Pisgah Family Health News

March 2013 - The Heart Health Issue

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Office News

Welcome Lindsey Bradley

Lindsey

Pisgah Family Health is proud to welcome Lindsey Bradley to our office. Lindsey started in December as our full time Medical Assistant.

Lindsey was born in Asheville and has lived in WNC her entire life. She has worked in the nursing field for 13 years, in both Family Medicine and specialty practices. She enjoys spending time with her two children Dawson and Camdyn. She also enjoys being outdoors, cooking for family and friends, and playing in the park with her daughter.

Office Reminders

WE ARE NOW TAKING NEW PATIENTS. We provide comprehensive care for infants, children and adults. If you know someone who needs a physician, please forward this Email or give them our phone number.

It is a new year. Please remember to present your new insurance cards to Kitty when checking in.

Office Hours

Our office hours are now 8:30-5pm Monday through Friday.  If there is low demand, we will close on Friday afternoon. When the office is closed, emergency care is available at the Urgent Care Centers and Mission Hospital ER.  Our answering service can be reached after hours at 251-4873.   Telephone calls are handled by Dr. Curran and his call partners.

  • We will have reduced hours March 25-28, for Spring Break.
  • We will be closed Friday, March 29 for Good Friday.
  • We will be closed Monday, April 22.

Medical News

Heart Health

Healthy Heart

Know Your Risks

Heart disease is the number one killer of both men and women, especially after the age of 50. Heart disease causes more deaths than cancer, but many people do nothing to prevent or detect it. Fortunately, you can reduce your risk of heart disease.

There are many different kinds of heart disease. Plaque in the heart arteries is the usual culprit. But there are many contributing factors. Choices you make every day can lead to damage to coronary artery walls.

  • Do you smoke?
  • Do you drink a lot of alcohol?
  • Are you overweight?
  • Do you spend the day sitting at a desk or in front of the television?
  • Do you avoid doing exercise?
  • Do you have diabetes or high blood pressure that is not under control?
  • Are you under a lot of stress?
If you answered yes to one or more of these questions, making changes might help you prevent or delay heart disease.

Signs of Heart Disease

Early heart disease often doesn't have symptoms. That's why regular checkups are important. Your doctor will check things like your blood pressure and cholesterol, and assess your personal cardiac risk. You might also have an ECG or EKG, an electrocardiogram.

Everyone should know the warning signs of heart disease. All chest pain should be taken seriously. If you have heart disease, you might feel chest heaviness, jaw pain, arm pain, or shortness of breath. But, chest pain can have other causes too, so it is important to check with your doctor to learn what is triggering yours.

Heart Attack? Call 9-1-1

Act in time: Learn the warning signs of a heart attack. If you or someone you know might be having a heart attack, call 9-1-1 right away. You need to take an ambulance to the hospital as soon as possible. Do not try to drive yourself, and do not have someone else drive you unless there is no ambulance service where you live.

These warning signs can include crushing chest pain and/or discomfort or pain elsewhere in the upper body, nausea, a cold sweat, fainting or lightheadedness, or shortness of breath.

Other signs of heart disease include a weak or numb feeling on one side of the face or body, dizziness, headache, shortness of breath, tiredness, and swelling in the ankles, feet, legs, stomach, and neck. Some people who have a problem with their heartbeat may report a fluttering in their chest or the feeling that their heart is skipping a beat or beating too hard.

Talk to your doctor if you have any of these signs. Your healthcare provider may want you to have testing or see a cardiologist.

What Can I Do To Prevent Heart Disease?

There are a lot of steps you can take to keep your heart healthy.

Try to be more physically active.

Talk to your doctor about the type of activities that would be best for you. If possible, aim to get at least 30 minutes of moderate-intensity activity on most or all days of the week. Every day is best. It doesn't have to be done all at once—10-minute periods will do. Start by doing activities you enjoy—brisk walking, dancing, bowling, bicycling, or gardening, for example. You might want to join an exercise group or even a gym.

If you smoke, quit now.

Smoking damages your artery walls, leading to heart disease and strokes. It's never too late to get some benefit from quitting smoking.

Follow a heart healthy diet.

Choose foods that are low in salt, fat, and cholesterol. Eat plenty of fruits, vegetables, and foods high in fiber like those made from whole grains. Avoid eating out, especially at fast food restaraunts. And if you drink alcohol, men should have no more than two drinks a day, and women only one per day.

