Contrary to what you might think, when a caller announces that they are a first aider, my heart often sinks, the problem being that “first aider” can mean anything from “knows how to put on a plaster” to the members of St John Ambulance and Red Cross who practice first aid all the time, are probably better at it than I am, and could resuscitate a plastic mannequin in their sleep. Since there is no real way of ascertaining the skill level of a first aider quickly, I tend to act as if they don’t know anything and give them all the instructions as I would an untrained person. This is probably very annoying to those first aiders who don’t need to be told and I apologise if you are one of them, but nonetheless it is better to give instructions that aren’t needed than not give those that are. I hope the following call will serve to illustrate this point.
A group of friends are walking along a canal in Islington and find a man (”probably a junkie!”) blue in the face and unconscious on the canal bank. Five of them get on their mobile phones and call ambulances, yelling “GET HERE QUICK! HE’S DEAD!” (because, obviously, the more calls we get, the bigger emergency it is, and the quicker the ambulance will come) while one of them, who did a first aid course when he was sixteen, leaps into action and Does Resuscitation. After getting the vital details, I try to establish that the self nominated First Aider is doing everything right, not an easy task when his five friends are all getting worked up and being asked to do the same thing.
“Listen here” says my caller, pompously “he’s a qualified first aider, you know. Just leave him to it and send the ambulance!”
I explain patiently (I do a lot of this, “patiently” gets harder and harder) that the ambulance is already on its way and my job is to help them look after the patient while they are waiting. After bellowing repeatedly at the caller asking him to tell me exactly what “resuscitation” the friend is doing, he loses his temper and complies.
“He’s got him on his side, he’s thumping him on the chest and another person is pouring water on his face!!”
Not quite what you’re supposed to be doing, you see.
I tell the caller that that is all wrong and finally he takes some notice of me, takes charge of the situation and yells at his friend “OI! YOU’RE DOING IT WRONG! STOP THUMPING HIM!!!”
Suddenly everyone is the picture of compliance and we get the man over on to his back, check in the mouth, open the airway and check for breathing. Much to everyone’s surprise, the man is breathing. I impress that there is to be no more thumping or water over the head until the ambulance arrives and everyone is just to stand back and let one person keep the patient’s airway open and watch his breathing. We get no more trouble until the ambulance arrives, although the caller does start crying into the telephone.
October 20th, 2005 at 9:38 pm
Now see, this
GET HERE QUICK! HE’S DEAD!
Would be a case of, well, there is really no rush anymore, right?
As an RN, with a few hospital codes under my belt, I would appreciate having a calm dispatcher prompting me what to do– say out on the lawn for instance. Having been in need of a resuscitation, I was very grateful to hear a calm EMT giving me familiar instructions as I came to. Under stressful situations, clear reasonable directions, perhaps especially for a trained person, help immensely. If I am faced with a friend or loved one in need of an emergency call, I know my mind is not working quite right, and full routine would be welcome.
October 20th, 2005 at 11:47 pm
I was once called to an elderly woman collapsed. She was in cardiac arrest and had been down too long for us to do anything. But her daughter kept saying, “I did everything like they do on the telly - I held her wrist and slapped her face - and her heart didn’t start!”
October 20th, 2005 at 11:55 pm
Haha, I can definately understand your hesitation! Some of the things that qualify for “First Aid” that I’ve seen, people and kits alike…
Though I must say before I became a volunteer ambulance officer, I did manage to do something useful and patch up an elderly man’s head when he decided to fall over while I was driving down the road.
I got someone else to make the call, and as I’d done my Workplace First Aid (2 day course) about 3 weeks ago (!!) and by the time the ambulance arrived they had a nicely packaged patient to wheel off.
October 21st, 2005 at 1:59 am
Had to ring myself an ambulance a while back. The dispatcher person was all nice and calm and sensible. Which was a bloody relief because I wasn’t.
October 21st, 2005 at 8:50 am
When l was in the police force,I attended an RTA one day and the driver was laid out on the ground and a “doctor” (He said he was a doctor !) attempting CPR on the unconcious patient,only he didn’t really seem to know what he was doing,so l asked if he was a medical doctor…”No” he says.”I’m a doctor of music !!” Sadly it didn’t matter much anyway,the driver had suffered a heart attack at the wheel and never regained conciousness.
October 21st, 2005 at 12:14 pm
I’m always keen to listen to despatchers, but have found that uttering the words “I’ll take this from here and am happy to clear.” before they start with the PDIs often makes EMDs smile down the phone and go “Excellent, call us back if you need anything.”
