One of the problems with crewing an ambulance is that you're more or less stationary the entire time, unless of course you're called to an incident. Okay so you can walk a little distance from the ambulance but you can't go too far, especially when you're reliant on the vehicle radio.
Being in the position of not being able to escape is when the 'uniform responsibility' issue rears its ugly head. I've said in the past that being in uniform often makes you the target of people's irritations, regardless of what your role is and what you do. If you're in uniform then you're official, if you're official then you're a target. This I experienced yet again at an event I was at recently.
You'd think a big national televised event coming to a small city would please some people. It brings the crowds in who then spend money (maybe not always) and it helps put the place on the map.
Clearly it doesn't please everyone though as my colleague and I were accosted by a local businessman who felt his business was being "ruined" by a few road closures. I don't think in this case he was actually blaming us, I think he just felt that we should share his pain and suffering. Perhaps he thought that as we were in uniform it was, at the very least, our duty to listen to him. Maybe he expected us to show some solidarity by declaring ourselves to be put out by such a large event.
Agreement was never going to happen, personally I enjoy these events. My colleague did listen though and nodded dutifully.
Wednesday, 21 September 2011
Monday, 19 September 2011
Meningitis and the fear factor
Meningitis is perhaps the illness that instils most fear into any parent. The speed with which it takes hold and the damage it can cause is horrifying. As someone who was taken to hospital with suspected meningitis as a youngster I am well aware of the urgency required. As it happens I didn’t have meningitis but there’s nothing like a good health scare to keep your parents on their toes.
So what is it? Meningitis is the inflammation of the meninges, the membranes that line the brain and spinal cord, and can be caused by either a viral, bacterial or (very rarely) a fungal infection. While all three are extremely serious, it is the bacterial infection that is more dangerous, the most common of which is meningococcal bacteria.
In a worst case scenario, meningitis can kill. Even assuming survival, damage to brain tissue can lead to disabilities such as brain damage or deafness; and septicaemia (blood poisoning) as a result of the bacteria may require limbs to be amputated. Meningitis is a medical emergency, if you’re in any doubt then get the patient to hospital. Not so long ago most patients would die, now it's about 10%. It’s still high but the chances of survival are so much better.
So how would you recognise meningitis? The initial symptoms can sometimes be confused with those of the flu, especially in cases of viral meningitis. The speed with which meningitis occurs is often the biggest clue. If flu symptoms appear rapidly, get the patient to hospital.
The symptoms include fever / vomiting, a severe headache, a stiff aching neck, an aversion to bright light, drowsiness, confusion a rash and seizures. If the patient is a baby then there could also be bulging of the soft spot on top of their skull. With septicaemia the symptoms can also include limb or joint pain, cold hands / feet, shivering, pale or blotchy skin and the breathing rate would increase. These symptoms may not all appear, and if they do they may not be in that order.
It is the rash and glass test that I’m sure most people will be familiar with when thinking of meningitis. If the patient has a rash then press a glass against it and the rash will normally go away as long as the pressure of the glass is applied. In the case of meningitis, as the rash is caused by burst blood vessels, the rash will not go away when a glass is placed against it. That said, if you do suspect meningitis, do not wait for a rash to appear as it may not appear until later, if at all.
As for treatment, the patient needs to get to hospital urgently. There is very little that can be done outside of hospital other than to make them comfortable. In hospital they will be able to give antibiotics to fight against bacterial infection, and keep the patient under close observation. A lumbar puncture (extraction of fluid from the spinal cord using a syringe) may be performed so fluid can be tested for infection and therefore confirm meningitis. If it's viral meningitis then antibiotics are of no use so the patient would be given rest, hydration and pain relief.
Meningitis can be quite a complicated illness so I’ve tried to make this as unscientific as possible so it is understandable. Instead I’ve concentrated on the symptoms and emphasised the urgency of getting the patient to hospital. If you would like more information on meningitis then visit the websites of either the Meningitis Research Foundation or the Meningitis Trust.
Meningitis Awareness Week runs from the 19th to 25th September 2011.
So what is it? Meningitis is the inflammation of the meninges, the membranes that line the brain and spinal cord, and can be caused by either a viral, bacterial or (very rarely) a fungal infection. While all three are extremely serious, it is the bacterial infection that is more dangerous, the most common of which is meningococcal bacteria.
