Healthy Heart Resource

Distributed March 2013

Learning Objectives

1 - Healthy Choices

2 - Early Recognition

3 - Early Access

4 - Early CPR

5 - Early Defibrillation

6 - Early Advanced Care

7 - Early Rehabilitation

8 - Minutes Count

Chain of Survival

What is the most important link?

You are the most important link in the community

Healthy Choices

Risk Factors You Cannot Change

• Genetics• Gender• Age

Risk Factors You CAN ChangeO.L.D.I.S.H.

• Over Weight• Lipids

• High Bad Cholesterol• Low Good cholesterol

• Diabetes• Inactivity• Smoking• High Blood Pressure

Smoking & Heart Disease Did you know that…?

• Smoking damages linings of heart arteries• Smoking lowers level of oxygen in your blood• Smoking increases blood pressure • Smoking increases blood cholesterol & plaque• Smokers have a greater risk of sudden heart attack• Second hand smoke can affect the heart

Smoking• Tobacco is made up of tar, nicotine and carbon

monoxide. It contains poisons such as cyanide, arsenic, formaldehyde (used to preserve dead bodies) and ammonia (the chemical used in house hold cleaning products).

• A lighted cigarette gives off more than 4000 chemicals.

• Two or three drops of pure nicotine can kill you.

Smoking: What does it do?

• Tar builds up in your lungs. When you inhale cigarette smoke, you take in a lot of carbon monoxide (the same substance that comes out of a car exhaust).

• The most addictive substance in cigarettes is nicotine.

Short term effects of smoking?

• Bad breath• Smelly clothes and hair• Getting out of breath and tired during sports

or other activities• Being less attractive• Being avoided by your non-smoking friends• It is an addictive habbit

Long term effects of smoking• More colds, coughs and sore throats• It can make you look older• Contributes to heart disease & fatal lung

diseases• Cancer in the lungs, mouth & throat• Smokers suffer from diseases such as

emphysema that causes breathlessness, heart attacks, strokes and blood vessel diseases.

Second Hand Smoke• Is a mixture of the smoke given off by the

burning end of a cigarette, pipe, or cigar, and the smoke exhaled from the lungs of smokers.

• It is also called environmental tobacco smoke (ETS)

• Exposure to second hand smoke is called involuntary smoking or passive smoking.

Effects of second hand smoke• It causes irritation of the eyes, nose and

throat.• Also irritates the lungs, leading to coughing,

excess phlegm, chest discomfort and reduced lung function.

• Affects the cardiovascular system, may cause chest pain and cancer.

Coronary Arteries & Coronary Artery Disease

• The coronary arteries (blood vessels on the heart itself) carry blood to the heart muscle providing a constant supply of oxygen and nutrients.

• Cardiovascular disease begins long before a heart attack.

• It begins when blood cells and fat begin to build up on the inside walls of the arteries that supply blood and oxygen to the heart.

• Gradually the amount of space inside the arteries gets smaller.

• They are not able to carry as much blood and oxygen as before.

• The heart has to work harder to supply the blood and oxygen that the body needs.

• This process is called « hardening of the arteries » or atherosclerosis.

• When the coronary arteries do not supply as much blood and oxygen as the heart needs, a person may suffer from an angina attack.

• If one of the coronary arteries becomes completely blocked so that no blood can reach a part of the heart, the person will have a heart attack.

Coronary Heart

Disease

Plugged Arteries (Plaques = Atherosclerosis)

1. Healthy artery 2. Beginning of plaque build up (can start at 9 or 10 years old)

3. Plaque size increase (grows faster with more risk factors)

4. Plaque rupture starts blood clot causing heart artery or stroke 5. Plaques that do not rupture grow and diminish heart function

1 2 3 4 5

The Canadian Food Guide Says females 14 to 18 need the following servings per day

• 7 vegetables & fruit• 6 grain products• 3 - 4 milk & alternatives• 2 meat & alternatives

The Canadian Food Guide Saysmales 14 to 18 need the following servings per day

• 8 vegetables & fruit• 7 grain products• 3 - 4 milk & alternatives• 3 meat & alternatives

