Welcome to this edition of The First Aid Show. Today we are going to look at an ALS scenario
in a short film presented by Tony, our paramedic, who presents our advanced life support course.
What we are going to look at now is a patient who is being transported to hospital under
non-emergency conditions, who suddenly becomes unresponsive en route. I asked my colleague
to pull over and to come into the back to give me some assistance. Meanwhile, I will
manage this scenario. Hello, hello, can you hear me? Kynan, can you come and give me a
hand? The patient's unresponsive. Airway. He has got no pulse and no respirations. Can
you set up the AED, please? Meanwhile, I will start chest compressions.
Stay calm. Follow these instructions. Make sure emergency services are called now. Begin
by exposing patient's bare chest. Remove or cut clothing, if needed. When patient's chest
is bare, remove the white square package from lid of AED. Do not touch the patient. Analysing
heart rhythm. Please wait. Shock advised. Do not touch the patient.
Stand clear.
Stand clear, shocking.
Press. Shock delivered. It is now safe to touch the patient. Give 30 rapid compressions
and two breaths as instructed.
Kynan, I think he is starting to take a breath.
Place heel of one hand on centre of chest between nipples.
Yeah, the patient is now breathing again.
Place heel of other hand directly on top of...
Yeah, he has got a respiratory rate of about 12 so we will pop some oxygen on for starters.
Hello, hello, can you hear me? He is still not responding. Can you keep talking to the
patient and I will continue the assessment?
Hello, can you hear me?
His airway is clear. Let me know if there is any abnormal noises coming from his airway.
He has got a good cap refill centrally. Central and peripheral pulses are good. I am going
to put an ECG on.
[pause]
I can see that the patient has got a normal sinus rhythm, which is good. Can you count
his respiratory rate for me, please? Pupils are equal and reacting. Can you just keep
talking to the patient, see if he responds?
Can you hear me? Hello. Can you hear me? It is Kynan from the ambulance.
Okay, sat is at 98 now so we are going to remove him from the oxygen and see how he
goes on. Okay. Hello, hello. Can you hear me? The patient is starting to respond now.
So we can see from that scenario that if we act quickly and definitively as soon as the
patient goes into a cardiac arrest, we stand a very good chance of reversing the ventricular
fibrillation as it was then and getting a successful outcome for that patient.