In a worst case scenario, meningitis can kill. Even assuming survival, damage to brain tissue can lead to disabilities such as brain damage or deafness; and septicaemia (blood poisoning) as a result of the bacteria may require limbs to be amputated. Meningitis is a medical emergency, if you’re in any doubt then get the patient to hospital. Not so long ago most patients would die, now it's about 10%. It’s still high but the chances of survival are so much better.
So how would you recognise meningitis? The initial symptoms can sometimes be confused with those of the flu, especially in cases of viral meningitis. The speed with which meningitis occurs is often the biggest clue. If flu symptoms appear rapidly, get the patient to hospital.
The symptoms include fever / vomiting, a severe headache, a stiff aching neck, an aversion to bright light, drowsiness, confusion a rash and seizures. If the patient is a baby then there could also be bulging of the soft spot on top of their skull. With septicaemia the symptoms can also include limb or joint pain, cold hands / feet, shivering, pale or blotchy skin and the breathing rate would increase. These symptoms may not all appear, and if they do they may not be in that order.
It is the rash and glass test that I’m sure most people will be familiar with when thinking of meningitis. If the patient has a rash then press a glass against it and the rash will normally go away as long as the pressure of the glass is applied. In the case of meningitis, as the rash is caused by burst blood vessels, the rash will not go away when a glass is placed against it. That said, if you do suspect meningitis, do not wait for a rash to appear as it may not appear until later, if at all.
As for treatment, the patient needs to get to hospital urgently. There is very little that can be done outside of hospital other than to make them comfortable. In hospital they will be able to give antibiotics to fight against bacterial infection, and keep the patient under close observation. A lumbar puncture (extraction of fluid from the spinal cord using a syringe) may be performed so fluid can be tested for infection and therefore confirm meningitis. If it's viral meningitis then antibiotics are of no use so the patient would be given rest, hydration and pain relief.
Meningitis can be quite a complicated illness so I’ve tried to make this as unscientific as possible so it is understandable. Instead I’ve concentrated on the symptoms and emphasised the urgency of getting the patient to hospital. If you would like more information on meningitis then visit the websites of either the Meningitis Research Foundation or the Meningitis Trust.
Meningitis Awareness Week runs from the 19th to 25th September 2011.
Friday, 16 September 2011
Whatever happened to personal responsibility?
I remember the good old days when we used to pick up the newspaper and have a laugh at our cousins on the other side of the pond for suing each over the most ridiculous things.
There was a story about a man who stole a motorbike, crashed it, then sued the owner because of the injuries he sustained. There was a woman who sued a shop because she had tripped over a toy left in the middle of an aisle, a toy her own child left there. And of course there was the woman who sued a well known fast food chain because she spilled a cup of hot coffee over herself. I’ve no idea how true any of these stories were but I’m sure you get the picture.
During my first trip to New York I remember having a chuckle at the adverts on the metro – 1800 DIVORCE, 1800 LAWYERS, 1800 WESUE4U. Okay so I made that last one up, but every single advert related to the legal profession and how best to get money out of someone else.
I think it was all so amusing because it was all so far away.
Those days are now long gone. More and more adverts feature on UK television suggesting you should get legal advice on any little accident you may have had. Am I even allowed to use the word accident anymore? As I write this there are probably lawyers trying to get it removed from the dictionary because there is no such thing as an accident, someone must always be at fault.
It is becoming more and more common for people to automatically think “who can I blame?” and “what can I get out of this?” whenever they have an accident. It's always someone else's fault, there no longer seems to be any sense of personal responsibility. The lawyers are probably right, someone is always at fault, but more often than not, the fault rests with the person who injured themselves in the first place.
Don’t get me wrong. I’m all for people being compensated when there is genuine need, when they have suffered long term damage as a result of someone else's actions. People should be held to account when they have been negligent, or perhaps even if they have just made an honest mistake, but a mistake nevertheless.
I fell down my father’s stairs recently. Maybe I should sue him for having stairs that are too narrow. Perhaps I should take legal action because he hadn’t taken the necessary precautions to ensure the carpet had enough grip to enable safe passage. On the other hand, perhaps I should just be a bit more careful in future and apologise to my father for waking him up in the middle of the night as I clattered down the stairs.
So the next time you have an accident and start to think how you can profit from it, just take a moment to think it through. Maybe you should look where you’re going next time. Maybe you should be less clumsy in the future. Maybe, just maybe, the accident was just your own stupid fault.
Despite mentioning the possibility of legal action in this post, it does not negate what I said in a previous post on whether first aiders can be sued if they get it wrong. No one has ever been successfully sued in the UK for carrying out first aid.
