Today I was in a shopping centre with my daughter and her best friend doing a bit of xmas shopping. We decided to get my daugthers' hair trimmed and on the way out of the salon, an elderly man dropped to the floor right in front of us. He fell face first and just lay there.
As one of the first people on the scene, we telephoned 999 for an ambulance. Becuase I was worried about the kids, I took a "back seat" and tried to get the kids away from the traumatic sight and keep the emergency services on the phone up to date with what was happening while another lady got on the floor next to the man and put him in the recovery position.
It took the ambulance about 10 mins to arrive. Within that time the centre security arrived and did some crowd control and tried to ask who saw what and get some answers to questions.
The man started to convulse, his pulse went very low and he stopped breathing. He turned purple in the face, the most purple of purlpes I've ever seen.
Once the paramedics arrived they started compressions and worked on him for over 20 mins.
By this time the kids were besides themselves and I decided it was best to move them straight away from the scene, so we left.
I actually am not sure if the man survived or not - when I went back to the hair salon an hour later to enquire if they knew anything, they said that they didn't think he had made it.
Other than knowing to clear the airpipes and put a person in a recovery position, I do not know any other first aid.
The whole time we were speaking to the emergency services on the phone while waiting for the ambulance to arrive, they were giving us instructions on how to check if he was breathing by using a mirror, but they never suggested we do compressions.
I can't help but wish that I knew more first aid that I could have applied today to help save that man's life.
Earlier this year I actually booked myself onto a St Johns' first aid course but then cancelled it due to lack of funds.
I pray that the man did make it. And I pray for his family.
He was probably just like me, out for the day doing a bit of last minute xmas shopping.
It is so sad.
Knowing how to do first aid could have saved a mans' life
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the-gnole
Re: Knowing how to do first aid could have saved a mans' lif
It's not your fault Laura, there are many more who would have walked by and not even made the 999 call.
The figures for survival rates of a cardiac arrest in the UK are not very good at al possibly only 1 in 10, but you have to know exactly what to do, in the case you witnessed a thump on the chest "might" have worked followed by CPR, but a De-Fib would have been better, but you won't find one in many places in the UK.
Can I recommend the St John courses that are available free of charge in most instances for a new years prep for all of the family?
It might not have saved this gent, but it might be useful in other circumstances.
The figures for survival rates of a cardiac arrest in the UK are not very good at al possibly only 1 in 10, but you have to know exactly what to do, in the case you witnessed a thump on the chest "might" have worked followed by CPR, but a De-Fib would have been better, but you won't find one in many places in the UK.
Can I recommend the St John courses that are available free of charge in most instances for a new years prep for all of the family?
It might not have saved this gent, but it might be useful in other circumstances.
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Carrot Cruncher
Re: Knowing how to do first aid could have saved a mans' lif
It certainly puts things in perspective when you witness something like that Laura, and like gnole says it's not your fault, you did the best you could. Even people who do have the necessary skills can freeze in those type of situations unless they are used to practising those skills.
Learning First Aid to a fairly decent level is probably one of the most neglected and under rated skills a prepper could learn, and i'm as guilty in that respect as everyone else.
Learning First Aid to a fairly decent level is probably one of the most neglected and under rated skills a prepper could learn, and i'm as guilty in that respect as everyone else.
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skippy
Re: Knowing how to do first aid could have saved a mans' lif
Firstly dont beat yourself up for not doing more than you did. Lots of folks would have done nothing.
In my job I see too many people needing first aid and both myself and the OH have extensive training to cope in these situations. Even then heart failure (MI) has a very poor recovery rate.
Hunt around in your local area for free or low cost 1 day 1st aid courses, usually st Johns or similar or if you are in employment, ask your employer if they will send you on an HSE approved 5 day course. (this ticks boxes for them under employer liability and Health and Safety). Worth a try anyway.
In any case and at risk of second guessing:
always remember ABC (Airways , Breathing , Circulation) In that order
Is their airway open?
Are they breathing?
Do they have a pulse?
