Moat Boat Race

So why do we sign up to be volunteer first aiders? Is it the sense of satisfaction we get when providing treatment and making the patient feel better? Is it the warm feeling we get when the patient says ‘thank you’ and we know we’ve made a difference? Or perhaps, and this is probably more likely, it is the opportunity to take part in the annual Moat Boat Race.

The Oxford / Cambridge Boat Race and even next years Olympics pale into insignificance when it comes to racing home-made rafts along the moat of the Bishop’s Palace in Wells – the blue riband event of the British sporting calendar.

Our theme this year was Dad’s Army so our raft – ominously named ‘We’re Doomed!’ – was draped in the latest in camouflage technology, shredded black and green bin liners tied round some garden netting. Our oarsmen, led by Chief Engineer Ian Abraham, were dressed up as various characters – Captain Mainwaring, Sergeant Wilson, Corporal Jones, Private Frazer, Private Godfrey and the delightful Mrs Fox – all wearing their finery from the era, and the odd colander as well.

Photo courtesy of Christina Borastero

Our efforts (Ian’s efforts) in boat and costume design were soon rewarded as ‘We’re Doomed!’ was judged to be the best boat. The ensuing celebration was short-lived however as we were stripped of our title a few minutes later as the judges realised not all the boats were in the water.

In the end the cavers were given the honour (our honour) but promptly dismantled their boat once the judging was over. One would think that judging should be based on the vessel to be raced rather than some reconstructed model. We’re not bitter but already we have our lawyers scrutinising the rule book to see if there are grounds for appeal. It may even go as for as the Court of Arbitration in Sport.

With that controversy out the way, Lady Luck smiled on us once more as we got off to a exceptional start in our first race – the Community Challenge. Taking an immediate lead we managed to hold the racing line, demonstrated exquisite naval manoeuvrability to make a perfect turn at the halfway point before charging our way down the final straight to win the race. There may have been stiff competition from the police, but we won and the trophy was ours.

With that glorious victory in the bag there’s perhaps no need to report on the rest of the event. More to the point, the less said about the rest of the event the better. Suffice to say we won no more trophies and we did get a little wet. The good news is that we got some other teams very wet too as the final race finished with a massive water fight. I really hope the police don’t hold any grudges as they were somewhat targeted. Of course when I say the final race finished with a massive water fight, it would be slightly more accurate to say the water fight started long before the race ended. Nobody ever said naval warfare was a fair game.

Someone get this drunk out of here

A few years ago when I was relatively new to first aid, I took part in a training exercise on the Mendip hills with some St John Ambulance colleagues. It had been reported that an aircraft had come down but thankfully the pilot had ejected and was last seen floating gently to the ground just a few miles away.

After searching the area near where he was last seen, we eventually came across him and it was immediately apparent his landing hadn't gone to plan. His parachute landing that is, obviously the aircraft landing hadn’t really gone to plan either (I think that’s what they call a bad day at the office). The parachute had become tangled in some branches and he needed to cut himself free to escape. Gravity being the pesky thing it is meant he promptly continued the rest of his journey to the ground. Bump. Snap!

To make matters worse, he was not alone. An annoying drunk guy had appeared on scene and thought he was helping us by grabbing hold of the pilot’s badly broken leg and shaking it about, just to show us where the injury was.

We managed to get the drunk away and proceeded to establish the severity of the break and what needed to be done to treat the injury, relieve the pain and prepare the pilot for transport to hospital. Incidentally this meant carrying the pilot in a stretcher down an eighty feet high cliff. They don't like to make these exercises easy for us.

Frustratingly the drunk guy kept returning and shouting his incoherent ramblings at us and generally being a nuisance. Fortunately for us, and more so for him, we had a more experienced member of the team with us and it didn’t take her long to realise we were no longer dealing with one patient and a drunk. We were dealing with two patients and the ‘drunk’ was potentially the more serious.

In trying to find out what exactly had been consumed to put him in this state, she soon found out he hadn’t drunk anything. Nor for that matter had he eaten anything.  Perhaps not the best thing to do, or not do, when you’re diabetic. Our ‘drunk’ turned out to be having a hypoglycaemic attack and his situation could get extremely grave without any treatment.

Now knowing the full story, we treated him for hypoglycaemia and managed bring him back round again. While that was ongoing, the pilot was having his leg strapped up so we could transport him down the cliff (to our actor’s great delight) and off to hospital.

Photo courtesy of Matt Gridley

So the moral of this story. Never assume a patient is drunk or under the influence of anything.  They may be suffering from something more severe. Of course, even if they are under the influence of alcohol, that is perhaps no reason to judge them. They should be treated the same as anyone else. Making assumptions however, could quite easily hide a very serious illness that requires urgent medical attention.

A sting in the tail

It's that time of year again. The sun is out (occasionally), barbecues are lit (sometimes), summer fetes are held (possibly indoors) and wasps are coming out to play (always).

I've been on first aid duty at a few events where wasps have been an issue and it's fascinating, and somewhat amusing, to see the various reactions by people when stung by these vicious beasts.