There was a story about a man who stole a motorbike, crashed it, then sued the owner because of the injuries he sustained. There was a woman who sued a shop because she had tripped over a toy left in the middle of an aisle, a toy her own child left there. And of course there was the woman who sued a well known fast food chain because she spilled a cup of hot coffee over herself. I’ve no idea how true any of these stories were but I’m sure you get the picture.
During my first trip to New York I remember having a chuckle at the adverts on the metro – 1800 DIVORCE, 1800 LAWYERS, 1800 WESUE4U. Okay so I made that last one up, but every single advert related to the legal profession and how best to get money out of someone else.
I think it was all so amusing because it was all so far away.
Those days are now long gone. More and more adverts feature on UK television suggesting you should get legal advice on any little accident you may have had. Am I even allowed to use the word accident anymore? As I write this there are probably lawyers trying to get it removed from the dictionary because there is no such thing as an accident, someone must always be at fault.
It is becoming more and more common for people to automatically think “who can I blame?” and “what can I get out of this?” whenever they have an accident. It's always someone else's fault, there no longer seems to be any sense of personal responsibility. The lawyers are probably right, someone is always at fault, but more often than not, the fault rests with the person who injured themselves in the first place.
Don’t get me wrong. I’m all for people being compensated when there is genuine need, when they have suffered long term damage as a result of someone else's actions. People should be held to account when they have been negligent, or perhaps even if they have just made an honest mistake, but a mistake nevertheless.
I fell down my father’s stairs recently. Maybe I should sue him for having stairs that are too narrow. Perhaps I should take legal action because he hadn’t taken the necessary precautions to ensure the carpet had enough grip to enable safe passage. On the other hand, perhaps I should just be a bit more careful in future and apologise to my father for waking him up in the middle of the night as I clattered down the stairs.
So the next time you have an accident and start to think how you can profit from it, just take a moment to think it through. Maybe you should look where you’re going next time. Maybe you should be less clumsy in the future. Maybe, just maybe, the accident was just your own stupid fault.
Despite mentioning the possibility of legal action in this post, it does not negate what I said in a previous post on whether first aiders can be sued if they get it wrong. No one has ever been successfully sued in the UK for carrying out first aid.
Saturday, 10 September 2011
World first aid day
We've all heard the phrase 'accidents happen' and it's absolutely correct, accidents do happen. Okay so we tend to call them incidents these days for legal reasons but whatever they're called, people do have mishaps and do get injured. To make life worse people also have a habit of becoming unwell, some more seriously than others.
A few years ago St John Ambulance, in preparation for its 'the difference' campaign, conducted a study that concluded that 150,000 people in the UK died each year in situations that did not need to result in death. The study concentrated on five scenarios: an unconscious patient who is breathing, an unconscious patient who is not breathing, a patient having a heart attack, a patient with a severe bleed and a patient who is choking.
All five scenarios have the potential to result in death, perhaps a few decades ago death was the natural result. This is the 21st century though and there are things that can be done to help people in need - you can give first aid. The study didn't for one moment suggest that all 150,000 would still be alive today if they had been given first aid, but it would have given them a chance and that chance is better than nothing.
First aid doesn't require experts, far from it. The skills aren't difficult to learn but they are skills that can keep the patient going. In all five scenarios, timing was vital. The target time for an ambulance to arrive in life-threatening cases is eight minutes. It doesn't take a great deal of imagination to realise how much someone could deteriorate if they're not breathing for eight minutes, or if they've been bleeding profusely for that time. The omens would not be good. But if you, or anyone else, could just maintain their breathing or stem the bleeding until help arrives, their chance of survival will increase.
Today is World First Aid Day so if there's one thing you do - resolve to save a life. If someone you loved or someone you didn't even know was injured or unwell, wouldn't you want to make a difference? Wouldn't you want to go to bed that night thinking "wow! I saved a life"? I know I would.
For more information on first aid and first aid courses visit the St John Ambulance web site.
A few years ago St John Ambulance, in preparation for its 'the difference' campaign, conducted a study that concluded that 150,000 people in the UK died each year in situations that did not need to result in death. The study concentrated on five scenarios: an unconscious patient who is breathing, an unconscious patient who is not breathing, a patient having a heart attack, a patient with a severe bleed and a patient who is choking.