If you assess, monitor and support if required these three things , then everything else in the first 10 minutes is trimmings. (with a few exceptions). Its not complex, its not difficult, It usually only take a few hours to learn and it will give a casualty the best chance.
skippy
In my job I see too many people needing first aid and both myself and the OH have extensive training to cope in these situations. Even then heart failure (MI) has a very poor recovery rate.
Hunt around in your local area for free or low cost 1 day 1st aid courses, usually st Johns or similar or if you are in employment, ask your employer if they will send you on an HSE approved 5 day course. (this ticks boxes for them under employer liability and Health and Safety). Worth a try anyway.
In any case and at risk of second guessing:
always remember ABC (Airways , Breathing , Circulation) In that order
Is their airway open?
Are they breathing?
Do they have a pulse?
If you assess, monitor and support if required these three things , then everything else in the first 10 minutes is trimmings. (with a few exceptions). Its not complex, its not difficult, It usually only take a few hours to learn and it will give a casualty the best chance.
skippy
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Jan Mayen
Re: Knowing how to do first aid could have saved a mans' lif
Yup, I can echo all that has been said above. Non hospital cardiac arrest has an incredibly low survival rate, virtually zero. I am the other half of Skippy, and for my sins I volunteer for the Ambulance Service as a first responder. Due to where we live, chances of getting an ambulance to our area within 20-25 minutes are low (as there is only one ambulance on duty at any one time), they decided to put in a First Responder team. We are alerted via pager and arrive with our lovely flourescent jackets and bags of stuff! We are all members of the public, trained by the same people who train paramedics in advanced first aid. We have to be able to do CPR for as long as it takes, we can put in airways, do suction, give oxygen and defib someone. So when you call 999, if I am on duty, then it is me you will get on your doorstep 15 minutes ahead of an ambulance! As an aside, we are not in place to fulfil government targets about answering calls in a certain time, the call isn't classed as answered until the ambulance gets there.
First off, we will introduce a couple of extra letters to the wonderful ABC. D, for danger. Basically whatever did that to them, make sure it isn't going to do the same to you! Have a quick check about, make sure they haven't just been electrocuted, had something fall on them which could have other stuff fall on you, if they are in the road get someone to stop the traffic. So D is added.
The other letter we add is R for response. Approach them, talk to them "Hello? Are you ok?" Guage their level of alertness. Medics use the Glasgow Coma Score (youwill hear this as GCS and then a number) to do this, which is overkill for what you will need to do. However, the basic principle is the same for us:
Alert. They respond to you normally. - great!
Hello? can you hear me? Can you open your eyes for me? Can you squeeze my hand? - no response? Go to the next level ->
Give them a small shake, usually a shoulder to see if you can wake them up. Don't do this too hard, especially if you suspect trauma. no response? Go to the next level ->
Cause pain. Now this doesn't mean take a running kick at them, there are 1001 different ways to do it, but pinching an earlobe is probably the safest! It hurts and will not likely make any trauma worse as a sternal rub (knuckles on the breastbone), or orbital press (pressing the bit of bone at the top of your eye socket) could make injuries worse. Again, you are looking for a response, either opening of an eye, moving of an arm to push you away etc.
Unresponsive. - Knackers
So AVPU, alert, voice, pain, unresponsive.
There are lots of sublevels of "with-it-ness" covered more in the Glasgow Coma Score, so they can be awake but not have a clue where they are or what has happened, talking but not the right words, gibberish or noises. All indicate different levels of injury. However, we are only really interested in AVPU. If you want a quick look, here is a linky to wiki but don't worry yourself too much about it, its not taught outside the emergency services. http://en.wikipedia.org/wiki/Glasgow_coma_score
So, we now have DRABC.
ABC, airway, breathing, cirulation.
Check their airway: open their mouth and check for anything in there, loose teeth, chewing gum, puke. Clear it if you can. Don't be afraid to roll someone if they have a mouth full of sick. If it is a non-traumatic collapse (i.e. they haven't been hit by a bus, but have collapses in the queue to get on) roll them without fear of causing injury. If it is traumatic, you need to be taught how to do this on a course - sorry!
Breathing. Look, feel, listen. Put your ear over their mouth, looking down over the chest. You can look at the chest for breathing, place a hand on the chest, can you feel it moving? Listen for breath.
