Cue The Madness

"55 year old female, breathing problems"

Community First Responders (CFR), rightly or wrongly are becoming a big part of pre-hospital care up and down the country. I could argue about the ethics of them for days on end. On the one hand, it's great that these people are giving up their own time to help their local community. That should be commended and overlooked. I am not being critical of ANY of the responders themselves, it is more that fact that they are needed and how they are used. The fact that all ambulance services are relying on un-trained volunteers to get to patients first and stop the clock speaks volumes about the shortcoming in budgets and man power. I know that in some areas, especially rural, the CFR scheme is invaluable. In others, like the city, it seems to be more or a PR and clock stopping exercise. Training standards across the country vary but in my area a 3 day St Johns Ambulance course is all they get. Then, they are given a radio, a response bag and mileage form and off they go. This isn't their fault, it is the system. They have little support and really are thrown in at the deep end.

After 6 months full time training, multiple assessments, months of placements and untold evening hours studying I didn't feel remotely ready to go out as a crew of two and meet patients. THAT was daunting! To do that after 3 days first is simply terrifying! The most important skill we learn as paramedics / EMTs / ECAs etc is talking to people. Making people calm, using tact, employing diplomacy and telling it straight when appropriate. This cannot be taught in a classroom. You learn it from experience and experience only. It cannot be taught on a 3 day course!

We arrived on scene to be greeted in the middle of the road by not one, but two members of the patients family waving their arms and jumping up and down. Clearly, today we would be acting in a calming role! Our patient was lying in bed, coughing and spluttering. To be fair it sounded like a horrible cough but not one that required all the pomp and circumstance that was surrounding her. We checked her over, listened to her breathing, did our usual battery of tests and came to the conclusion that she had pneumonia. Unfortunately, pneumonia is one of those big medical words that very few people have an understanding of and as such, strikes fear into many. Like many conditions, pneumonia can be serious in the very young, the very elderly and people with complex medical needs. She was none of the above so was going to be just fine! convincing her and her family of that was another matter....

As I was explaining what was going to happen and how pneumonia was just a simple chest infection in walked the CFR! Clearly control had forgotten to cancel them! It would normally just be a case of swapping call signs and they would leave but today this young guy decided to stay. Our patient was getting her stuff ready while I told the CFR what had been going on. Everything seemed quite calm, the patient was no longer panicking and her family had stopped hovering and fussing. Bliss! Cue the CFR.....

"My dad had pneumonia." he blurted out.

"Oh, how hold was he?" said the patient inquisitively.

"He was only 53."

"Was he OK, did he recover well?"

"No, he died."

Cue the madness.......

The room became hysterical and I mean seriously hysterical! They were all mourning over her inevitable death like Victorians. They were not far off picking out their black outfits! I tried and tried to resolve the situation but in vain. The CFR backtracked and said that he had had other medical problems too but what had been done, could not be undone. We went out to the ambulance, patient and relative's arms waving like the Harlem Shake and off we went to hospital. The CFR left the scene of the crime with his tail between his legs. Can you imagine the face I had on?!