Q & A with Dr. Raymond Bahr

Dr. Raymond Bahr is passionate about cardiac care and preventative education. His passion to disseminate lifesaving information is a driving force at ACC Accreditation Services. The Deputy Heart Attack Program and Early Heart Attack Education (EHAC) is the brainchild of Dr. Raymond D. Bahr.


You talk a lot about Saver or Enabler. What does that mean?


The bystander is perhaps the most important when someone is in the midst having a heart attack. There are three types of heart attack presentations everyone should know about…


What are they?


There is the one that drops you dead and you have no chance at all to survive unless you can be defibrillated fast (chances are not that good). However, if the bystander knows how to perform Cardio Pulmonary Resuscitation – CPR – there is a chance of survival.

With the second type, the patient will appear very weak and sweating cold beads across their foreheads. The person here is most likely experiencing severe pain across the chest. They will often describe it as “an elephant or Mack truck sitting on their chest”. The saver knows quickly to call 911 and get an ambulance. Time is important — 80% of the heart damage will occur within the first two hours. Unfortunately, the average time to get into the hospital is about two hours and this has not changed much over the years. Even within the Hospital, the average time to open the clotted blocked heart vessel is 60-90 minutes.

The third type begins when the patient experiences “beginning mild chest symptoms” before they progress to the severe chest pain that will bring them into the hospital. It is here where the bystander or becomes either an enabler or saver.


Is it really enabling?


In the first two presentations, it is obvious what is taking place and the Bystander will be usually … no getting around this. But, in the third type, the patient in the early stage will not look sick and no one will suspect that anything is taking place. The patient many times will be denying their symptoms because the “inconvenience” will ruin their day. That’s when the bystander then becomes the enabler, because they behave like it’s no big deal.


So even “little” episodes are a big deal?


Heart attacks are the No. 1 killer of the adult population in the U.S., because we allow it to be a crashing illness. It need not be. Everyone forgets about what is happening until it is too late. Taking action early prevent s the heart attack from progressing.


So what should everyone know…the basics?


To save a life, overcome the resistance and struggles that the patient may throw up to avoid not going to the hospital.


Yes, but how do you do that?


The ideal approach to intervention can be recalled through a simple acronym: SPICE which stands for:

  • Simple
  • Persistent
  • Influential
  • Calm
  • Empathetic

So do all that, but take action, don't wait?


Do not take the time to attempt an evaluation. Get them to medical care as soon as possible. Find out what they need . To be a saver, the bystander needs to interrupt their day to save the life of another … and what could be a better use of someone’s time than that?