Vegetable & Fruit Serving Sizes

• 1/2 cup fresh fruit or vegetable• 1/2 cup frozen fruit or vegetable• 1/2 cup canned fruit or vegetable• 1/2 cup 100% juice• 1 cup leafy salad• 1 piece whole fruit

Grains Products Serving Size

• 1 slice bread • 1/2 bagel• 1/2 pita • 1/2 cup cooked rice• 1/2 cup pasta• 1/2 cup couscous• 1/2 cup cold cereal• 3/4 cup hot cereal

Milk & Alternative Serving Size

• 1 cup whole milk• 1 cup soy fortified beverage• 3/4 cup yogurt• 1 ½ oz (50g) cheese

Meat & Alternatives Serving Size

• 1/2 cup cooked fish or shellfish • 1/2 cup poultry • 1/2 cup lean meat• 1/2 cup shelled nuts • 1/2 cup seeds• 3/4 cup tofu• 3/4 cup cooked beans (legumes)• 2 eggs• 2 tablespoons peanut butter

Foods to Eat in Moderation• Cakes • Pastries• Cookies• Ice cream • Frozen desserts• Candy• Doughnuts • High fat muffins• French fries• Nachos

• Potato chips• Fruit flavoured drinks • Soft drinks• Sport & energy drinks

Foods to Avoid

Foods and beverages that are really high in calories, fat, sugar and/or salt (sodium)

Types of Fats• Saturated Fats: Increase Blood Cholesterol• Hydrogenated Fats: Increase Blood Cholesterol• Monounsaturated Fats: Decrease Blood

Cholesterol• Polyunsaterated Fats: Decrease Blood

Cholesterol• Omega-3 Fats: Decrease Blood Cholesterol

Saturated Fats• Fatty meat• Dairy products (except skim milk)• Poultry skin• Egg yolk, butter, lard• Vegetable oil shortening• Cocoa butter, coconut• Tropical oils: coconut, palm, palm kernel

Hydrogenated Fats• Cakes • Pastries• Cookies• Ice cream • Frozen desserts• Candy• Doughnuts • High fat muffins• Potato Chips

Monounsaturated Fats• Oils: canola, peanut, olive, sesame• Nuts: hazelnuts, pistachios, almonds, pecans,

peanuts• Soft margarine• Fish• Olives, avocados• Peanut butter

Polyunsaturated Fats

• Sun flower seeds• Soybean• Corn• Soft margarine• Almonds, pecans, walnuts

Omega – 3 Fats• Canola oil• Fish & seafood• Flax seed• Walnuts• Soybeans• Omega – 3 eggs

Why Should I Exercise?

• Your heart is a muscle and needs to “workout”.

• Exercise increases blood circulation to all muscles.

• Daily activity helps maintain a healthy weight, reduce fat, and increase muscle.

What’s in it for me?

• Daily physical activity makes you stronger and think better

• Daily physical activity reduces the risk heart attack by 50%

• Daily activity lowers blood pressure

• Daily activity keeps weight under control

How Can We Become More Active?

• Take fitness and gym classes• Walk, run, or bike • Participate in a sport• Join and use an activities facilities • Swim• Stretch your muscles everyday

Get your community services hours…• Raking leaves, shovel snow, or

vacuum to help someone out.• Take the dog for a walk

Recap on Healthy Living Module Slide

Early RecognitionMinutes Count!

Signs & Symptoms of a Heart Attack

• Chest pain or discomfort that persists for 5 minutes despite rest• May feel like pressure, squeezing, burning, or pain• May be located in the centre of the chest• May move to the shoulders, neck, jaw, arms, or back

Any combination of these symptomsmay indicate a HEART ATTACK!

Signs & Symptoms of a Heart Attack

• Shortness of breath• Pale skin • Sweating• Weakness and fatigue • Nausea, vomiting and/or indigestion• Nervousness and fear• Denial

Any combination of these symptomsmay indicate a HEART ATTACK!

