Early Heart Attack Care In The Workplace

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Heart disease is the number one killer of the adult population. It has been that way since the turn of the century. It kills more Americans each than all of the Americans killed in past wars. Indeed, it is the war at home. Yet it is also a war that is solvable if we can make Americans aware that heart attacks have beginnings and that it is in these beginnings that effective intervention can take place preventing death and damage to the individual. EHAC (Early Heart Attack Care) is an awareness message can easily be taught bringing out this message. Most Americans know CPR. It is a household word. EHAC needs to be equally well known for it is on the other end of the spectrum. CPR is for the dead .... resuscitation. EHAC is for the living .... prevention of the heart attack itself.

The workplace is an ideal place to start the EHAC message in that half of the heart attacks take place at work and many of these in the early morning hours (6 to 10 o'clock in the morning). EHAC provides an alert system for this. We can look upon heart attack. as an accident ready to happen. It will take the worker out completely or it will take him out of work for at least 3 months and his effectiveness is lost. The formula for dealing with the problem is to recognize early symptoms before they get out of hand and then have a buddy system that brings the patient into a user friendly chest pain evaluation area. Across the country right now there are hospitals developing Chest Pain Centers in their Emergency Departments allowing this user friendliness approach to take place. What we desperately need is for employers to seriously consider adding the EHAC educational message to their programs.

The National Safety Council has endorsed the EHAC program. Initially this was presented to the National Conference in Dallas on November 1995. The objectives of the EHAC program are very similar to the National Safety Council.... protecting life and promoting health. Our mission is also the same. The mission of the National Safety Council is to educate and influence society to adopt safety and health policies, practices and procedures that prevent and mitigate human suffering and economic losses arising from preventable causes. No where is this more true than in the EHAC message. Within a short period we will make this information available to the National Safety Council throughout the United States.

In Maryland we take great pride in introducing this EHAC message across the country, but we would like to share it with, members in the Safety Council of Maryland. We will begin shortly to set up an educational program that will be very similar to CPR training in that it will be available for providers as well as for instructors so that the message can be perpetuated in the workplace. What's important here is to recognize is that the formula for treating cardiac arrest (CPR) in patients with severe chest pain having a heart attack is well known. What needs to be worked out is a formula for managing the patient with mild stuttering chest discomfort not perceived as pain, but important enough to be checked out. Perhaps the most important aspect is in the co-worker or bystander who needs to recognize that a heart attack may be imminent. It is just this type of approach.... a "good Samaritan" or "buddy system" that will prevent the problem from happening.

We invite all employers in Maryland to consider adding the EHAC program to their safety message to their employees. St. Agnes HealthCare stands ready to coordinate this with the Safety Council of Maryland so that we can be the first state to effectively put this message into place. At the National Meeting in Orlando Florida we will focus on the EHAC message for the Nation, but we would like to be able to tell them that Maryland has already instituted just such a program.

Raymond D. Bahr, MD, FACP, FACC
Medical Director
The Paul Dudley White Coronary Care System
St. Agnes HealthCare
Baltimore, Maryland

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