As part of our obligation as a doctor we have to have annual update cardiopulmonary resuscitation training and this also applies to the whole practice team.
We have found over the past few years that it makes sense to have sessions which include a cross-section of staff and even opening it up to patients that want to participate aswell as the the young adults of staff.
A report of a rare miraculously saving of a life
On December 23rd 2017 Dr Livingston was cosily at home recharging her batteries after a very busy surgery watching “Love Actually” with her daughter and her boyfriend when there was a loud frantic knock at the door. It was the nextdoor neighbour she was totally beside herself. Her husband had collapsed.
Dr Livingston knew he had heart problems so she immediately went into ‘doctor mode’ She instructed the 2 teenagers ( her daughter had attended CPR training ago but her boyfriend had never attended any training) to bring their phones ( not usually far from there sides, anyway!) Her daughter who remembered that there was a pocket mask strapped to the stairs in the hall had the presence of mind to grab that as well and the team hurriedly followed the neighbour to the house. Sure enough the husband was sited against a wall in a collapsed state. Immediate assessment demonstrated he was unrousable, not breathing and with no pulse. He had had a cardiac arrest.
The team managed to drag him onto the kitchen floor. Instantly the learnt procedure was put into action, and Dr Livingston allocated instructions to her team- the boyfriend called 999 and was communicating with the ambulance service ,very calmly listening and responding appropriately to their questions.
Meanwhile, Dr Livingston had immediately started CPR (basic life support with my daughter). Her daughter maintained good airway and Dr Livingston commenced chest compressions. She commented how exhausting it was and infact had not performed this for many years in a ‘real situation’ and then only in a hospital situation. Her daughter astutely observed that her mother was getting tired and then took over cardiac compressions. Before the ambulance arrived a police car arrived with a defibrillator. Although she had had training on this but she had never actually used and automated external defibrillator. They followed the spoken voice instructions it gave them.
After about 3 shocks the A.E.D said in a clear voice ‘movement detected’. The team paused in shear amazement ‘It was incredible,’ commented Dr Livingston.
Subsequently, two ambulance crews arrived and they took over and when he seemed stable the patient was transferred to Ealing Hospital. On arrival at hospital the Glasgow coma scale was used to assess the severity of brain injury and prognosis. The initial Glasgow Coma Scale provides a score in the range 3-15; patients with scores of 3-8 are usually said to be in a coma, remarkably his was 15.
This was a true miracle, as it is reported that of cardiac arrests in a hospital set up only 7% of people survive this man not only lived to tell the tale but survived his near-death experience without any damage to his heart muscle or his brain, an outcome extremely rarely seen following an out-of-hospital cardiac arrest.
When Dr Livingston and myself discussed this, I felt empowered to blog about this and Dr Livingston felt it was paramount to share her story with other GP’s by posting on a closed facebook page called Resilient GPs. Usually she would get 1 or 2 responses but on this occasion had over 700 !!
Many GP’s after reading the account decided to open up their basic life support training to the staff’s teenagers and family and purchase pocket masks and keep them at home and in the car. Dr Livingston will be advocating to all staff and both her daughters to put a pocket mask in their cars.
Moreover, the practice would be prepared to offer hosting CPR courses at the surgery for anyone interested or facilitate where a course could be done.
When the team got back home after lots of cups of tea Dr Livingston asked her daughter how she was feeling and was she upset by it?
She admitted it was scary but even though it was 2 years since she had attended the course she said the thing she particularly remembered the trainer saying,
‘If you dont do anything they will die so you may as well try. Even if just do chest compression that will help. That is what everyone needs to know- have a go !!’
Dr Livingston felt immensely proud of these teenagers , who not only immediately jumped into action without thinking but ‘saved a life’.
Well done – an absolute game – changer.
A week after this there was routine practice training update. The first time with the new practice defibrillator. The trainer simulated a cardiac arrest, which was brilliant, but completely forgot the practices had it’s own device.!!
The most important thing if some one has a cardiac arrest is to fibrillate as soon as possible
A few days later Dr Livingston passed the gentleman’s son in the street and asked how his father was feeling. He replied, ” he seems fine but that his ribs were aching a lot” he was virtually totally unaware of the magnitude of what had happened and not only had he survived but that his life had been restored without brain injury.
As days went by it gradually it registered this man’s life had been saved by a team that was confident and empowered to act quickly and efficiently and then the team were showered with gifts!