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Cardiac distress symptoms in women

In the wake of Carrie Fisher’s death four days after she suffered a massive heart attack, one thing that was reported by some news outlets was that she had been in “significant distress” on the flight. We don’t know the exact details of this, but in my experience as an EMT, it often means “hysterical woman having a panic attack and thinking she’s dying…*woman dies* …oops, guess she really was dying.” 

It is SO IMPORTANT to remember that many women present in what medicine considers an ‘atypical’ manner for heart attack, but it actually IS typical…for women. Women are more than twice as likely to die from cardiac emergencies, not because our physiology is that much different than men and thus gives us a worse chance at survival (it’s actually better if treated promptly and adequately), but because our symptoms are more likely to go unrecognized or to be dismissed entirely.

Thus, please take a moment to review and pass on this list of cardiac distress symptoms as seen in women: 

Shortness of breath - This is the most common one. If a woman, especially one without prior history of respiratory issues or shortness of breath, seems to be having trouble catching her breath and/or complains of such, pay very close attention. If she continues to feel winded after sitting or laying down, it’s probably time to call for help.

Feeling of impending doom - This can range from a sense of general unease to a full-blown panic attack. This one is extremely important, and is the symptom most commonly disregarded by doctors and hospital staff. If a woman tells you that she feels ‘not quite right,’ or like something terrible is about to happen, or that she’s about to die, LISTEN TO HER FFS. 

Nausea and “indigestion” - Also common. Heart attacks frequently present as a feeling of vague nausea or indigestion, but unlike typical heartburn, antacids and other OTC treatments will not alleviate the symptoms.

Hiccups - Unexplained hiccups, especially if seen with any of the other symptoms listed above, can be indicative of heart muscle that is being acutely or chronically starved of oxygen.  The exact mechanism isn’t known, but it’s thought that the enzymes released by the dying muscle irritate the pericardium and adjacent diaphragm, causing spasms in the healthy muscle. 

Fatigue - This is another commonly seen symptom, and is often overlooked or ignored as just transient tiredness. Many women having a heart attack will complain of feeling “flu-like” symptoms of nausea, sweating, fatigue, and shortness of breath, and they’ll lie down for a nap and never wake up. 

Lightheadedness - A feeling of being lightheaded or about to faint isn’t terribly uncommon in many benign conditions, and many women experience it on a monthly basis. However - be aware when it appears unexpectedly or unexplainedly, and/or with one or more of the other symptoms on this list. 

Sweating (diaphoresis) - Heart attack does funny things to the sympathetic nervous system, which is behind reflexes such as sweating and hiccups. If a lady is experiencing unexplained or excessive sweating, pay attention to anything else that might be going on with her. 

Tingling or numb extremities - A feeling of numbness or “pins and needles” tingling in the extremities can be an important sign that cardiac function is being impaired and those body parts aren’t receiving enough oxygen. 

Peripheral and/or central cyanosis - Often accompanies tingling or numbness, and is considered a later-stage symptom of cardiac distress and heart failure. Finger and toe tips will turn pale or blue first, and lips and gums after that. Important to remember that darker-skinned women may present cyanosis as ashen, grey, or darker purple rather than pale or blue. 

Back pain - Pain between the shoulder blades, in the cervical spine, or even further down in the torso or lumbar region can be a symptom of heart attack. Alone, it isn’t that suspicious, but if it’s unrelenting and presents with any of the other symptoms above, keep a watchful eye on things. 

Classic “crushing” or “tight” chest pain or pressure - Women DO experience this classic pain, too, just not as frequently as men do. This may be due to our higher pain threshold, or differences in blood volume, or maybe we’re just not sure because nobody’s bothered to really study it. Whatever the reason, some women do still experience the crushing or tightening pain, and others may experience less painful pressure or tightness that doesn’t seem to be relieved by anything.