All five scenarios have the potential to result in death, perhaps a few decades ago death was the natural result. This is the 21st century though and there are things that can be done to help people in need - you can give first aid. The study didn't for one moment suggest that all 150,000 would still be alive today if they had been given first aid, but it would have given them a chance and that chance is better than nothing.
First aid doesn't require experts, far from it. The skills aren't difficult to learn but they are skills that can keep the patient going. In all five scenarios, timing was vital. The target time for an ambulance to arrive in life-threatening cases is eight minutes. It doesn't take a great deal of imagination to realise how much someone could deteriorate if they're not breathing for eight minutes, or if they've been bleeding profusely for that time. The omens would not be good. But if you, or anyone else, could just maintain their breathing or stem the bleeding until help arrives, their chance of survival will increase.
Today is World First Aid Day so if there's one thing you do - resolve to save a life. If someone you loved or someone you didn't even know was injured or unwell, wouldn't you want to make a difference? Wouldn't you want to go to bed that night thinking "wow! I saved a life"? I know I would.
For more information on first aid and first aid courses visit the St John Ambulance web site.
Monday, 5 September 2011
First aid mythology
Can you carry out CPR on someone who potentially has a spinal injury? After all, if you're repeatedly pushing down on their chest directly above the spine then you could aggravate any injury. It could even result in paralysis for the patient. Fair point? It's a genuine question I've been asked several times.
Now let's look at this logically, what are the consequences of not carrying out CPR? If the patient is not breathing then quite soon they are going to die as the organs are starved of oxygen. I don't know about you, but death sounds like a far worse form of paralysis to me.
An article the Independent's website, based on a survey carried out by the British Red Cross, suggested that people are discouraged from learning first aid because they are scared of the consequences should they get it wrong. This fear is caused by the myths that exist about first aid, myths like the example given above.
I'm not a lawyer so it would be inappropriate for me to offer legal advice. In order to successfully be sued, I would guess that a patient must demonstrate that a first aider caused more harm than would otherwise have occurred. As the Independent article states, nobody has ever successfully been sued in the UK for carrying out first aid.
So would you sleep better at night knowing that you helped someone in need, potentially you saved a life? Or would you sleep better knowing that the patient's condition deteriorated but never mind, at least you did no wrong? Let's look at it the other way, wouldn't you want someone to help you out if you were ill or injured? Or would you be happy for everyone to walk on by?
Don't be put off by the myths, go to the St John Ambulance website now (or once you've finished reading this) and find out where and when the next course is. Learn to save a life, learn to be the difference.
First aid is such an easy skill to learn and like any form of learning, you build on it as your confidence and experience grows. That's not to say the patient's condition won't worsen, it may will do. As long as you act within your limits; as long as you have assessed the patient by examining them, questioning them and advising them; and as long as you feel confident you could justify your actions; it sounds to me like you have a fairly credible defence.
What kind of defence is doing nothing in case you get it wrong?
Now let's look at this logically, what are the consequences of not carrying out CPR? If the patient is not breathing then quite soon they are going to die as the organs are starved of oxygen. I don't know about you, but death sounds like a far worse form of paralysis to me.
An article the Independent's website, based on a survey carried out by the British Red Cross, suggested that people are discouraged from learning first aid because they are scared of the consequences should they get it wrong. This fear is caused by the myths that exist about first aid, myths like the example given above.
I'm not a lawyer so it would be inappropriate for me to offer legal advice. In order to successfully be sued, I would guess that a patient must demonstrate that a first aider caused more harm than would otherwise have occurred. As the Independent article states, nobody has ever successfully been sued in the UK for carrying out first aid.
So would you sleep better at night knowing that you helped someone in need, potentially you saved a life? Or would you sleep better knowing that the patient's condition deteriorated but never mind, at least you did no wrong? Let's look at it the other way, wouldn't you want someone to help you out if you were ill or injured? Or would you be happy for everyone to walk on by?
Don't be put off by the myths, go to the St John Ambulance website now (or once you've finished reading this) and find out where and when the next course is. Learn to save a life, learn to be the difference.
First aid is such an easy skill to learn and like any form of learning, you build on it as your confidence and experience grows. That's not to say the patient's condition won't worsen, it may will do. As long as you act within your limits; as long as you have assessed the patient by examining them, questioning them and advising them; and as long as you feel confident you could justify your actions; it sounds to me like you have a fairly credible defence.
What kind of defence is doing nothing in case you get it wrong?
