How to save a life.

I saved a mans life recently.

It may come as a surprise, but it’s not that often paramedics get to say this. We help people every single shift we work, no doubt about it, and we certainly contribute a huge amount to the survival of a lot of people. But this man was dead, and then he was alive again. Talking to me. Even for paramedics, this is relatively rare!

This post isn’t about how heroic my actions were, but how simple they were, and how anyone (not just paramedics, doctors, nurses or other health care professionals, but anyone) could have done the same thing! On the way to hospital the patient’s condition continued to improve, to the point were he was alert and talking to us. I’m going to follow-up his progress the next time I’m at that hospital.

That may sound impressive, and the crew and I certainly did a good job, but there was nothing we did that any bystander couldn’t have done with the right knowledge. Our fancy paramedic skills like intubation, giving drugs etc didn’t save this man, we didn’t need to do them. Being in the right place at the right time so that we could start early compressions and defibrillation (shock) were what did the trick, and these can be done by anyone with access to a phone, a public access defibrillator (PAD) and enough courage.
workplaces_tile

The emergency medical services (EMS) attempted to resuscitate 28,000 out of hospital cardiac arrests (OOHCA) in 2013 (1). Unfortunately, a lot of cardiac arrest calls the ambulance service go to don’t end in a good outcome. Your chances of survival to hospital discharge if you go into cardiac arrest outside of hospital in the UK are 8.6% (1) and this is often due to the patient being in a non-shockable rhythm, or the patient not receiving immediate, good quality bystander CPR. The number of people being in a shockable rhythm by the time EMS arrive could be increased if patients receive immediate CPR by the public. Therefore, calling 999 immediately and providing CPR could improve the chances of survival for a lot of people (2). The current rate of bystander CPR in the UK is roughly around 43%(3), compared with 73% in an area of Norway (survival rates for OOHCA in Norway – 25%)(4). Bystander defibrillation with a PAD was measured in South East England at 1.74%(5). When someone goes into cardiac arrest, every minute without CPR and defibrillation reduces their chances of survival by 7-10%.(6,7,8) What would you do? It is scary. People don’t know what to do. People are scared they’re going to end up hurting someone more than helping. They don’t know where the nearest PAD is. Your best bet? Call 999. The call takers are amazing and will talk you through what to do, and will often know where the nearest PAD is. PADs are safe to use by anyone, they give clear spoken instructions and you won’t end up shocking someone you shouldn’t. Help will be there soon and you have the potential to save a life. If you want to do more or be better prepared, there are basic life support (BLS) courses you can do and they will improve your knowledge and confidence, or check out the British Heart Foundation website. They provide the CALL PUSH RESCUE campaign. As the video below states:

‘…the worst thing you can do, is nothing’. 

Any thoughts on bystander CPR, PADs or OOHCA, please comment below!

Learn BLS – https://www.bhf.org.uk/heart-health/nation-of-lifesavers/heartstart Using Defibrillators – https://www.bhf.org.uk/heart-health/nation-of-lifesavers/using-defibrillators References (Taken from Consensus Paper on Out-Of-Hospital Cardiac Arrest in England – Resuscitation Council, 2014)

http://www.england.nhs.uk/statistics/stasistical-work-areas/ambulance-quality-indicators/ 2. Waalewijn RA, Tijssen JGP, Koster RW. Bystander initiated actions in out-of-hospital cardiopulmonary resuscitation: results from the Amsterdam Resuscitation Study (ARREST). Resuscitation 2001; 50:273–279. 3. Perkins GD. Data on file. OHCA database. (reference from https://www.resus.org.uk/pages/OHCA_consensus_paper.pdf) 4. Lindner TW, Soreide E, Nilsen OB, Torunn MW, Lossius HM. Good outcome in every fourth resuscitation attempt is achievable-An Utstein template report from the Stavanger region. Resuscitation 2011; 82:1508-13. 5. Deakin CD, Shewry E, Gray H, Public access defibrillation remains out of reach for most victims of out-of-hospital sudden cardiac arrest. Heart 2014; 100:619-623. 6. Holmberg M, Holmberg S, Herlitz J. Incidence, duration and survival of ventricular fibrillation in out- of-hospital cardiac arrest patients in Sweden. Resuscitation 2000; 44:7-17 7. Larsen MP, Eisenberg MS, Cummins RO et al. Predicting survival from out-of-hospital cardiac arrest: a graphic model. Ann Emerg Med 1993; 22:1652-8. 8. Valenzuela TD, Roe DJ, Cretin S, Spaite DW, Larsen MP. Estimating effectiveness of cardiac arrest interventions: a logistic regression survival model. Circulation. 1997; 96:3308 –3313.
Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s