Arm and jaw pain - Another “classic” heart attack symptom, and a bit more common than central chest pain. Unexplained pain in the left arm or shoulder, and on the left side of the neck or jaw, should not be ignored by anyone.

do you ever think about how the night neil was taken was just a regular night and then suddenly it just wasn’t?

like the foxes kicked ass on court.  and to quote, following the game, “neil could practically feel the excitement radiating off [dan].” i mean they’re crushing it, they haven’t lost a game yet, the entire team’s probably waiting on liquor and sleep.  it’s an amazing, wonderful night.  i mean, shit, “thank you, you were amazing” followed by allison sending a significant look to matt?  she’s probably running through her head how much she’s about to win over bets.

but then the riot starts. there’s bottles thrown and then punches, and andrew’s getting an elbow to the face, and renee’s defending allison, and neil-

neil’s gone.

and then you’ve got everything flipping on its head.  like what do you think the foxes were thinking?  as andrew was choking out kevin, what are the chances matt was thinking about all the times neil avoided telling obvious truths?  as aaron was being bandaged up, do you think nicky was thinking about neil’s collection of languages?  do you think allison was giving a whole new connotation to “you were amazing” as they sat in the hotel room and waited to know if they’d be going back to PSU short one fox?  was abby thinking back to skin marred with scars she can’t even begin do describe the awfulness of?

they went from riding the high of another won game to crashing at the idea that they were never going to see neil josten again

here are some more trojan hcs that no one asked for

  • there are two dead ants in the corner of laila and alvarez’s dorm, which alvarez has named cabbage and theodore. laila insists they get rid of them. alvarez says she can’t just throw away her children like that
  • jeremy has a habit of walking into a room distracted by his phone (usually twitter or texts with kevin), and he’ll stop in the middle of the room and just sit on the floor, continuing to text
  • this leads jean to constantly trip over him because he’s not expecting jeremy to be sitting right inside the doorway when he comes back from class
  • laila could not for the life of her figure out how to double-knot her shoelaces until she was a junior in high school
  • jeremy has zero navigational sense. at all. jean has to do both the navigating and the driving when they’re in the car together. road trips are a nightmare
  • alvarez has a tattoo of a little astronaut on her arm, just because she thought it looked cool (it does)
  • jean and laila are always competing at something. sometimes they get identical puzzles and see who can put them together fastest, sometimes it’s shopping cart races at walmart at three in the morning.  there’s a pair of freshman backliners that somehow always end up in the baskets of these shopping carts
  • laila is Terrible at math, and is very frequently getting basic equations wrong
  • the biggest argument laila and jean have ever had is over whether fruity pebbles or fruit loops were better.  laila was all for fruit loops, and jean insisted fruity pebbles were superior.  they didn’t talk for three days after
  • jean gets rid of all the black in his wardrobe now that he’s no longer with the ravens. everything is colorful and bright, socks and shoes included
  • alvarez’s favorite nail polish color is called “hush money” purely because it’s called “hush money”
  • jeremy is really good friends with a sophomore striker, and he’ll take her out for breakfast every few weeks, and they’ll talk about new episodes of whatever anime they’re both watching, or a recipe jeremy really wants to try, or how the sophomore’s girlfriend accidentally dyed her hair orange
  • laila loves strawberries.  so much.
  • jeremy has, on several occasions, stopped the car because he saw a dog he wanted to pet
  • jean and laila have two fish that they take care of together, named butter and hargrove the eighth
  • alvarez used to figure skate. she takes laila on ice skating dates all the time partly because laila is terrible at ice skating and alvarez thinks this is adorable, but also partly because she really likes to show off
  • if she knows jean is having a hard time sleeping, alvarez will just send him a continuous stream of memes. most contain cats
  • jeremy has reading glasses
  • (jean Loves jeremy’s reading glasses)
  • laila is demiromantic
  • alvarez loves poetry, she has an entire shelf on her bookcase dedicated to her favorite collections, and has some of her favorite poems memorized. instead of singing/humming to herself when she’s spacing out, she’ll very quietly recite these poems
  • jean can do a perfect impersonation of lightning mcqueen, and very frequently uses it to make some of the freshmen laugh
  • they’re all actual rays of sunshine whom i love
7

“
It’s really changed my self-confidence. It’s changed how I view the world when I’m just walking around. I feel more secure, knowing that I don’t need to completely rely on security guards for my personal safety, which really affects how I see everything. To have that confidence is important. It really takes you out of your mind and puts you in almost a meditative place. You’re forced to focus on the next move, the next attack or defence, and how you’re going to respond. It’s similar to chess in that it takes so much strategy, but it has so much more consequence that you’re just in that moment completely. I love the balance of both the physicality and the mental aspects of it all. I don’t necessarily follow fighting, but I love training. I don’t have a favourite fighter, for example, but I love the art and the pursuit of it.”

