Here’s one to hopefully make you giggle a bit!!
Called to a local nursing home for a collapse? breathing.
I am working on the Rapid response car, so I set off at the speed of light to try and meet the Cat A response time of 8 mins from time of connection of the phone call to the control room.
Sure enough 5 minutes later I arrive on scene and I take a moment to imagine the control room staff standing and cheering as they congratulate my timely arrival on scene (Try and imagine a scene from NASA control when a successful launch occurs) where I am now in a position to use all of my advanced life support skills to save yet another life!
Anyway, back to reality!
I gather my kit from the back of the car, which is no mean feat in itself, and stumble my way into the home. I am shown to the farthest bedroom on the highest floor (well known ambulance fact – If you ever have to go into a home or sheltered accommodation, make sure they put you as close to the main entrance door as possible, as it is highly unlikely that you will be poorly. We always end up going to the farthest room in the building for the poorly patients) where I find an elderly man lying on the bed with no signs of life.
No evidence of rigor and no post mortem staining, so I get some help from the staff and move him onto the floor and start CPR. Whilst I am doing this, I ask for a quick history. The care staff, including the registered nurse, state that they came in to check on him and found him gasping for breath. Whilst one ran down and dialled 999, the other stayed with him to “comfort him” It transpired that shortly afterwards he stopped breathing, but they still comforted him……..No CPR though.
Following the time line of events, it looked like he had been “down” for less than 5 minutes so resuscitation was on the cards, a quick check with the paddles of the defib showed PEA (pulseless electrical activity). At the time we were still doing ventilation’s first (this was a couple of years ago) so I ensured his airway was clear, inserted a OPA (oropharyngeal airway), and delivered 2 ventilation’s. I was just about to start compressions when I asked
“Can anyone do heart massage?”
A male nurse, Michael, stepped forward and said
“Yes, no problem, would you like me to help?”
Fantastic!, now that I have an extra pair of hands I can think about securing the airway with an ETT and then get another one of the carers to “bag the patient” whilst I get on and gain IV access and deliver the cardiac drugs.
Then all my enthusiasm for my helpers disappeared in the blink of an eye, or rather I should say, the moment of disbelief when I noticed just how effective the cardiac compressions were being delivered by my “able” assistant.
As I am at the head of the patient looking down, I see Michael with both hands flat on the either side of the patients chest, there is no downward pressure being applied to compress the heart in the thorax, instead, I kneel with open mouthed amazement as I watch this fully qualified registered nurse gently rub his hands in a circular motion around the patients nipples (imagine Daniel in the Karate Kid – “Wipe on, Wipe off!).
M999: “You`ve got to be kidding me???”
M999: ” What do you think you are doing? You said you knew cardiac massage!”
Michael: ” Yeah, this is how we were taught it”
No time to argue, I take over both functions and decide on continuing basic life support until my back up crew arrives. As I am waiting Michael asks if he could “do the breathing for the patient”. Err, Let me think now……… NO!!
He starts delving into my kit bag looking for things to help with, he asks if I want a blood pressure reading.
IS THIS REALLY HAPPENING???
I decide to make the best treatment decision of the day, I ask him if he will go back down to the car and bring a box of gloves from the boot up for me. I didn’t need any, just wanted to get him away from me and the patient.
Shortly afterwards my back up crew arrive in the room carrying a box of gloves in with them with a quizzical look on their faces.
“What do you want these for????”
If only they knew!