"Old dude, collapsed outside"
Weekends off in the ambulance service are a rarity. For the first two years of service my rota required me working 7 out of 10 weekends. It's now improved to 5 out of 10. At the time, I was living outside of London with my partner enjoying a rare sunday off. We were dressed and ready to meet friends for lunch. He was wearing smart jeans, shoes and shirt and I was donning skinny jeans, boots and a rather risque top. Why the hell not?! We were running late as usual and just as we were about to leave there was a knock on the door.
"Who the hell is that?!"
And the inventor of the door rests happily in his grave. We would have to open it to find out! With an air of frustration I swung the door open. A young lad stood there, about 15 years old.
"Are you guys the paramedics?"
"Mmm, yes. Why?" I said hesitantly.
"Some old dude has collapsed in the street"
Balls! Off I went up the garden path, and sure enough, about 6ft from the front gate on the grass verge besides the pavement was indeed an old dude lying on the floor. I recognised the look on his face. It was the dead face all EMS have come to know only too well.
"What happened?"
"He was just walking along and fell to the floor, he didn't move so I got you"
"OK, call 999"
I checked for a pulse, nothing. Breathing......nothing. Airway clear. I started CPR. As this was going on my partner came to the door to see what the fuss was about. Seeing me bounce up and down was enough! He came running out, opened the car that happened to be next to the 'old dude' and got out our response and paramedic bags. Despite no oxygen cylinder I did CPR and ventilations while my partner started getting stuff ready to intubate and cannulate. The kid was on the phone requesting an ambulance and was understandably panicking. He had given the address but was trying desperately to describe what was going on with little success or accuracy.
"Hold the phone to my ear, you've done great"
"Hello there, this a confirmed cardiac arrest, witnessed collapse, CPR in progress by LAS Paramedic, cause unknown. I'll put the kid back on for anything else you need"
"Thank you, there are 2 vehicles on route, they should be there in 3-4 minutes"
We carried on doing what ambulance services do best. He was intubated and cannulated, chest exposed and chest shaved by the time the ambulance arrived. They clearly hadn't got the message about who was on scene as when they came over they said:
"Well done, you've done a great job, are you first aiders"
I think as she said it she realised that first aiders don't normally intubate and cannulate but it was amusing all the same. They attatched oxygen to the BVM and the defib to the chest. The 'old dude' was in Ventricular Fibrillation which is a rhythm we can shock. By now a large crowd had arrived and if you've read my previous blog 'The bystander and me....' you'll know how I thrive on it!
"Stand clear, oxygen away, shocking now"
The body jolted as the shock was delivered, just as you see on TV. It was wonderfully dramatic! I continued CPR for 2 minutes as is customary after a shock whilst the crew got the bed ready. When the two minutes was up I checked the carotid pulse at the neck and the crew checked the radial pulse at the wrist.
"I've got a pulse!"
"So have I!"
We helped them load him up, still bagging him and then he started breathing on his own. We gave out details to the crew and left them too it. When packed up our gear and headed off to lunch. Arriving late with sweat on our brows and mud on our knees let to some suspect looks and awkward questions but we had a good tale to back it up.
We heard on the grape vine that 'Peter' had survived but it was only rumour. 6 weeks later there was a knock at the door. There he was. Completely different to how I remember but he had come to thank us for saving his life. This was the first time i'd ever met someone we had 'got back' and it was a felling I will never forget. That feeling of ecstasy and joy was enough to forgive the lack of flowers and chocolates. It remains my only off duty cardiac arrest and the one I look back on with most fondness. It just goes to show the importance of early CPR. That more so than any of the drugs and skills we bring to the table. It really does save lives.
Take the time to look at the British Heart Foundation's new advert campagne if you haven't already. Compression only CPR. That's what can be the difference between life and death. If you're lucky you'll be able to use the phrase we did as we drove off.
"Another life saved!"
If you would like to attend a FREE 2 hour course in London on Basic Life Support contact the London Ambulance Service at resustraining@londonambulance.nhs.uk for more information.