online" column in this publication, reported a rather unconventional new stroke treatment. Dr. James Grotta introduced this new treatment, the product of research by the University of Texas, while speaking at the American Neurological Association meeting in Seattle on Oct. 13, 1999. The University of Texas researchers found that giving patients one alcoholic drink, followed by two or three cups of coffee, almost completely eliminated stroke damage in ischemic strokes (which comprise 80 percent of all stroke cases.) They found that the "Irish coffee" worked just as well as the potent drugs used at that time for stroke treatment. The researchers found that alcohol administered by itself made the stroke worse, and caffeine by itself had no effect. The proportions could not be modified much, and using the mixture as a preventive measure didn't seem to help. An alcoholic drink was defined as 12 ounces of beer, 5 ounces of wine or 1.5 ounces of distilled spirits.
Readers are encouraged to report any additional procedures potentially helpful in cardiac emergencies that this author has not covered.
References
- De Jarnette, Dr. Major Bertrand. Chiropractic First Aid. Privately published by Major DeJarnette, DC, 1966.
- Amaro, JA. Phoenix and dragons and tigers and turtles, or how to save a life. Dynamic Chiropractic, March 15, 1991.
Hal Miller, DC
Elkhart, Indiana