Know Your Cholesterol

Cholesterol is a type of fat in some foods. Eating fatty foods can raise the cholesterol in your blood. High blood cholesterol levels causes plaque to build up in your arteries. You should have a cholesterol blood test at least every 5 years. This will tell you your total cholesterol level as well as the LDL ("bad" cholesterol), HDL ("healthy" cholesterol), and triglycerides (another bad fat). High cholesterol can be treated with diet, exercise, supplements, and medications.

Keep a healthy weight.

You should be aware of your ideal body weight, and learn your BMI (body mass index). A BMI of 25 or higher means puts you at greater risk for heart disease and diabetes and other health conditions. Also, men with a waist circumference greater than 40 inches, and women with a waist circumfence greater than 35 inches, have increased risk of heart disease. Following a healthy eating plan and being physically active might help you reduce your cardiac risk.

Source: National Institutes of Health

CPR technique

CPR

Learning how to perform cardio-pulmonary resuscitation (CPR) saves lives.

The tips provided below are not a substitute for formal training in CPR. The American Heart Association and the American Red Cross offer CPR courses regularly.

For more CPR education, enjoy these videos: The American Heart Association teaches CPR.
and American Training Safety Institute CPR techniques.

Conventional CPR consists of chest compressions and rescue breathing. The American Heart Association continues to support this approach to CPR, but recent research demonstrates that rescue breathing may be unnecessary and potentially detrimental in cases of cardiac arrest. "Compression Only CPR" should be performed by lay people or anyone uncomfortable with full CPR technique.

CPR is typically administered in cases of cardiac arrest. Signs of cardiac arrest include an absence of heartbeats, blood flow and pulse. When blood stops flowing to the brain, the person becomes unconscious and stops regular breathing.

The ABCs of CPR are Airway, Breathing, and Circulation.

Airway

  • If a person has collapsed, determine if the person is unconscious. Gently prod the victim and shout, “Are you okay?” If there is no response, shout for help. Call 911 or your local emergency number.
  • If the person is not lying flat on his or her back, roll him or her over, moving the entire body at one time.
  • Open the person’s airway. Lift up the chin gently with one hand while pushing down on the forehead with the other to tilt the head back. (Do not try to open the airway using a jaw thrust for injured victims. Be sure to employ this head tilt-chin lift for all victims, even if the person is injured.)
  • If the person may have suffered a neck injury, in a diving or automobile accident, for example, open the airway using the chin-lift without tilting the head back. If the airway remains blocked, tilt the head slowly and gently until the airway is open.
  • Once the airway is open, check to see if the person is breathing.
  • Take five to 10 seconds (no more than 10 seconds) to verify normal breathing in an unconscious adult, or for the existence or absence of breathing in an infant or child who is not responding.
  • If opening the airway does not cause the person to begin to breathe, it is advised that you begin providing rescue breathing (or, minimally, begin providing chest compressions).

Breathing (Rescue Breathing)

Pinch the person’s nose shut using your thumb and forefinger. Keep the heel of your hand on the person’s forehead to tilt the head back. Your other hand should remain under the person’s chin, lifting up.

  • Inhale normally (not deeply) before giving a rescue breath to a victim.
  • Immediately give two full breaths while maintaining an air-tight seal with your mouth on the person’s mouth. Each breath should be one second in duration and should make the victim’s chest rise. (If the chest does not rise after the first breath is delivered, perform the head tilt-chin lift a second time before administering the second breath.) Avoid giving too many breaths or breaths that are too large or forceful.

Circulation (Chest Compressions)

After giving two full breaths, immediately begin chest compressions (and cycles of compressions and rescue breaths). Do not take the time to locate the person’s pulse to check for signs of blood circulation.

Alternately, if you are performing "Compression-Only CPR" you may skip directly to this step:

  • Kneel at the person’s side, near his or her chest.
  • With the middle and forefingers of the hand nearest the legs, locate the notch where the bottom rims of the rib cage meet in the middle of the chest.
  • Place the heel of the hand on the breastbone (sternum) next to the notch, which is located in the center of the chest, between the nipples. Place your other hand on top of the one that is in position. Be sure to keep your fingers up off the chest wall. You may find it easier to do this if you interlock your fingers.
  • Bring your shoulders directly over the person’s sternum. Press downward, keeping your arms straight. Push hard and fast. For an adult, depress the sternum about a third to a half the depth of the chest. Then, relax pressure on the sternum completely. Do not remove your hands from the person’s sternum, but do allow the chest to return to its normal position between compressions. Relaxation and compression should be of equal duration. Avoid interruptions in chest compressions (to prevent stoppage of blood flow).
  • Use 30 chest compressions to every two breaths (or about five cycles of 30:2 compressions and ventilations every two minutes) for all victims (excluding newborns). You must compress at the rate of about 100 times per minute.
  • Continue CPR until advanced life support is available

Source: http://www.emergencycareforyou.org/

How to use an Automated External Defibrillator

AEDsmall You may also want to view this video: How to use an AED.

