A couple of months ago, I did some things that I hope I’ll never, ever have to do again. Warning: this post contains simulated blood, gore and stressful situations.
I arrived on the scene of a road traffic collision to find a motorcyclist wedged beneath a car. I held his head and supported his neck. Another person removed his helmet and cleared his mouth of vomit so he could breathe.
I’ve done bits and pieces of first aid training before. I remember every year in PE classes throwing a life-belt or rope into the pool, bandaging snake bites, fiddling with triangular bandages and trying to memorise complex combinations of breaths and compressions to resuscitate a plastic dummy. I vaguely remember my mum doing a first aid course, too, when I was a kid: practicing a bandage-twisting thing (doughnut roll) and a slightly different but no less complex combination of breaths and compressions.
And then a couple of years ago I did a First Aid at Work course with Andy Sullivan from Emergency Life Support Team (ELST). We were tucked away in a small, boring meeting room, ready for a small, boring PowerPoint presentation. But Andy didn’t teach like that.
“If one of you collapsed right now and went into cardiac arrest, would you be alive or dead?” he asked. We shuffled our notebooks, waited for someone else to say something, mumbled a few things: we’d be alive; alive for a few minutes; alive until a doctor said otherwise; alive if our brain was still alive. Andy let us have our discussion and said, “Let me put it to you: if someone’s heart is not beating, that person is dead. They’re not going to get better without intervention. They are dead. So anything that you do now, as a first aider, is not going to make them worse.”
It was a lightbulb moment for me: what matters is not so much choosing the right sized bandage or perfecting the doughnut roll (not generally taught in first aid courses any more) but potentially keeping someone not-dead-enough until the emergency services arrive.
And then a couple of years ago I did a First Aid at Work course with Andy Sullivan from Emergency Life Support Team (ELST). We were tucked away in a small, boring meeting room, ready for a small, boring PowerPoint presentation. But Andy didn’t teach like that.
“If one of you collapsed right now and went into cardiac arrest, would you be alive or dead?” he asked. We shuffled our notebooks, waited for someone else to say something, mumbled a few things: we’d be alive; alive for a few minutes; alive until a doctor said otherwise; alive if our brain was still alive. Andy let us have our discussion and said, “Let me put it to you: if someone’s heart is not beating, that person is dead. They’re not going to get better without intervention. They are dead. So anything that you do now, as a first aider, is not going to make them worse.”
It was a lightbulb moment for me: what matters is not so much choosing the right sized bandage or perfecting the doughnut roll (not generally taught in first aid courses any more) but potentially keeping someone not-dead-enough until the emergency services arrive.
I bandaged the profusely bleeding hand of a farm labourer who had hammered an enormous nail through the middle of it. I called 999 and watched a hypothermic teenager go into cardiac arrest, then debated whether to move them to a clear area for the ambulance crew or continue administering CPR in the current position.
Since doing the First Aid at Work qualification, I’d only had to put my training into practice once: cleaning, bandaging and elevating a person’s arm after a minor onion-slicing accident. But in the back of my mind I’d been thinking about consolidating and refreshing my first aid knowledge.
Sure, I knew how to perform a jaw thrust to open a partially blocked airway, but what was the the protocol with compressions - was it really to the rhythm of “Staying Alive”? Had Andy said that mouth-to-mouth was optional? Plus, I’d forgotten about embedded objects, what to do to protect a casualty’s spine and what all those different bandages in the first aid kit were actually for.
Sure, I knew how to perform a jaw thrust to open a partially blocked airway, but what was the the protocol with compressions - was it really to the rhythm of “Staying Alive”? Had Andy said that mouth-to-mouth was optional? Plus, I’d forgotten about embedded objects, what to do to protect a casualty’s spine and what all those different bandages in the first aid kit were actually for.
This is important stuff to know. There are so many accidents on the A21 between Hastings and John’s Cross, it’s probably only a matter of time until I’m first on the scene. Or what if we’re out walking and find a farmer who’s overturned her tractor and is pinned underneath? Even more likely, what if we’re having dinner with friends or family and someone has a heart attack?
I was a bit concerned that knowing something in theory wouldn’t help me in a crisis. After all, I’ve completely forgotten things before - like trying (twice!) to call the UK emergency services on 000 (the Australian number) instead of 999 (the UK number). So I jumped at the chance to do a two day Wilderness First Aid course with ELST.
I was a bit concerned that knowing something in theory wouldn’t help me in a crisis. After all, I’ve completely forgotten things before - like trying (twice!) to call the UK emergency services on 000 (the Australian number) instead of 999 (the UK number). So I jumped at the chance to do a two day Wilderness First Aid course with ELST.
I discovered a mountain biker wedged in the fork of a tree after a nasty fall - his bone was sticking out through his thigh - and I found his Ventolin, tried to keep him calm and gathered his medical history as my companions did what they could for his leg.
The first day started with introductions. There were four other participants - two from Sussex Wildlife Trust, a school sports teacher and someone who is setting up a kayaking business. Andy was joined over the weekend by a number of other instructors, too. Andy himself has spent 17 years in the Fire Service as a firefighter and instructor and three years as an NHS Resuscitation Officer. Mark Pittock has spent 27 years in the Fire Service and has been on one tour of Afghanistan as an RAF Reserves Medic. Rob Wilkinson is a paramedic and nurse with 14 years service with the Kent, Surrey and Sussex Air Ambulance.
The day was spent in conversation, learning through storytelling, props, questioning, talking and examining first aid equipment. Every now and then, we’d pop outside to put the theory into practice on the plastic dummies, then head back inside for a debrief.