Circulation. This is the difficult bit. Circulation is difficult to detect, even for medical professionals. You will be hyped up, your own pulse will be bouncing and it is really easy to feel your OWN heartbeat in your fingers and not the casualties! So, the ambulance service during a 999 call now advise people not to check for a pulse, but go off what the casualty looks like & their breathing. If they are grey/blue/purple then their circulation isn't too good, so start CPR. If their breathing is less than 6-8 breaths per minute, start CPR. Basically, start CPR. When you call 999 the operator might tell you to watch the patient and tell them when the casualty takes a breath. This might seem a bit weird, but they have a gadget on their system whcih allows them to analyse the breathing pattern and advise you on what to do. We do something called "agonal breathing" whcih is the type of breathing prior to an arrest. This is what they are checking for.
Now, there are a bazillion videos on youtube about how to do CPR so I won't bore you with all that. But my own tips:
Compressions are more important than mouth to mouth. If you can't do mouth to mouth, just do compressions. It is better than nothing.
It is knackering. Get your knees on something comfy and don't be afraid to swap other people in to take a turn if needed.
The current rate is fast at 100 compressions per minute. The daft little song used to be "nelly the elephant", well now do it to singing "stayin' alive" by the beegees and you won't be far off!
The ratio is 30 compressions and then two breaths, if you are confident giving breaths.
If you are doing AV (artificial ventilation - mouth to mouth) beware of the puke. Seriously.
If someone rocks up with a defib, they are bloody brilliant. Even with no training, you will be able to use it. Turn it on. There will be a big obvious button somewhere. It will now talk to you throughout the incident, so don't panic if you don't know what to do. The pads are like giant plasters with a picture on them showing where they should be stuck on, just make sure it is well stuck and you don't trap anything under the pad such as jewellery or clothing.
A lot of shopping centres have them on the wall now. Just be sure not to be touching the patient at all when it is analysing them as it will detect your pulse not theirs, and make sure 100% that no-one is touching them if it advises a shock. You get to shout "CLEAR" like on TV
Here is a video of the lifeguards on Bondi Beach using their defib for real. Stuff to note, is the fact that the guy looks like he is breathing. He isn't. The "gasping" response is what your body does when the heart has stopped but your brain is still trying to keep you alive. The rate they use is waaaaay too slow. This was filmed a good while ago and it has been updated to much faster. The protocol for drowning (as in this case) is slightly different as they have to give rescue breaths first rather than jumping straight into CPR. Drowning and asphyxiation are probably the most likely to get a good result like this as the heart has stopped simply due to lack of oxygen and will fibrillate (twitch without rhythm) for ages. The heart stopping due to injury (heart attack), drugs, blood loss or trauma is far less likely to be recoverable as to have a good chance you have to be able to reverse the reasons.
A defib will only shock if the heart is in a shockable rhythm. If the heart as stopped all activity and is just sat there, then it will NOT shock them. It will shock them if they are in VF or VT which is basically the heart having a dickyfit and fibrillating, twitching and not really got its arse in gear. Think of a defib shock as a kick up the bum for the heart. No use if it is "dead" but works if it is just all out of sync. It will not shock the patient if they have a normal heart beat, and will not shock the patient until you press the relevant button on the machine (as you have to get everyone to not be touching them).
So. We have learned a little bit extra about ABC. A couple of new letters D & R which help us do the right thing, we have learned about a defib and hopefully seen one in action.
Other stuff.
If someone has been in a traumatic accident and they are unconsious but breathing, don't move them too much. Protect their airway however you see fit. Sod the recovery position, move them as little as possible with the more hands on the better.
Never, ever, ever, ever, ever remove a helmet, be it motorbike, horse riding, cycling or anything. Leave it on.
People can look drunk when they are not. Diabetics look drunk, head injuries look drunk, strokes look drunk, hypothermia looks drunk. Never assume.
The 999 operator will help you, they will guide you as much as you want. Talking to them will not slow down the ambulance arriving. You need to give them the address and what is wrong, after that the big white disco bus in on its way, they are just there to help you after that.