FACTS ABOUT 911

I know this is long, but please read and reblog this so that we can try and circulate HELPFUL information instead of deadly suggestions.

After stumbling across the last post I reblogged that was full of a lot of DANGEROUS, BAD, TERRIBLE advice in reference to how to handle calling 911 when in danger, I feel compelled to at least try and get some better information out there in the Tumblr community. I am a 911 dispatcher and the first piece of advice I have for anyone in an emergency situation (or even for someone that calls 911 accidentally) is:

DO NOT HANG UP. In case you didn’t get that the first time, I said DO NOT HANG UP THE PHONE. We cannot help you if we do not know where you are, and contrary to what is apparently popular belief, we are NOT mind readers & without knowing your location (which you must provide) we CAN NOT get you help.

To help you understand the importance of this, I’m going to explain to you what happens when you call 911 in my center and in the centers in my area.

911 line rings.

We answer: “_______ (name of your agency) 911, WHERE is your emergency?”

In a perfect world, the caller will respond with the address of their emergency.

If you are unable to do so, we will start to retransmit your location. It takes time. Again, in a perfect world, we can usually get it in less than 10 seconds, but we do not live in a perfect world and so it often doesn’t happen that quickly. (Also, if you’re in an apartment complex, trailer park, hotel, etc, it’s not going to give us the room, lot, etc. number that you’re actually in, even with a retransmit). It is true that if you call from a landline your address will often populate for us, however, the address is NOT always right! We need you to try your ABSOLUTE BEST to provide us with an accurate address. By not knowing your location, you’re prolonging the response time. The call has to be answered, have a confirmed address, type of call that we’re responding to so that the correct responders are dispatched, and then it has to be dispatched. In smaller jurisdictions, their fire/EMS is often volunteer. That means: THEY ARE COMING FROM HOME TO THE STATION. It takes time & the more time we waste just trying to figure out where you are, the longer you’re going to be waiting for a life saving response.

The TERRIBLE information post that is going around tells you to call 911, hang up, and then turn your phone off. NO, NO, NO. That is the absolute WORST thing you could ever do. When a 911 hang up comes in we attempt to call the line back twice. If the line isn’t open long enough to retransmit an address (which most of the time it’s not), that’s it. The call gets out in and closed. There is literally NOTHING WE CAN DO TO HELP YOU. Even if we DO retransmit an address and there is no sign of a disturbance or no other indication that there is an emergency, we often do not send a responder because if we send one to every call, we’d be wasting a LOT of time and resources. We receive 911 hang ups/accidental 911 calls ALL DAY LONG. (Side note: the most common ones that we receive come from disconnected cell phones. Every cell phone (disconnected or not) with battery life can call 911, but 911 CANNOT call those phones back). If you call from a disconnected cell and we’re not able to get a location (or are and not hear any signs that would indicate a need for service), you will most likely not get the help you need.

Moral of this point: DO NOT HANG UP and KNOW WHERE YOU ARE. Try to pay attention to mile markers on the interstate & landmarks, signs or road names. If you call accidentally-STAY ON THE LINE. We (at least at my agency) will ask you to verify your name and address and that there is no emergency. As long as nothing feels/sounds wrong about it to us, we won’t send an officer to knock on your door. You won’t get in trouble. No one will be mad. Just stay on the line so that we don’t waste time and resources on a call that is not emergent.

Disclosure: some agencies offer text to 911. Don’t assume that you can text 911 unless you know that your locality has that capability. A lot of them don’t. If you’re able to safely call you should ALWAYS call rather than text. It’s faster and more efficient.

Moving on-

Answer our questions. We’re not asking you questions for our own amusement. Everything we ask you on the line is for your own safety and for the safety of our responders. They are much more well equipped to handle your emergency if they know what they’re walking into and what supplies they need to bring in with them when they come. We’re NOT going to send our fire/EMS into a scene that is not safe, so answer our questions so that we know which resources need to be provided to you. I know that often times the calls that people place to us are during some of the worst, most terrifying moments of their lives & we WANT to help you in the best way that we know how. We ask the things that we ask because it’s required & because the more we know, the higher the quality of service that we provide you will be.