Woman tend to take the sting in their stride by just brushing it off and getting on with their day. I don’t think I’ve ever actually had a woman request first aid for a wasp sting.

Children are quite shocked at first by this new pain sensation as they cannot see any obvious cause such as a wound or a bruise. They'll sob for a short time until they realise the pain is fading and then start to enjoy the attention they receive.

As for blokes, their reaction is the most entertaining as they approach the first aid post, hiding the pain by speaking through gritted teeth, and asking for some kind of magic medicine. It’s nearly always the burlier blokes who look the most upset. It's often tempting to congratulate them on being such brave little soldiers before sending them on their way.

So how would you treat a sting? Look out for any signs of danger first as a sting can have dire consequences. Are there any indications that they could go into anaphylactic shock - rapid pulse, laboured breathing, swelling around face or developing a rash? Is there a history of it, have they or a family member suffered from anaphylaxis? Was the patient stung in the mouth or on the neck where any swelling could cause breathing difficulties? If so then seek medical attention. If the patient is anaphylactic and has an auto-injector (epinephrine) pen then you could help them to use it.

In the meantime, sit them in a comfortable position that relieves any breathing difficulties, this usually means sitting them upright. If the pulse rate drops and they begin to look pale, lie them down and put their feet up as this gets blood and oxygen to the upper part of the body where it’s needed most.

In the vast majority of cases however, a sting is not in any way serious, just a wee bit of pain that soon fades. If this is the case and there are no indications of an allergic reaction or breathing difficulties, I would be inclined to leave it. Speaking as someone who is a wasp magnet and has been stung many times, the pain does go away quickly.

If you have something chilled, e.g. cold drink or ice, then place this against the sting in order to numb the pain and reduce any inflammation.

Of course the best thing to do is not to get stung in the first place. If you do see a wasp nearby, just leave it alone and don’t start taking wild swipes at it. Inevitably you will miss, look silly and get stung in the process.

Exterminate, exterminate!

If you’ve been to a football match or a concert then you’ll have seen volunteer first aiders from St John Ambulance.  They stand out quite well in their shiny yellow jackets.  As well as sporting events and music shows, there’s loads of other event we cover and some of these are slightly more… bizarre.  This week was one of those - the Dalek Invasion at RNAS Yeovilton.

I'm sure everyone who's ever visited Planet Earth before knows who (or what, not quite sure on that one) a Dalek is, and the ‘invasion’ was a chance for Dr Who enthusiasts to celebrate his arch nemesis.  Okay so I'm not sure you can celebrate someone whose sole raison d'être is to exterminate, but it was a chance for fans of the long running TV show to display their fully functional replica Daleks, most of which were controlled by an operator inside.

It didn't end with the Daleks.  Dozens of actors were dressed up in costumes depicting characters from across all eras of Dr Who and the majority of visitors had donned the outfits of their favourite hero / villain.  And it didn’t end there either.  Each person took on the full persona of their character and played that role to perfection throughout the day. It's quite incredible the lengths people will go for their chosen hobby.

St John Ambulance and Dr Who has a joint history stretching back to the very first episode when the logo appeared on the side of the Tardis.  It soon disappeared but in recent years it has made a return and it’s now displayed in all its glory on the side of the most famous police call box in the world.  I can only assume its presence is to identify Dr Who as a first aider.  Well his sonic screwdriver does everything else so it may as well act as a first aid kit too.

I'm not quite sure how you treat someone who's been attacked by a Dalek but naturally you need to look for signs of danger first.  Politely ask the Dalek if it would kindly stop exterminating people for just a brief moment.  If the patient has been exterminated then admittedly there's very little a first aider could do.  On the other hand, I'm not sure first aiders have the authority to diagnose extermination.  Best leave that one to the professionals.

As for treating a Weeping Angel victim, I have no idea. Does the patient even exist in the first aider's dimension?  Would the first aider need to go back in time and how would they do this, by also becoming a victim?  That really doesn't comply with the whole ‘watch out for danger’ policy.  Best leave that one to first aiding Time Lords.

Sometimes the bite is worse than the bark

The NHS Information Centre released figures showing that the number of hospital admissions for animal related injuries in England and Wales has seen quite an increase in the last year. Dog related admissions are up 5% to 6,120 cases. Admissions due to non-venomous insect bites and stings, insects such as bedbugs and mosquitoes, are up 19% to 3,620 cases. Admissions as a result of other animals, particularly larger animals such as cows and horses, increased by 8% to 2,560 cases.

It is perhaps worth noting that these figures are for all admissions so they are not just bites as you might first expect. With the larger animals like cows and horses the injuries are likely to be bruising or fractures caused by being knocked over. Thankfully injuries from the larger animals are few and far between. Cows in the UK are relatively placid unlike their Belgian cousins as I discovered recently. Belgian cows tend to snarl rather than moo, and don’t ever go into their field as they will hunt you down.

Bites are more concerning though as you never know how deep the bite has gone and how much damage has been done to the tissue under the skin. Nor can you tell what nasty germs have been transferred from mouth to wound. Tetanus and rabies are both a risk although the latter not so much in the UK. The vast majority of dogs are all bark and no bite but if they do feel threatened in any way then animal instinct may take over as they try to protect themselves or their territory.