I hope this helps someone at some time. Of course none of this is a substitute for a course. It only takes a day, and I always think it could help me save someone I love. If you have any questions, please just ask.
First off, we will introduce a couple of extra letters to the wonderful ABC. D, for danger. Basically whatever did that to them, make sure it isn't going to do the same to you! Have a quick check about, make sure they haven't just been electrocuted, had something fall on them which could have other stuff fall on you, if they are in the road get someone to stop the traffic. So D is added.
The other letter we add is R for response. Approach them, talk to them "Hello? Are you ok?" Guage their level of alertness. Medics use the Glasgow Coma Score (youwill hear this as GCS and then a number) to do this, which is overkill for what you will need to do. However, the basic principle is the same for us:
Alert. They respond to you normally. - great!
Hello? can you hear me? Can you open your eyes for me? Can you squeeze my hand? - no response? Go to the next level ->
Give them a small shake, usually a shoulder to see if you can wake them up. Don't do this too hard, especially if you suspect trauma. no response? Go to the next level ->
Cause pain. Now this doesn't mean take a running kick at them, there are 1001 different ways to do it, but pinching an earlobe is probably the safest! It hurts and will not likely make any trauma worse as a sternal rub (knuckles on the breastbone), or orbital press (pressing the bit of bone at the top of your eye socket) could make injuries worse. Again, you are looking for a response, either opening of an eye, moving of an arm to push you away etc.
Unresponsive. - Knackers
So AVPU, alert, voice, pain, unresponsive.
There are lots of sublevels of "with-it-ness" covered more in the Glasgow Coma Score, so they can be awake but not have a clue where they are or what has happened, talking but not the right words, gibberish or noises. All indicate different levels of injury. However, we are only really interested in AVPU. If you want a quick look, here is a linky to wiki but don't worry yourself too much about it, its not taught outside the emergency services. http://en.wikipedia.org/wiki/Glasgow_coma_score
So, we now have DRABC.
ABC, airway, breathing, cirulation.
Check their airway: open their mouth and check for anything in there, loose teeth, chewing gum, puke. Clear it if you can. Don't be afraid to roll someone if they have a mouth full of sick. If it is a non-traumatic collapse (i.e. they haven't been hit by a bus, but have collapses in the queue to get on) roll them without fear of causing injury. If it is traumatic, you need to be taught how to do this on a course - sorry!
Breathing. Look, feel, listen. Put your ear over their mouth, looking down over the chest. You can look at the chest for breathing, place a hand on the chest, can you feel it moving? Listen for breath.
Circulation. This is the difficult bit. Circulation is difficult to detect, even for medical professionals. You will be hyped up, your own pulse will be bouncing and it is really easy to feel your OWN heartbeat in your fingers and not the casualties! So, the ambulance service during a 999 call now advise people not to check for a pulse, but go off what the casualty looks like & their breathing. If they are grey/blue/purple then their circulation isn't too good, so start CPR. If their breathing is less than 6-8 breaths per minute, start CPR. Basically, start CPR. When you call 999 the operator might tell you to watch the patient and tell them when the casualty takes a breath. This might seem a bit weird, but they have a gadget on their system whcih allows them to analyse the breathing pattern and advise you on what to do. We do something called "agonal breathing" whcih is the type of breathing prior to an arrest. This is what they are checking for.
Now, there are a bazillion videos on youtube about how to do CPR so I won't bore you with all that. But my own tips:
Compressions are more important than mouth to mouth. If you can't do mouth to mouth, just do compressions. It is better than nothing.
It is knackering. Get your knees on something comfy and don't be afraid to swap other people in to take a turn if needed.
The current rate is fast at 100 compressions per minute. The daft little song used to be "nelly the elephant", well now do it to singing "stayin' alive" by the beegees and you won't be far off!
The ratio is 30 compressions and then two breaths, if you are confident giving breaths.
If you are doing AV (artificial ventilation - mouth to mouth) beware of the puke. Seriously.
