So what should we do if we're out hiking and have a heart attack / Stroke and there is no cell phone reception and no chance of getting help anytime soon ???

i would hope that it is not yet my time to go. but if it was, then i'd try to realize what a great setting i was in and go peacefully. for me, better in the woods doing something i like rather than in a hospital with death being prolonged.

if not your time yet, rest up, try to weather the immediate storm, and when possible get out. exercise will increase the damage.

after working in ers for many years it became apparent to me that when your time was up, your time was up.

i saw people who never should have died - young and/or good health otherwise, found immediately, cpr / first aid begun instantly, excellent pre-hospital care, finest mds and nurses, patient died. i saw others who should have died - all that could possibly be wrong with the above scenario, was - and who survived. go figure.


bsmith

I'm not sure I could even identify somebody having a heart attack vs some other critical condition.

I couldn't have said it better. I'd rather be found later by the next hiker down the trail than end up in a convalescent center waiting for my turn.

Better yet. . . I've noticed a trend that when people who are in very good physical condition (read athletes) have a heart attack, it's usually catastrophic and they are DRT. Folks who are out of shape have a slower heart attack and they have time to take aspirin and call an EMT. Anybody else notice this or am I seeing a trend that's not real? I'd rather go with the first group; ie., doing something active that I enjoy one moment and BOOM -- game over, DRT.

As a practicing Cardiologist I deal with this daily. Aspirin (if not given before arrival) is one of the first things given to chest pain patients upon arrival to the ER. It should not routinely be given to someone suspected of having a stroke without further testing first. Both heart attacks and stroke may present with atypical or confusing symptoms, BUT rarely (never?) are they confused with each other.

Heart attack an Stroke Warning Signs:
http://www.americanheart.org/presenter.jhtml?identifier=3053


Additional statements from the American College of Cardiology re: aspirin use with heart attacks:

http://www.acc.org/qualityandscience/clinical/pdfs/UA_NSTEMI_Final_pocketpullout.pdf

http://www.acc.org/qualityandscience/clinical/guidelines/stemi/index_pkt.pdf page 14


The American Heart Assoc. site has additional comments on the effects of NSAIDS (Tylenol, Motrin, etc.)
As it relates to heart attacks (use the search function)


Discussion at the Wilderness Medicine meetings relative to “wilderness cardiology” usually revolve around the use of aspirin and possibly beta-blockers. In “wilderness” (or “survival”) situations your resources for emergent cardiac care are usually pretty limited. Urgent evacuation (if possible) is usually you best option.

Marduk & JCWohlschlag

Thanks for those links, great information.

Acethaminophen is by far the safest of the bunch. There's a risk of liver-damage, but that's only after a long period and a high concentration of the stuff.

If you put it in contrast, the chances of getting stomach-problems with Ibuprofen are far greater than the chance of liver-problems with Acethaminophen..

I just started carrying half/dose aspirin per my doctor's recommendation and to take one daily. But I carried it anyway in my FAK.

As I recall, I've never been prescribed Tylenol, but I have been prescribed Motrin (in the 800 mg form) on more than one occasion as an anti-inflammatory. For me, aspirin works just fine for minor headaches (with the dual use of being available for heart attacks) although I probably should add Tylenol to the kit for others who are aspirin intolerant.

That said, when the side effect of one drug is an ulcer and the side effect of another is death, I'll risk getting an ulcer. YMMV

Yup. I take one every morning, along with a handful of prescription meds and some vitamins, and carry more along, in case of the big one. Or a simple headache. Then do not bother my stomach at all, nor do the 800mg motrin I take on a pretty regular basis for my bum back. A co-worker got chest pains at the office one night, his partner had him pop an aspirin then ran him over to the hospital...minor heartattack, no damage, thanks, according to the dr, to the aspirin...