Brain blood vessel blockage that stops blood getting to some brain tissue

What is a Stroke?

Brain blood vessel rupture that stops blood getting to some brain tissue and bleeds inside skull causing increase pressure and injury

Signs & Symptoms of a Stroke• Paralysis or numbness on one side of the body• Sudden partial loss of vision • Difficulty speaking• Nausea• Headache• Convulsion• Loss of consciousness• Denial

Can you ……SpeakSmileStick out your tongue

Stroke• Remember The 1st Three Letters... “S.T.R.”

– “S” Ask the individual to STAND, SMILE and then STICK out their tongue

– “T” Ask the person to TALK in a simple sentence (i.e. . . It is sunny out today)

– “R” Ask him or her to RAISE both arms.

NOTE : • If he or she has trouble with ANY ONE of these tasks, call 911

immediately and describe the symptoms to the dispatcher.

Recap on Early Recognition Module Slide

Early AccessMinutes Count!

• Heart attack• Obstructed airway • Allergies• Drug reaction• Drowning

• Electrocution• Suffocation• Gas poisoning• Stroke• Smoke inhalation

The first 10 minutes count when someone has a …

Get Professional Help• Call 9-1-1• When possible have a bystander call for you• Tell them - where you are

- who you are- what happened

• Always ask if they understand• Let them hang up first• Niagara has dispatch assisted CPR

Dispatch Questions• What’s the address of the emergency?• What’s the phone number you are calling from?• What’s the problem, tell me exactly what happened?

(not obvious) Are you with the patient right now? (not obvious) How many (other) people are hurt (sick)? (choking) Is (s)he still choking now?

• How old is (s)he? (unsure) Tell me approximately, then?

• Is (s)he conscious?• Is (s)he breathing?

Recap on Early Access Module

Early CPRMinutes Count!

Function of the Heart and Lungscheck out student or teacher pages at www.heartniagara.com

• The heart and lungs provide oxygenated blood to the body, including the brain and the heart muscle

• The lungs add oxygen to the blood and remove carbon dioxide

• The heart pumps (circulates) blood through the lungs and then to the body, including the brain and the heart muscle

Heart

Lungs

The Path of Oxygen

• Oxygen enters the body through the mouth and nose with each breath

• Oxygen travels through the air passages into the lung tissue

• Oxygen moves through the lung tissue into the blood

Lower airway

Upper airway

Anatomy of the Lungs• The lungs are located on either side of the heart• Each time you breathe in, your lungs fill with

fresh air containing oxygen.• When you breathe out, you remove waste like

carbon dioxide• Air that enters your lungs contains about 21%

oxygen.• Air that you breathe out contains about 16%

oxygen and 5% carbon dioxide.

Anatomy of the Heart• Heart is a hollow muscle about the size of your fist.• Heart is located in the center of the chest, beneath the

lower half of the breastbone, at the nipple line.• It is a two-sided pump.• The right side of the heart receives blood from the

body and sends it through the lungs where waste (carbon dioxide) is removed and fresh oxygen is added.

• The left side of the heart receives the oxygenated blood from the lungs and sends it through large vessels (arteries) to the rest of the body.

• With each beat of the heart, blood rushing through the arteries creates a pulse that you can feel.

• The pulse varies according to your age, fitness and level of activity.

How Does Your Heart Work?• Your heart is a muscle that has only one job and that is

to pump blood to every part of your body.• The human heart is divided into four separate spaces

called chambers. Two chambers are on the upper part; two are on the lower part.

• The top two chambers are the right and left atria. Atrium receive blood from the lungs and body.

• The bottom two chambers are the right and left ventricles. Ventricles pump blood out of the heart.

• Every time your heart beats, blood is being squeezed out by the ventricles.

• Blood moves only in one direction. Valves in the heart keep the blood from moving backwards.

• A muscular wall divides the right side of the heart from the left side. Blood cannot flow from one side to the other.

Minutes Count!0-4 minutesClinical deathBreathing and pulse stop.

4-6 minutesBiological deathBrain cells may start to die.