If someone rocks up with a defib, they are bloody brilliant. Even with no training, you will be able to use it. Turn it on. There will be a big obvious button somewhere. It will now talk to you throughout the incident, so don't panic if you don't know what to do. The pads are like giant plasters with a picture on them showing where they should be stuck on, just make sure it is well stuck and you don't trap anything under the pad such as jewellery or clothing.
A lot of shopping centres have them on the wall now. Just be sure not to be touching the patient at all when it is analysing them as it will detect your pulse not theirs, and make sure 100% that no-one is touching them if it advises a shock. You get to shout "CLEAR" like on TV
Here is a video of the lifeguards on Bondi Beach using their defib for real. Stuff to note, is the fact that the guy looks like he is breathing. He isn't. The "gasping" response is what your body does when the heart has stopped but your brain is still trying to keep you alive. The rate they use is waaaaay too slow. This was filmed a good while ago and it has been updated to much faster. The protocol for drowning (as in this case) is slightly different as they have to give rescue breaths first rather than jumping straight into CPR. Drowning and asphyxiation are probably the most likely to get a good result like this as the heart has stopped simply due to lack of oxygen and will fibrillate (twitch without rhythm) for ages. The heart stopping due to injury (heart attack), drugs, blood loss or trauma is far less likely to be recoverable as to have a good chance you have to be able to reverse the reasons.
A defib will only shock if the heart is in a shockable rhythm. If the heart as stopped all activity and is just sat there, then it will NOT shock them. It will shock them if they are in VF or VT which is basically the heart having a dickyfit and fibrillating, twitching and not really got its arse in gear. Think of a defib shock as a kick up the bum for the heart. No use if it is "dead" but works if it is just all out of sync. It will not shock the patient if they have a normal heart beat, and will not shock the patient until you press the relevant button on the machine (as you have to get everyone to not be touching them).
So. We have learned a little bit extra about ABC. A couple of new letters D & R which help us do the right thing, we have learned about a defib and hopefully seen one in action.
Other stuff.
If someone has been in a traumatic accident and they are unconsious but breathing, don't move them too much. Protect their airway however you see fit. Sod the recovery position, move them as little as possible with the more hands on the better.
Never, ever, ever, ever, ever remove a helmet, be it motorbike, horse riding, cycling or anything. Leave it on.
People can look drunk when they are not. Diabetics look drunk, head injuries look drunk, strokes look drunk, hypothermia looks drunk. Never assume.
The 999 operator will help you, they will guide you as much as you want. Talking to them will not slow down the ambulance arriving. You need to give them the address and what is wrong, after that the big white disco bus in on its way, they are just there to help you after that.
I hope this helps someone at some time. Of course none of this is a substitute for a course. It only takes a day, and I always think it could help me save someone I love. If you have any questions, please just ask.
Last edited by Jan Mayen on Sat Dec 24, 2011 4:38 pm, edited 3 times in total.
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metatron
Re: Knowing how to do first aid could have saved a mans' lif
I've done and renewed my first aid training, but to be completely honest I'd never help anyone I don't personally know as you are just opening yourself up to litigation, everyone is looking for a payday and with out personal insurance against such a thing its not worth the risk.
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Jan Mayen
Re: Knowing how to do first aid could have saved a mans' lif
Basically, you have protection through "implied consent" which is if they were able, they would consent to you saving their life! There has (to my knowledge) never been a successful attempt at litigation. I guess I am lucky as I am covered by the ambulance service who defend their staff/volunteers to the hilt.metatron wrote:I've done and renewed my first aid training, but to be completely honest I'd never help anyone I don't personally know as you are just opening yourself up to litigation, everyone is looking for a payday and with out personal insurance against such a thing its not worth the risk.
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bulldogeagle
Re: Knowing how to do first aid could have saved a mans' lif
that is a very sad but true statement of the world today where an act of kindness leaves anyone open to litigation, i did first aid many years ago whilst working in the building trade and can probably remember enough to do CPR but whether i would in view of the above statement is doubtful.metatron wrote:I've done and renewed my first aid training, but to be completely honest I'd never help anyone I don't personally know as you are just opening yourself up to litigation, everyone is looking for a payday and with out personal insurance against such a thing its not worth the risk.