Heart attacks

Brian: This week, our resident physician, Dr Dennis Haynes, is going to talk about heart attacks.

Dennis: Well, more precisely about what we can do – anyone, that is, I’m not just talking about doctors or people with medical training – what we can do to save the lives of people who have heart attacks. Did you know that about 300 people die of a heart attack in Britain every day?

Brian: Well, I knew heart trouble was the principal cause of death, but...

Dennis: What I’d like to make clear is that many of them could be saved if we all learnt a very simple technique.

Brian: The first symptom may be a sudden collapse, isn’t that so?

Dennis: Yes. Very often in the middle of a crowd, for example in an underground station. Now the people nearest to the person will be sympathetic and one of them will probably call an ambulance, but by the time anyone specialised arrives the victim may be dead, and in the meantime, most people are usually afraid to act, for fear of doing something wrong.

Brian: Yes. I was in that situation once, and I was terrified that if I did anything, I might kill the person. I was relieved that there happened to be a doctor in the crowd.

Dennis: Well, there’s no need to be scared if you know what to do and you may save someone’s life. In effect, if you want to stop a heart attack you have about three or four minutes to ensure three things. It may help you to remember them if we call them A, B, C – airway, breathing and circulation. Airway has to do with the fact that a person who’s unconscious may choke because, if he’s lying on his back, his head may fall forward and his tongue will press against his palate.

Brian: Isn’t that what they call swallowing your tongue?

Dennis: Yes, though that’s literally impossible. But it’s similar to what happens when we’re asleep, except that if you’re asleep, you’ll wake up rather than choke. The remedy here is simple. Just tilt back the person’s head by lifting his chin.

Brian: So that solves the airway problem, problem A. What next?

Dennis: Next, you have to make sure the person’s breathing. Lay him on his side while someone goes for help. If he’s not breathing, breathe for him by extending his neck, pinching his nose and breathing into his mouth. After a couple of breaths, you have to deal with the trickiest problem, the circulation.

Brian: Problem C?

Dennis: Yes. The best place to check the circulation is in the neck at the side of the windpipe. If there’s no pulse, you have to create one with external cardiac massage.

Brian: What’s that in simple terms?

Dennis: It means pressing on the lower part of the patient’s breastbone with both hands, just over once a second. You should squeeze rather than press hard. The idea is to massage blood out of the heart and round the body. In practice, you also need to do some mouth-to-mouth breathing, approximately two breaths for every 15 pumps.

Brian: It sounds complicated.

Dennis: No, not really. You could learn it with a few minutes’ practice. And the main thing is that once you know you can do it, you can cope with the much simpler problems you’re far more likely to come across, knowing how to deal with someone who has fainted, for instance.

(from Synthesis Advanced, by W.Fowler. Unit 6.2)

UNIT 4

Lesson B

First Aid

I = Interviewer

C = Dr Clarke

I Dr Clarke, when an accident happens the people present are much more likely to be people of the general public and not members of the medical profession. Now, how good are we? I mean would you say that a little knowledge is a dangerous thing? If we’re not sure what to do, is it actually best not to do anything at all?

C Well, they’re obviously interesting and important questions. Yes, first aid is terribly important and you can save lives if the right action is taken. I’d say that uhm ninety percent of first aid is common sense, and only ten percent is specialist knowledge. If someone isn’t breathing, you must give them artificial respiration, and I think most people know how to do that. If the person is bleeding, the bleeding must be stopped. I think these things are obvious. Medical help must of course be sought and someone must decide whether the victim can be taken to hospital, or whether, given the nature of their particular accident, the victim should be left alone.

I Yes, can we talk about road accidents more specifically in a moment?

C Yes.

I Is there one particular kind of accident where generally we get it wrong, we follow our common sense but it lets us down, and we do the wrong thing?

C Yes, I think there are two things associated with that. On the subject of burns, for example, some people put cream or grease or butter on, and this in fact makes the burn hotter; and the other thing…

I I’m sorry to interrupt. What should we do about burns, then?

C Well, you need to decide first of all how bad it is. If it is a minor burn, the best thing to do is to put the burnt area under the cold tap, or slowly pour on iced water.

I I see.

C This should be done for about ten minutes, and it stops the heat from spreading. However, if it is a bad burn, what we call a third-degree burn, don’t touch it, you really should get for this kind of burn expert help immediately. Cover the burn very lightly with something clean like a sheet or a, or a handkerchief and then go straight to a hospital. The other thing people do is to give drinks, especially alcoholic drinks, which means that if the patient needs an operation, we can’t give an anaesthetic.

I So, it’s better not to give any drinks at all.

C Certainly not alcoholic drinks. If the patient complains of thirst, he should wash his mouth with water and not swallow.

I This is very useful. Now back to road accidents. Could you give us some general advice on what to do at the scene of a car accident?

C Yes, three things. First of all you should check that the victims are breathing. I mean if they’re not, give artificial respiration. The most common injuries in car accidents in fact are fractures and bleeding, so the second thing to do is stop the bleeding. Thirdly, er … very important don’t move the victim unless it’s absolutely necessary. I mean, if any bones are broken, the injury could be made much worse by moving the victim. You should keep them warm, loosen any tight clothing, and try to reassure them. They’ll probably be suffering from shock, so just stay with them until expert help arrives. It’s a very good thing to do.

I Right, I see. Now, of course, there are a lot of accidents we haven’t had time to talk about. But do you think it’s worth while for the general public to find out about them, and find out how they can help.

C Sure, sure, yes, yes. I do indeed. I mean, I would advise people to find out as much as they possibly can. I mean, many of us freeze and panic when faced with a crisis. So, you know, why not learn about basic first aid?

I Dr Clarke, thank you very much.

(from Headway Intermediate, by J. and L.Soars. Unit 8)

UNIT 5

Lesson A

Down the pub

To drink or not to drink? Britain is famous for its pubs, and the British are traditionally regarded as a nation of beer-drinkers. But now all this is changing, says Chris Foulkes, an editor of wine books at a London publishing house. Michelle asked him to tell us about the latest trends in British drinking habits:

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