The team coach, Ewen, recognises that Sean has had a cardiac arrest and commences CPR. One of the by-standers phones 999. Bert, the local policeman, who is a trained Community First Responder is contacted by emergency services. He was out visiting in a nearby village when he was contacted and arrives with an AED 15 minutes after CPR has been commenced.
As was discussed in the Introductory section of the resource, the series of events required to resuscitate someone after an OHCA is known as the Chain of Survival.
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Ewan, Bert and Sean’s family all feel very relieved that Sean’s care is now in the hands of healthcare professionals.
Slide 1 – Readiness.
Ewan – As a shinty coach, Ewan was offered the opportunity to undertake First Aid training, including CPR. He completed a first aid course two months ago.
Public Access Defibrillator – the local community organised a number of fund-raising events and purchased a PAD (or AED), which is situated beside the community hall.
Bert – Bert is the local policeman, who lives in the village. He has undergone Community First Responder training.
Slide 2 – Early recognition and call for help
Ewan, the shinty coach assesses Sean, listens for breathing and feels for a pulse. He realises that Sean has had an OHCA and asks one of the parents to phone for an ambulance This is the first time Ewan has been involved in responding to a cardiac arrest. Sean’s parents and numerous bystanders are watching what he is doing.
Issues to think about:
- How might Ewan be feeling? Anxious, nervous.
- What might Sean’s family be feeling? Disbelief, distress, shock.
- What might the bystanders be feeling? Guilt, helplessness.
Slide 3. Early CPR
Ewan commences CPR. He thinks of the song “Stayin alive” by the Bee Gees used in the TV advert with Vinnie Jones. Hard and fast Hands-only CPR from The British Heart Foundation (YouTube).
Issues to think about:
- What might it be like for Ewan being watched by so many people he knows?
- Fear of doing the wrong thing.
- Responsibility for Sean’s life.
- What might it be like for Sean’s family witnessing resuscitation?
- Distressing.
- Frightening.
Slide 4. Early defibrillation
Bert, Community First Responder, has been alerted to the situation by Ambulance Control. He arrives to help Ewan, bringing the AED with him. Ewan explains that he has been doing chest compressions for about 15 minutes.
Bert establishes that Sean is in a shockable rhythm and one shock is administered, without Return of Spontaneous Circulation (ROSC). Bert and Ewan continue resuscitation attempts, as dictated by the AED, until the ambulance crew arrive. During that time they administer three shocks. Sean now has a pulse but is not breathing.
Issues to think about:
- How might Sean be feeling?
- Relieved that has support.
- Exhausted with doing chest compressions.
- How might Bert be feeling?
- Worried about Sean’s down-time before got pulse and about brain injury.
- Worried about Sean’s family and what they are going through.
- How might Sean’s family be feeling?
- Hopeful, as Sean has pulse.
- Confused about what is happening.
Slide 5 – Post resuscitation care
Two paramedics and an ambulance technician arrive by ambulance.
Bert explains what has happened. “Eighteen year old boy, collapsed playing shinty. Coach started CPR about about 25 minutes ago. I arrived 10 minutes ago with the AED. He’s had three shocks and we now have a pulse but he’s still not breathing.”
The paramedics are concerned about the length of downtime Sean has suffered and the impact it will have on him but, as he now has a pulse, they continue with resuscitation. They stabilise Sean’s condition, as per Resuscitation Council UK Guidelines.
Pulse point
Sudden cardiac death is the leading cause of mortality in young people participating in sports. It is estimated that 12 apparently healthy, young people (aged 35 or under) die from undiagnosed heart conditions in the UK every week. Although arguments have been put forward for a national screening programme, the UK National Screening Committee does not currently recommend universal screening to reduce Sudden Cardiac Death in people aged 12-39.
