A Group Of Dummies
On Wednesday 21st November we were lucky enough to receive a First Aid training course from the London Ambulance Service. Norman, our trainer, has been an Ambulance Technician in South London for over ten years and passed a wealth of practical knowledge on to us during the two hour session. The course was well attended with fourteen London Branch members attending.
The London Ambulance Service (LAS) and British Heart Foundation have been campaigning to improve Basic Life Support (BLS) skills in London. This has proven to be a success with the survival rate from heart attack improving from less than 10% to over 15% in the last couple of years. This is a remarkably low percentage of the 10,000 or so cardiac arrests that LAS receive calls for per year but shows how much the campaign can achieve in a short space of time.
I’ll use the rest of the article to talk about some of the skills we learned on the course. Of course my waffling is no substitute for a real First Aid course so if you don’t understand anything here you may want to have a word with our Training Officer!
Order of Response
Through the BSAC syllabus we are taught that upon discovering a casualty we should follow a sequence known as “Dr ABC” (Danger, Response, Airway, Breathing, Circulation). LAS’ basic teaching (which we received) drops the use of the ‘C’. The amateur rescuer cannot be expected to check for circulation: the risk of spending too much time searching for a pulse or, worse, mistaking your own pulse for the casualty’s is too high. So the order of response we were taught to follow is “DRAB”.
Approaching a Casualty
Clearly it is unwise to risk injuring yourself while attempting to help someone. Norman’s tip was to make sure you look all around and above a casualty before approaching them – make sure there is nothing that can hurt you too, for example live electric cables. As a general rule if you encounter two or more casualties then you should be wary of approaching as there could be something that may hurt you like noxious gas, electricity, etc.
Showing his South London roots Norman suggested approaching a casualty from the ‘head end’. If they suddenly spring to life they would find it a lot harder to reach out and kick you. You should talk to them using commands like “Open your eyes” as it works better with drunkards. Only ever get down on one knee: it is a lot quicker to get up and run away if you need to.
Chest Compressions
Previous life support guidelines recommended performing 15 chest compressions for every two “Rescue Breaths”. Studies determined that it took up to 12 compressions to build up sufficient ‘pressure’ in the circulation leading to only three ‘effective’ compressions. Now the guideline has changed to 30:2 giving 18 effective compressions instead.
While performing BLS the casualty may start “pinking” up (returning to a more normal skin colour) which shows that your efforts are working. One of the common reasons for ineffective Rescue Breaths is apparently an inadequate nose hold and neck extension. Ineffective Rescue Breaths may come straight back out of the nose rather than go into the lungs. The resultant gust of air onto the rescuer’s cheek may lead them to incorrectly believe that their casualty has started breathing again.
The rate at which chest compressions should be performed is very high: 100 per minute. A good way to ensure you are at the right speed is to hum to yourself and work at the rhythm of the tune. Norman suggested “Nelly the Elephant” as being at the correct tempo or “Another One Bites The Dust” by Queen; although the latter should probably not be sung out loud in the vicinity of an unconscious casualty… We were told that the average response time for an ambulance in London is eight minutes, an awfully long time to perform CPR.
I hope I am correct in reporting that everyone thoroughly enjoyed the course, and learned an awful lot. I think even Norman enjoyed it, teaching an unruly rabble like us. I’d like to run another similar course in the future, so if anyone wants to attend then please get in touch.