Friday, 2 September 2011
Practice makes perfect
I did my First Aid at Work (FAW) course about 4 ½ years ago and in that time I have treated one person at work. I've treated many more outside of work with St John Ambulance, but only one at work. Admittedly I treated her twice in the space of two days for completely unrelated things, but two incidents in that time is not a lot. Most of the other first aiders I know at work have treated a similar number.
That doesn’t mean I propose more people at work should get injured (although as a civil servant it's often tempting), it means that to me it's apparent there would be a significant amount of skills fade over that time. From passing the initial assessment, it's three years before the first aider next needs to be assessed
I have no doubt that the FAW students would do a fantastic job if someone collapsed in front of them as they came out the assessment centre. They would be probably do a great job if it happened a week later, a month later, maybe even six months later. But what about a year later or three years later? Would they still be competent then?
I am keen runner and I try to get out as often as I can but if I go a couple weeks without running then I really notice it when I do hit the streets again. I did a course on defence acquisition two years ago during my previous job but if you were to ask me any questions on it, I would probably struggle to answer them. The reality is that any ability, skill or knowledge you have will start to fade if it is not used.
So what benefit does the FAW qualification provide? In my place of work there are several first aiders who don’t seem to know one end of a bandage from the other, and some who can never remember the ratio of chest compressions to rescue breaths during cardio pulmonary resuscitation (CPR). These are fairly basic skills. To be quite honest, these people are not up to scratch and it would be better for my employer just to provide a first aid kit. Let people sort themselves out if injured rather than rely on someone else. I would rather be treated by someone who knew they weren't competent than someone who mistakenly thought they were.
So do employers now need to have a staggered programme of when their first aiders qualify just so there are at least some competent ones at any given point in time? Should employers ensure that at least one member of staff gets injured each week just to make sure that first aiders get plenty practice?
I personally think that if the FAW qualification is to be of any benefit, rather than just another tick-in-the-box exercise to meet yet another government target, the assessments should be changed to being held every year. Three years is simply too long. Employers should be encouraged to provide additional training to their first aiders if only to ensure they do not forget what they have already learnt.
Perhaps a Continuing Professional Development scheme could be put in place so first aiders don’t allow their training to go to waste. Setting up an online system so that every few months they have to answer some questions would at least keep them thinking about first aid.
It’s important that when the time comes and someone in the office actually becomes ill or gets injured, at least the first aider would remember what to do without having to hesitate.
That doesn’t mean I propose more people at work should get injured (although as a civil servant it's often tempting), it means that to me it's apparent there would be a significant amount of skills fade over that time. From passing the initial assessment, it's three years before the first aider next needs to be assessed
I have no doubt that the FAW students would do a fantastic job if someone collapsed in front of them as they came out the assessment centre. They would be probably do a great job if it happened a week later, a month later, maybe even six months later. But what about a year later or three years later? Would they still be competent then?
I am keen runner and I try to get out as often as I can but if I go a couple weeks without running then I really notice it when I do hit the streets again. I did a course on defence acquisition two years ago during my previous job but if you were to ask me any questions on it, I would probably struggle to answer them. The reality is that any ability, skill or knowledge you have will start to fade if it is not used.
So what benefit does the FAW qualification provide? In my place of work there are several first aiders who don’t seem to know one end of a bandage from the other, and some who can never remember the ratio of chest compressions to rescue breaths during cardio pulmonary resuscitation (CPR). These are fairly basic skills. To be quite honest, these people are not up to scratch and it would be better for my employer just to provide a first aid kit. Let people sort themselves out if injured rather than rely on someone else. I would rather be treated by someone who knew they weren't competent than someone who mistakenly thought they were.
So do employers now need to have a staggered programme of when their first aiders qualify just so there are at least some competent ones at any given point in time? Should employers ensure that at least one member of staff gets injured each week just to make sure that first aiders get plenty practice?
I personally think that if the FAW qualification is to be of any benefit, rather than just another tick-in-the-box exercise to meet yet another government target, the assessments should be changed to being held every year. Three years is simply too long. Employers should be encouraged to provide additional training to their first aiders if only to ensure they do not forget what they have already learnt.
Perhaps a Continuing Professional Development scheme could be put in place so first aiders don’t allow their training to go to waste. Setting up an online system so that every few months they have to answer some questions would at least keep them thinking about first aid.
It’s important that when the time comes and someone in the office actually becomes ill or gets injured, at least the first aider would remember what to do without having to hesitate.
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