Overcoming Reluctance

The mild pain of angina is easily denied by the victim and by others nearby, because:

The symptoms are mild.
The onset of pain is not easily noticed.
The victim is conscious and looks normal.
There is a strong tendency to continue business as usual.
In many cases, there are no risk factors.
The victim is seldom ill and feels indestructible.
The victim needs to feel always in control.
The victim is worried about what others will think.

The following are strategies to overcome denial and resistance to medical attention:

• Find out the most critical issue on the victim's mind.
• Suggest that the victim "check it out" quickly, because it's better to be safe than sorry", and "they can do more in a hospital than at home."
• If the patient refuses to call 911 offer to drive the patient in a private car, which may be less embarrassing than an ambulance
• lf there is anxiety regarding the spouse, offer to contact the spouse of the victim.
• Try to relieve the tension with humor.
• Enlist family members to help you.
• Be personal and be persistent. Sit and talk, and don't go away.
• Congratulate the victim on his or her good fortune:
  "Great! You are early....you can be helped."
• If all else fails, take charge and be aggressive about getting the victim to a hospital.

An important first step is to identify the MCI - most critical issue - on the patient's mind, and then try to disarm it.

The ideal approach to intervention can be recalled through a simple acronym, ACT WISELY. The Early Heart Attack Care Giver should:

A Acknowledge the problem.
C Be Calm.
T Be Tenacious and do not give in.

W Be Willing to give your time.
I Be Influential.
S Keep it Simple.
E Be Empathetic.
L Help Link the patient with early symptoms to the hospital.
Y Say Yes - l will do it!

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