A shift in the life of a CFR
It’s a miserable 0430 on a Tuesday morning. The alarm goes off. Oh yes, a Responding day….
Rings and watch off, uniform on, scrubbed up and ready to go. Check the van and start her to make sure she’ll go when the first call comes in. Check the equipment, PPE, defibrillator and materials – masks, oxygen, pulse oximeter, bandages and medicines pouch. It’s dark, so check the torch. A cup of coffee and then hit the ‘On Duty’ button on the airwave radio. A minute later the siren wails to confirm that I’m connected to the computerised despatch system and a quick call to the Emergency Operations Control to confirm the types of call and the length of the shift and I’m ready to respond.
We’re all here for the Cardiac Arrest – the highest priority and the call that will activate the quickest response of all. Time is precious here – every second counts. I’ve been on call for 420 hours since we were re-tasked on the 5th June post the initial lockdown. I’ve responded to 24 calls in that time. So yes, we do sit and wait a lot, but everything changes when the radio bursts into life again.
Adrenaline pumps through your system as you hurriedly scroll through the incoming text. What priority is the call? what is the background? and then what’s the postcode and house number?. Enter the code into the satnav and off into the cool morning air. I push the button to indicate I’m mobile on the call within 30 seconds, van warm and setting out. I put on the windshield light to show I’m on a call and head for the patient. There’s no breaking the speed limit allowed, so I rely on people’s courtesy and awareness to give way when needed. The frustration of not being able to help the patient whilst driving, and potential scenarios going through my mind. I imagine the ‘process’ to go through, what the house will be like, what are the priorities for the patient.
I’m at the postcode, and a torch beam normally finds the house number. Sometimes you rely on a code for a key safe to gain access, sometimes the door is left open. Now I don PPE to protect the patient and myself before entering the house. If the call is a Cardiac Arrest, speed is of the essence. The key is to assess any dangers and then to treat the patient as fast as possible using the defibrillator which we all carry whilst maintaining chest compressions (Cardio Pulmonary Resuscitation). In addition we communicate with the Emergency Operator to update them with the status of the patient. The ambulance will be on the way as fast as possible and the ‘A’ team will be on scene very soon, however our local presence means that even with the highest level alert, I have been ‘on scene’ up to 12 minutes before the ambulance – vital time to improve the likely outcome for the patient.
If the call is not a Cardiac Arrest, I might say ‘Hi, I’m Nigel and I’m a First Responder. I’ll look after you until the ambulance gets here’. People are naturally scared – the patient and their loved ones. There are often dogs to be reassured, narrow entrances, small spaces, lights to be put on, TV to switch off. If the patient is conscious, the key is to complete observations to support the ambulance crew when they arrive. If Control isn’t sure of the situation you may call to update them on the seriousness of the patient so they can in turn brief the ambulance crew what to expect.
After the initial concern and taking observations there’s often time to chat and reassure the patient and their relatives. The fact that someone is there in a time of crisis with the expertise to help if things take a turn for the worse is comforting for everyone.
The ambulance arrives and I give the crew a handover of the patient’s condition, history and any medications they may be taking or other relevant information, plus the actions I’ve taken in support of the patient and hand over to them for further observations and action. Where possible, I’ll ask the crew if I’ve done the right thing and ask for any feedback, then I’m back to the van and home again to swab equipment and get ready for the next alert. I log the call and then think through how it went, building experience as every second counts and every patient is unique. At 1430 after 8 hours, the shift ends, I log off and get changed for the rest of the day.
If anyone feels like they would want to join our team, we would love to have more CFR’s (please contact firstname.lastname@example.org in the first instance). We’re here to save lives – every second counts.