October 21st, 2005 at 9:06 pm
I’m a First Aider (ex-St John) and I completely sympathise with you. The number of times we get told off for “doing it wrong” by people whose entire first aid experience was a Brownies badge 50 years ago is astonishing. From my experience, I generally find that ambulance dispatchers are very helpful - generally they check you’re doing the right thing and say to ring back if things deteriorate, which is exactly what I want to hear. I do tend to get a bit frustrated with all the questions about the patient’s medical history, mainly because I seem to always be calling ambulances for patients who have been both unconscious and alone since I found them. Ah well, c’est la vie.
October 21st, 2005 at 9:19 pm
If you answer “Don’t know — I don’t know the patient and he’s been unconscious and alone since I got here” the call taker should skip the rest of the medical history questions. Although sometimes I go into autopilot because I’m so used to saying the same things in the same order… I say things like “And has he got asthma? Sorry, you said five seconds ago that you’d never seen him before in your life and that he wasn’t able to communicate with you. Please ignore me”. And then the caller thinks I am an idiot. This tends to happen at around 6am on a nightshift.
October 21st, 2005 at 11:21 pm
here’s a question for you to answer . i am currently a first aider with the brcs (former st john) and we are now being told not to give out casulties names when ringing 999, to me this just seems plain stupid as the emd’s sometimes have info that that we don’t. i just wanted to get your opinon about this and evryone elses on this stupid rule. !!!!
October 22nd, 2005 at 12:11 am
In Nee Naw Training we are taught to only get the names of patients when it’s an urgent call as opposed to emergency (ie a doctor who wants an ambulance in an hour or more), psychiatric patients and pregnant mothers. At all other times it’s a “nice to know” as opposed to “need to know”. If a caller gives me the name of the patient I put it in but otherwise I don’t ask for it. Carelines will generally give the patients name. That means the crew can enter the house calling a name which I guess is much friendlier than and not so intimidating for the elderly person.
It’s the same with the callers name - generally we put down son, mother, female neighbour, passerby or whatever they are. However if I’m staying on the line with a caller I ask their name as it makes it much easier to have a conversation with them. If you met someone in a pub for the first time and were chatting with them you’d ask their name so basically the same rule applies.
Do you agree Nee Naw??
October 22nd, 2005 at 8:30 am
Yep, I agree. The patient’s name isn’t particularly relevant to us, as we don’t keep any records about patients, but there are situations where it is needed. These are women in labour, people with sickle cell and certain other special cases who are being taken to a particular hospital where they are well known to the hospital (so we can let the hospital know we are coming), calls from doctors, carelines, etc (so if we have to ring them back, we can say “it’s about the ambulance for Mrs Smith”), and for certain addresses which are “flagged” on the computer indicating that there have been problems with an individual at that address before (eg. ambulance crew assaulted). Otherwise, as Newbie says, it’s nice to know but not essential. However, some other ambulance services do always ask the name of the patient. With the London Ambulance Service, not giving out the patient’s name shouldn’t cause you many problems, but I’d advise you to tell whoever made up that rule to make an exception for women in labour. We need to ring the hospital to let them know that they’re coming so they can get things ready for her.
October 22nd, 2005 at 8:30 am
PS. Out of interest, what is the logic behind this “not giving out the patient’s name” business?
October 24th, 2005 at 12:39 am
I once assisted an elderly gentleman who had collapsed outside my workplace. I later discovered that his daughter - who had been with him the whole time, was an RGN. She felt very silly for not being able to perform relevent first aid - having since been in that situation, having someone calm around or on the other end of the phone is a great help.
October 24th, 2005 at 11:53 am
As a workplace first-aider, if I was in a calling the ambulance situation I would be very appreciative of being talked through the rescuss process. Even if I’m doing it right, the reassurance that I am indeed doing the right thing is good.
Fortunately, this has never happened (touch wood). Recalcitrant casualties have happened though:
Me: Go to Casualty
Them: No
Me: That’s a Very Big Laceration on your hand; you might need stitches
Them: No, I need to get all this finished, and you’ve bandaged me up
Me: You’re shaking and sweating, you really should go to Casualty.
Continue for several minutes. Person goes off to other building, I decide that if he passes out it’s someone else’s responsibility, and fill in a suitably sarcastic accident form.
Best thing? We’re on the hospital site. It’s a two minute walk (not even big white taxi ride) to Casualty.
October 24th, 2005 at 12:52 pm
I would much rather have someone telling me what to do, too. If you’re not doing it every day and don’t have a perfect memory you are likely to forget something, especially if it is a loved one.
October 24th, 2005 at 8:10 pm
If it was my mum lying there not breathing, I’d probably need someone telling me what to do too
November 7th, 2005 at 12:08 am
Working as a 999 call taker myself, I find it strange the number of GP’s who do not know how to do CPR…..worrying!