So how would you treat a dog bite? Well if you’re the first aider, the first thing to do is make sure the dog is not a threat to you. It’s very difficult to treat a patient while you have a set of jaws clamped round your arm. Make sure it is no longer present, properly restrained or someone trained to deal with dangerous dogs has been called and are on their way.

The wound itself, in the first instance, would be treated like any other wound. If it is bleeding heavily, get the patient to apply pressure by placing their hand over the wound, and also get them to elevate it (if possible). Both actions are designed to stem the flow of blood. The wound should be cleaned out with soap and warm water and a dressing applied. Obviously if you're in the middle of a park, soap and water are in limited supply so just clean it out as best you can until you are able to do it properly. If you don't have any dressings then use anything appropriate to bandage the wound. A shirt or a tie would do as long as they're clean.

The level of treatment required depends on the extent of the injury, but in all except the most minor of cases I would suggest getting seen by a medical professional. This does not necessarily mean going to A&E, it could just be going to see your GP or the out-of-hours GP. It is best to see a medical professional just to make sure you’re not going to get an infection. If you do get an infection, at least it can be treated promptly.

As Nick Ross would say though, "don't have nightmares, do sleep well." Nearly all dogs are harmless and playful. There are over ten million dogs in the UK so that puts the number of hospital admissions into perspective. The most dangerous creature you'll ever come across is man, and they have a far nastier bite.

Give society some credit

Okay so this blog is nothing to do with first aid but it is about volunteering.
 
For many of us, the last few days I’m sure has been quite distressing / despairing / embarrassing (delete as appropriate, or add more). Neighbourhoods have been burnt down, communities destroyed, livelihoods lost. People are rioting, so we are told, because they live in such poverty that this is the only way of getting their voices heard. Yet they seem to be stealing from others who are no better off than them.
 
The dominant image of the last few days was of 89 year old Aaron Biber in his ransacked hairdressing salon. He didn’t look a wealthy man. There was that video of some guy sitting on the ground, already bleeding, in tears and looking traumatised. He didn’t look rich, but they mugged him anyway. Many of the owners of the damaged shops probably started off in as much poverty as the looters, but they fought their way out of that poverty by setting up their own businesses, businesses now destroyed. With that destruction goes the hope of employment to others desperate to escape the poverty.
 
With this as the backdrop to the situation we find ourselves in, it’s quite embarrassing to be British right now, knowing the rest of the world is watching the footage and wondering if this is how we behave normally. You know this country has sunk to such low levels when even the Iranians are calling for restraint.
 
Fast forward a few hours though and civilised society has started to mobilise and a new army of people have taken to the streets. People armed only with a broom, a pair of gloves and the occasional cup of tea. People arriving by the trainload are volunteering their own time so they can take to the streets and clean up the carnage that was created only a few hours previously.
 
This is so much more than just cleaning up the mess. It is about people taking pride in their neighbourhood, community or city. It is about taking pride in themselves. It is about showing support for those who have lost everything and letting them know they are not alone in this. It is about telling the rioters to do what they want, civilised society will always rise above them.
 
There have been a few commentators who, rather than blame the looters, are blaming society for forcing them to take the action they did. That’s fine, I don’t want to use this forum to condemn the violence or try to understand the excuses. But if society is to blame, look at all the volunteers who are out cleaning the streets. That is society, follow its example.
 
Well done to every single person who took part in the #RiotCleanUp campaign. It’s not just the streets you are cleaning but the image of this country. By giving up your time to help others, you have restored a declining faith in humanity and helped make British people proud to be British again.

New resus guidelines (not really)

IIt was recently reported that a team from Bristol including researchers from the University of the West of England, Great Western Ambulance Service NHS Trust and University Hospitals Bristol NHS Trust who were doing research into cardio pulmonary resuscitation (CPR).  The research was aiming to establish if there was a better way of resuscitating a patient in cardiac arrest.

It was reported that the study was going to take a year to complete but obviously they've come to a quick conclusion already.  I guess I must have missed that bit of reporting.

It looks like chest compressions are no more and rescue breaths have disappeared too.  What seems to be favoured, at least according to cabin crew at Ryanair, is to give the patient a sandwich and a soda. Charging for them of course.

During a flight from England to Sweden a passenger went into cardiac arrest but instead of performing CPR as they are supposedly trained to do, the cabin crew offered the passenger a sandwich and a soda.

They reported that "he had low blood pressure."  Indeed a patient's blood pressure does tend to drop when they stop breathing and the heart stops circulating blood around the body.

There was good news though and "the man appeared to stabilize."  At this point he was presented with his bill. Clearly a sandwich and soda does work as a form of treatment in cases of cardiac arrest so I will be sure to pack them in my first aid kit from now on.  I wonder if there will be further research on what sandwiches and types of soda work best - peanut butter on white bread washed down with a bottle of Irn Bru sounds like a winner.  What could possibly go wrong?

I just need to work out a new pricing policy now.