6-10 minutesBrain damage very likely.

10 minutes PLUSBrain cells dieIrreversible damage to brain.

What is CPR?Cardiopulmonary Resuscitation (CPR)

The best chance for survival depends on early CPR and early defibrillation

What Can I Do?

• CHECK surroundings• CHECK the victim• CALL 911• CARE ABC

Cardiopulmonary Resuscitation(CPR)

AIRWAY (A) Opened and remains clear

BREATHING (B) Check breathing - give breath if needed

CIRCULATION (C) Check skin colour - give compressions if needed

To increase the number of people that survive heart attacks by increasing the number of people trained in

bystander CPR

• Bystander CPR can double the chance of surviving a cardiac arrest

• Less than 1 in 3 people who have a heart attack get bystander CPR

• Everyone in our community can respond in an emergency with CPR

Your Goal

Recap of Early CPR Module

Early Defibrillation

Locate AED and follow instructions

Locate and get the AED and follow

instructions

Locations in Niagara

Early Advanced Care

10,000 steps or 60 minutes of daily activity will make a difference

Heart Niagara CPR course throughGrade 9 Physical Education

Skills you learn in the CPR Class

• How to manage- a conscious choking victim- unconscious choking victim

• Adult CPR• Child CPR

Level of Consciousness

ALERT - Speak to victim to see if awake

VERBAL - Shout at the victim to see if they are sleeping

PAIN - Pinch and pat

UNRESPONSIVENESS - If the victim still does not respond,

assume they are unconscious

CPRABC’s AIRWAY - Check to see if anything is blocking the airwayBREATHING - Look, listen and feelCIRCULATION - Check skin colour

30-2 - 30 compressions / 2 breaths

The presentation was put together by Heart Niagara to support heart health curriculum

in secondary school with materials from 1. Heart Niagara www.heartniagara.com

2. Health Canada www.hc-sc.gc.ca

3. The American Heart Association www.americanheart.org

4. The Heart & Stroke Foundation of Canada www.hsf.ca

5. Niagara Region Public Health www.niagararegion.ca

6. Niagara EMS www.regional.niagara.on.ca/medicalservices

7. Region of Niagara www.regional.niagara.on.ca

8. Nutrition Data www.nutritiondata.com

9. Red Cross www.redcross.org

Injury Prevention

How CPR Can Make a Difference in

Infants and Children

Injury Prevention

Motor Vehicles• Buckle up! Everyone!

• Children up to 4 years and 40 lb:

use child-restraint device (install correctly!)

• Children 40-80 lb: use belt-positioning booster seat

• Children taller than 58 inches and more than 80 lb and

adults: use lap and shoulder belt

• Children 12 years or younger should sit in the BACK seat

Injury Prevention

Pedestrians• Supervise children near traffic• Teach children to stop, look, and listen before

crossing the street and to use crosswalks Bicycles• Always wear bike helmet (ANSI-or Snell-approved)• Ride on right side of road; avoid busy streets

Injury PreventionDrowning• Supervise children near water, including bathtubs

and pools, at all times!• Completely surround outdoor pools with fences• Be sure children wear life vests when swimming

in a natural body of water or boatingFirearms• Store all firearms UNLOADED and LOCKED Burns and smoke inhalation• Use smoke alarms (check batteries twice a year)• Keep drapes and furniture away from heaters

Injury Prevention

Poisonings• Keep poison out of reach of children• Do not store in drinking containers or bottles• Place poison control number near phoneFalls• In high buildings place gates on all windows in children’s

rooms• Use gates to block stairways from infants and toddlers

Injury PreventionSudden Infant Death Syndrome• Place healthy infants to sleep on their backs (“Back to sleep”)• Do not put any stuffed toys or fluffy comforters

or quilts in the crib with the babyChoking• Do not allow infants and small children to play

with small toys• If a toy is small enough to fit in a standard toilet

paper roll, it can block a child's airwaySuffocation

• Do not allow infants or children to play with plastic bags, balloons, or drapery cords

Questions?