I was really interested to hear about the emergency services system in East Sussex and surrounding counties: call centre protocol from who’s taking the call to who decides what to send (paramedic, ambulance, air ambulance), what each service is trained to do (e.g. who can and can’t administer drugs), which hospitals casualties can be sent to for what, and so on. There is so much going on behind the scenes every day that is so easy to take for granted. When you call 999, an enormous, dedicated and hopelessly overstretched service snaps into action. While one of the messages I took from the course was, “Don’t hesitate to call 999 if you think it’s a real emergency,” the other was, “Don’t call 999 if it’s a problem you could just as easily take to your GP to solve.” (I hear stories of people drunk dialling 999 after a night out hoping to get a free lift home and I despair. Take a good hard look at yourselves, people!)
I was really interested to hear about the emergency services system in East Sussex and surrounding counties: call centre protocol from who’s taking the call to who decides what to send (paramedic, ambulance, air ambulance), what each service is trained to do (e.g. who can and can’t administer drugs), which hospitals casualties can be sent to for what, and so on. There is so much going on behind the scenes every day that is so easy to take for granted. When you call 999, an enormous, dedicated and hopelessly overstretched service snaps into action. While one of the messages I took from the course was, “Don’t hesitate to call 999 if you think it’s a real emergency,” the other was, “Don’t call 999 if it’s a problem you could just as easily take to your GP to solve.” (I hear stories of people drunk dialling 999 after a night out hoping to get a free lift home and I despair. Take a good hard look at yourselves, people!)
I ran through the woods in the direction of panicked yelling to find an arborist had cut his arm off with a chainsaw. I helped guide him down (put him on a jacket - don’t want him getting hypothermia) and watched my companions improvise a tourniquet out of rope.
On day two, Andy went through a few questions we had from the previous session, showed us some burns dressings and gave us a few more pointers and tips. Then the fun really began. The difference between this course and many other first aid courses is the real life scenarios, presented by actors in casualty make up.
First, there was a nasty fall. The kid had a huge bruise around one eye and was lying at the bottom of a cliff. Don’t fall over the edge yourself. Is he responding? No: he’s unconscious. Is he breathing? Can’t tell. Listen, feel, watch. Ten seconds feels like an age . . .
We went back to the tent to debrief. Only inside was a man complaining of intense pain in his chest and arm. He’s just eaten lunch. He’s very pale. The pain is getting worse. Call 999. Any allergies you know of? We stand around a bit helplessly watching this guy have his heart attack. And then he’s out. We pop him on the floor and begin CPR . . .
First, there was a nasty fall. The kid had a huge bruise around one eye and was lying at the bottom of a cliff. Don’t fall over the edge yourself. Is he responding? No: he’s unconscious. Is he breathing? Can’t tell. Listen, feel, watch. Ten seconds feels like an age . . .
We went back to the tent to debrief. Only inside was a man complaining of intense pain in his chest and arm. He’s just eaten lunch. He’s very pale. The pain is getting worse. Call 999. Any allergies you know of? We stand around a bit helplessly watching this guy have his heart attack. And then he’s out. We pop him on the floor and begin CPR . . .
We went through both scenarios afterwards. Who called 999? Did we get all the information we could have from the cardiac arrest patient while he was awake and conscious? We should use the SAMPLE mnemonic if it helps. Wasn’t it strange that we all felt something a bit like relief when the man in the tent finally passed out - relief that we could finally do something.
Then there was the motorcyclist under the car; the hypothermic teenager; the arborist with the severed arm; the cyclist with the extravagantly fractured femur. Each scenario presented a different set of problems and, despite being fully aware that these were staged scenarios, it was all too easy to feel the panic, adrenaline surge and queasiness as we dealt with each one.
But with each scenario I found I could remember more. Danger, response, airway, breathing. Call 999. Support the C-spine. Recovery position. SAMPLE. Continuous compressions. Pressure and elevation.
Then there was the motorcyclist under the car; the hypothermic teenager; the arborist with the severed arm; the cyclist with the extravagantly fractured femur. Each scenario presented a different set of problems and, despite being fully aware that these were staged scenarios, it was all too easy to feel the panic, adrenaline surge and queasiness as we dealt with each one.
But with each scenario I found I could remember more. Danger, response, airway, breathing. Call 999. Support the C-spine. Recovery position. SAMPLE. Continuous compressions. Pressure and elevation.
I was in a car accident - I collided with a pedestrian who was sprawled unconscious and bleeding from his ear on my windscreen. My airbag didn’t deploy. I had a bloody nose, a suspected broken rib and - scarier still - I couldn’t feel my legs. Then the car caught fire. Let me tell you: I was extremely relieved at that point that all three passers-by happened to be trained first aiders.
It’s not often an instructor finishes a two day course by saying, “I hope I’ve just wasted your weekend.” But as we wiped the golden syrup and red food dye off our noses and legs, the bruises off our faces, and the mushed up digestive biscuits off our mouths and hands, we understood exactly what Andy meant.
I hope I never have to put this knowledge into practice, but at least now I know what to do and I’m pretty sure I could do it. Could you?
I hope I never have to put this knowledge into practice, but at least now I know what to do and I’m pretty sure I could do it. Could you?
ELST is based in East Sussex, but Andy also runs courses in Kent, Surrey, West Sussex, Hampshire and beyond. Check their website for further information. Oh, I should also mention that if "Staying Alive" is too hard to remember for compressions, you could try an even less appropriate song, "Another One Bites the Dust".
I sometimes undertake freelance work for ELST. I was not paid to write a positive review of this course. All images courtesy of Andy Sullivan, ELST.
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