How to portray yourself as a caring person..

Todays scenario is that we have a bloke who's 60 years old, is
overweight, smokes, drinks and eats fried breakfasts. He starts to
complain about severe chest pains so he's bundled into a van and taken
to the nearest medical centre (on a power station) for assessment.

Did they decide he needed an ECG and phone an ambulance or did they
decide he needed an ECG and tell his manager to get him the **** off
site?

No way will I name the station but I will admit to being a touch
surprised at their reaction.

 

Is (was?) he a contractor?

 

I can't possibly be the only person who spotted the pun!

 

Just did an AED[1] course yesterday and was reminded of the maxim
"Don't take your casualty to help, bring help to the casualty." Were I
in your situation, given my training[2], I'd have stuck to my guns and
insisted on getting an ambulance to the victim in-situ.

All else apart, what would you have done if he'd collapsed in the seat
next to you as you were driving? Had he done so, death by asphyxiation
from a blocked airway would have been very likely.

Of course, I realise that you weren't able to make such a choice, and
yes, your erstwhile employer wants a kick in the balls for such
behaviour. Consider getting Health and Safety involved. Arse should be
kicked, big-style, as this was blatantly putting someone into a
seriously dangerous situation, and should be treated as seriously as
insisting someone walks into a hot zone with no badge and no
protection.

[1] Automatic External Defibrillator. We have 90-odd of these
http://www.zoll.com/product.aspx?id=75 spread around our various
buildings in Basel.
[2] The Swiss take such things as qualifications very seriously. Part
of the course was to perform CPR for 7 minutes continuously, with your
performance being logged and needing a >80% success rate at both chest
compressions and breathing. (I got 96% and 93% respectively). The
print-out is then stapled to a pass certificate and needs to be kept
for five years, for reasons not at all clear to the instructors.

 

It needs to be kept for 5 years as this is usually the amount of time
to review and change the guidelines. The Resuscitation Council (UK)
will be changing the guidelines in 2010 to take into account the
research/anectodal evidence that has been produced since 2005 (last
guideline change). Having evidence of which algorithm you followed is
always handy.

I presume that the ERC (European Resus Council) will be doing the same.
They all tend to work together so that algorithms that are followed by
the advanced providers are all the same.


--
Nursey RN
ALS Instructor & APLS Provider
MIRTTH#6 IbW#09 4#COFF EFFA MOP#1
Honda CBF600 ABS
(nursey at ukrm dot net)
UKRM FAQ: http://www.ukrm.net/faq/
Shameless Plug: http://www.blakeley.co.uk

 

Yeah, I guess, although the 'evidence' is kept by the trainer, not the
trainee. Is it the same with your mob?

Indeed. This was the subject of some discussions yesterday, and it
seems likely that a 'no-breathing' algorithm may be adopted in the
next year or so. But for now they're still sticking with 30/2.

 

We produce a certificate with the training date so that we can then
look at the guidelines that would have been used. That is the only
information that is given to the trainee. We will hold the rest of the
details. Whilst I have seen the quality assessment manikins and used
them, we don't for training. We have to assess each candidate by "eye".

The no breathing is a bit of a sticky subject. Paediatric algorithms
will probably remain the same with regard to breathing as the mechanism
of cardiac arrest is usually different. Kids tend to have a cardiac
output right up until the last and then go into a non-shockable rhythm.
They will need oxygen (as provided by breathing and cpr to get the
stuff around the body).

Adults usually have a primary cardiac event which precipitates
ventricular fibrillation or ventricular tachycardiac (without pulse)
both of which require a shock. Before that, they most likely would
have been breathing normally. Lets just move that round the system,
hence start compressions before putting the breathing into place.

It also has to do with the "artificial" blood pressure that you are
creating during compressions. Takes a long time to get to a decent
level, but drops off really quickly.

One this that we are expecting for the next guideline change is
compressions to be ongoing whilst the defibrillator charges! Really
not looking forward to teaching that next year.


--
Nursey RN
ALS Instructor & APLS Provider
MIRTTH#6 IbW#09 4#COFF EFFA MOP#1
Honda CBF600 ABS
(nursey at ukrm dot net)
UKRM FAQ: http://www.ukrm.net/faq/
Shameless Plug: http://www.blakeley.co.uk

 

Hmmm, intersting. Mine dew, we were specifically training with
adults-only kit, such as is provided in the workplace, so what we
heard about potential changes would not have included kids.

Another interesting point. We were told that the AED would _not_
deliver a shock for tachycardia. I guess this would only be worthwhile
with the full ACLS team and drugs on hand?

Ouch. Careful placement of hands requitred, I imagine. _Very_ careful.
Although the ones we have are on piece, with both pads attached and a
central piece over the sternum, through which you continue
compressions between shocks, So I guess it wouldn't be much of a
developement from that...

 

It's a problem when you're a sub-contractor and don't have the clout
to fight back at them.

It gets worse because he insisted that if we wouldn't take him to his
'home' hospital he'd drive himself there. Only about 60 miles up the
M6...

My employer wasn't very happy about it when I told him what was
happening but agreed that we (the company) would be in World of shit
if we sat him in the car park and phoned an ambulance and no way was I
going to let him drive.

It ended up ok though because it was a muscle spasm causing the
problem .

 

Redundancies? **** that, we walked out this morning.

 

Get back to work, you fucking slacker!

 

Working for Total? Not many people are anymore by the looks of
things.

 

Just to clarify this:

We took a hike because of the strikes at oil refineries across the
country. We'd better all hope it's quickly resolved because it'll
escalate across all refineries and power stations very quickly and
I'll lose money over it.

 

We're not working there but that's the reason.

 

I did one a few weeks ago, for workplace reasons. I really hope I'm
never called upon to use it.