ALSO: While we’re asking you the questions, most likely RESPONDERS HAVE ALREADY BEEN DISPATCHED. If you didn’t get that, read it again. You can’t imagine how much time we spend trying to argue answers to questions out of callers because we’re being screamed at: “JUST GET THEM HERE QUICKLY.” “HE/SHE/I’LL BE DEAD BEFORE YOU GET THEM HERE,” etc. you’re wasting your time and mine. Try your best to work with us because our number one goal is to get you the help you need as quickly as possible. Contrary to popular belief, we don’t do this for the money. The medics, fire fighters, police officers and animal control officers DON’T do this for the money. (It’s not there, in case you were wondering.) we do this because we genuinely care about other human beings. We want to HELP. We CARE. We are here to protect and serve, but we cannot do that effectively if people are constantly fighting against us.

If you have any questions about how things work here or need advice as to how to handle a call in to 911, feel free to ask and I will give you the best advice that I can. Just please, please don’t listen to terrible misinformation (like calling, hanging up and turning your phone off). These situations are often the line between life and death. As cliche as it sounds, help us help you. Much love, Tumblr fam!

Also, to any of my fellow dispatchers, feel free to add to this. I know that things can vary from one locality to another, so I think any input would be helpful! I tried to just stick to the basics in this post for that reason. :)

@therapy101 @thistherapylife @socialworkmemes @all-about-psychology @theangrytherapist @thecalminside could you guys please reblog this to try and circulate correct information about how to receive help in an emergency situation? There is some VERY bad information going around that provides dangerous suggestions in reference to calling 911 and that makes me so afraid for anyone that reads it and thinks that it’s true.

Don't disrespect EMS.

Admitted a STEMI from cath lab. Story was he called the ambulance and ambulance activated the STEMI team prior to arrival. My orientee said “So the ER just takes the ambulance crews word for it that it was a STEMI?” I replied “Well, they are all trained to spot EKG changes for that reason so yes.” He said “That’s stupid. What if they were wrong?” So I pulled out the patient’s ambulance EKG which had very minute elevation in leads II, III, & avf & asked him to find the elevation. He was unable to so I showed him the changes & the reciprocal depression. I said “You don’t get to act better than someone just because you get paid more & went to school longer. Without those guys out there to catch that this patient could have had major heart damage from precious minutes being wasted.” He shut up for a bit at least. 😠

best case scenario: it’s nothing.
he dropped his bag to help someone out,
it got moved out of the way,
he’ll turn up and start bitching about tears and dirt stains,
you’ll tell him to shut the hell up, even though he won’t listen,
he never listens,
and you’ll hang on to every word as he keeps talking.
(this is unlikely. he wouldn’t set that bag down,
wouldn’t abandon any of his things even if
the world was burning)

next best scenario: someone stole it.
he’ll be battered and bruised,
because no one got that bag without a fight,
and you’ll tell him what a fucking idiot he is.
he’ll make some joke,
he always does,
and you’ll remind him again of how much you hate him.
he’ll remind you of how much you don’t.
(this is slightly less unlikely, but be realistic—
he wouldn’t give up any of his things even if he were burning)

okay, next best: he ran.
“best” is a relative term here,
“best” implies it’s anything good but really your chest
has never felt so fractured and the ground is tilting and everything is
wrong.
maybe he ran. is that why he asked you to let him go?
why he insisted he be set free?
(this is even less unlikely. it borders on likely, be honest.
he’d throw all his things to the wind if he felt like he was burning)

next best: he was taken.
you know he’s perched on a throne of lies,
buried in his own secrets of a past he tried to torch.
he isn’t safe, he never was, never was going to be,
no matter what you had to say about it.
stopshakingstopshakingstopshaking thisisn'thelping—
you hate him. you hate him so much. you hate
that you hurt for him.
(this is likely. this is very likely.
he’d never let his things go unless you were burning.)

worst case scenario: he’s dead.

—  if you were really amazing you wouldn’t have let him go // es