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Lending a hand during a cardiac emergency

Nima Jalali, MD, leans against a doorway. He offers these tips in case of a cardiac emergency arises.
Dr. Jalali knows firsthand how bystander intervention can save a life.

An automated external defibrillator (AED) can restart the heart – but anyone with CPR training can help when a heart attack strikes

If someone collapsed near you, would you know what to do? When a referee had a heart attack during a Lawrence High School basketball game in December, he was fortunate that a Northwell Health emergency medicine doctor and two interns from an athletic training program were there. The referee’s alive thanks to their training and the school’s AED (automated external defibrillator).

“We were able to get an AED on the referee quickly,” said Nima Jalali, MD, a fellow in emergency and sports medicine at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell. In fact, sports medicine fellows at the Zucker School of Medicine ensure that AEDs are available court- and field-side at all sports events they cover. With more than 1,800 residents and fellows, Northwell’s program is one of the largest in the country.

The Lawrence High School referee has healed and thanked everyone who helped that day. Dr. Jalali credited Richard Ravo, the school’s head athletic trainer, and David Lebron and Jennifer Lopez, athletic training students at Hofstra, for collaborating with him to save a life. “Luckily, we were courtside and in the right place at the right time,” he said.

What does an AED do?

Applied to the chest, an AED automatically detects if the heart is beating erratically (arrhythmia). If — and only if — there is a correctable arrhythmia, the AED delivers a powerful jolt of electricity. That electric pulse can shock the heart back into normal rhythm, Dr. Jalali explained.

But you don’t have to be an emergency department doctor or even have access to an AED to help save a life. The American Red Cross notes that most people who survive a cardiac emergency are initially helped by bystanders.

It’s a matter of staying calm and knowing enough to follow some basic steps.

How to help someone having a heart attack

You can be a lifesaver, too. Responding to a cardiac emergency requires two main things: speed and focus.

“That’s how any emergency department doctor would react. Laypeople can react that way, too,” said Dr. Jalali.

“Stay calm, so you’re able to understand what’s happening and focus on the task at hand,” he said. That task is to do high-quality, hands-only CPR with an adequate depth and number of chest compressions until emergency medical services arrive.

Here’s what Dr. Jalali says to do when someone has an apparent heart attack:

  • Pick someone to call 9-1-1. Ask a specific person, rather than shout a request or assume someone will call. It’s easy for people to get caught up in the commotion of an emergency and lose sight of the need to call for help. Ask if anyone knows CPR. 
  • Check the pulse. “When someone goes down, check the pulse right away, for no more than 10 seconds,” Dr. Jalali said. A heart attack can cause rapid, weak or irregular pulse. 
  • Make sure the person is on a hard surface (not a mattress, for instance) and on his or her back. 
  • Place one of your hands in the center of the patient’s chest and the other hand on top of the first.
  • Implement hands-only CPR with two to two and a half inch compressions, 100 to 120 compressions per minute. 
  • Allow for the chest’s recoil between compressions.

Dr. Jalali’s best advice: Take a basic life support course that follows the Advanced Cardiac Life Support and American Heart Association standards and guidelines, especially if you attend athletic events.

“It’s something easy to do with a high reward,” Dr. Jalali said.

Signs of a heart attack

  • Chest pain or pressure
  • Cold sweats
  • Shortness of breath
  • Lightheadedness or dizziness
  • Weakness or fatigue
  • Pain, aching or discomfort in the neck or upper body
  • Nausea
  • Numbness or tingling in the arm
  • Loss of consciousness or collapse 

Check Northwell's community events calendar to find an infant/child CPR program near you. For adult CPR programs, visit the American Red Cross's Training Services website.

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