What is an AED?

Automated External Defibrillators (AEDs) are lightweight, battery-operated, portable devices that are easy to use. AEDs are often located in public places, such as malls, churches, and government buildings. Sticky electrodes send information about the person's heart rhythm to a computer in the AED. The computer analyzes the heart rhythm to determine whether an electric shock is needed. If a shock is needed, the AED uses voice prompts to tell you when to give the shock, and the electrodes deliver it.

Using an AED during cardiac arrest may restore a normal heart rhythm. Every minute counts. It is important to use the AED as quickly as possible, even before emergency personel arrive. Training to use an AED and administer CPR saves lives. However, untrained people also can also use an AED to help save someone's life.

What to do first

If you see a person suddenly collapse and pass out, or if you find a person unconscious, confirm that the person can't respond. Shout and shake the person to make sure he or she isn't sleeping. If there is no response, you should assume the person has had sudden cardiac arrest.

Call 9–1–1 or have someone else call 9–1–1. If two rescuers are present, one should provide CPR while the other calls 9–1–1 and gets the AED.

Check the person's breathing and pulse. If breathing and pulse are absent, locate and apply the AED as soon as possible. If an AED isn't yet available, begin 2 minutes of CPR. Then use the AED (if you have one) to check the person.

After you use the AED, or if you don't have an AED, continue CPR until emergency medical help arrives or until the person begins to move. Try to limit pauses in CPR.

After each 2 minutes of CPR, you can use the AED again to check the person's heart rhythm and give another shock, if needed. If a shock isn't needed, continue CPR.

Using an Automated External Defibrillator

AEDs are user-friendly devices that can save the life of someone having sudden cardiac arrest.

Before using an AED, check for puddles or water near the person who is unconscious. Move him or her to a dry area, and stay away from wetness when delivering shocks (water conducts electricity).

Turn on the AED's power. The device will give you step-by-step instructions. You'll hear voice prompts and see prompts on a screen.

Expose the person's chest. If the person's chest is wet, dry it. Remove metal necklaces and underwire bras. The metal may conduct electricity and cause burns. You can cut the center of the bra and pull it away from the skin. If the person has a lot of chest hair, you may have to trim it using a razor in the AED kit. If the person is wearing a medication patch that's in the way, remove it and clean the medicine from the skin before applying the sticky pads.

Check the person for implanted medical devices, such as a pacemaker or implantable cardioverter defibrillator. (The outline of these devices is visible under the skin on the chest or abdomen, and the person may be wearing a medical alert bracelet.) Also check for body piercings. Move the defibrillator pads at least 1 inch away from implanted devices or piercings so the electric current can flow freely between the pads.

AEDs have sticky pads with sensors called electrodes. Apply the pads to the person's chest as pictured on the AED's instructions. Place one pad on the right center of the person's chest above the nipple. Place the other pad slightly below the other nipple and to the left of the ribcage. Make sure the sticky pads have good connection with the skin. If the connection isn't good, the machine may repeat the phrase "check electrodes." Check that the wires from the electrodes are connected to the AED.

Make sure no one is touching the person, and then press the AED's "analyze" button. Stay clear while the machine checks the person's heart rhythm. If a shock is needed, the AED will let you know when to deliver it. Stand clear of the person and make sure others are clear before you push the AED's "shock" button.

Start or resume CPR until emergency medical help arrives or until the person begins to move. Stay with the person until medical help arrives, and report all of the information you know about what has happened

Source: http://www.nhlbi.nih.gov/health/health-topics/topics/aed/

Heart Anatomy

The following information will NOT be on the test, unless you happen to be studying for your medical boards.

Also enjoy this video on Heart Anatomy.

Heart Gross Anatomy

Heart Interior Anatomy

About our Newsletter

Dr. Curran and the staff at Pisgah Family Health are proud to publish the Pisgah Family Health News to our patients.  Our goal is to provide regularly updated information about the office and current medical topics.  We plan to publish a new issue each quarter with breaking news.  The newsletters will also be archived on our website, www.PisgahFamilyHealth.com/

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