From the fast lane to an orange juice

Trundling along the A14 on my way back from a meeting in Birmingham, 2 hours passed without incident but then I came upon the aftermath of an accident, a silver car crumpled at an angle against the central reservation.

There were no skid marks and it didn’t look like any other vehicles were involved. Someone had pulled over; a lady was outside the car on her phone. In front of me a lorry was inching past the incident. I stopped and rolled down the window, asking if I could help, ‘do you know First Aid?’ was the response.
As a member of Lowland Search and Rescue my Land Rover is fitted with flashing amber strobe lights, these came on.
I jumped out not knowing what to expect but as I approached the silver car I thought through a simple risk assessment. No fire, no smoke or steam, engine was off, car looked stable and it was on all 4 wheels. Both driver and passenger doors were open.
‘In there’ said the lady on the phone, I stuck my head through the passenger side.
A man was slumped back in the driver’s seat. Another man was trying to get a response from him ‘hello’ he was shouting ‘are you alright?’
The driver needed an ambulance. I lifted my head to the lady on the phone mouthing ‘Ambulance?’ She responded with thumbs up.
Good… help is on its way… But for now I’m the help.
Suddenly the slumped driver arches his back; his eyes open and roll backwards, I could see only the whites. He took a breath but not a normal breath, a short, gasping, disturbing breath. Then nothing silence, a moment of quiet… what the hell was that?
Is he awake?
Has he come round?
‘Mate,’ I say to the man trying to get a response, ‘could you jump in the back and support his head?’ he moves round to the back.
Ok, C spine supported.
‘Hello, hello my name is Dave can you hear me?’ I say tapping on his shoulders as spoke, ‘hello, can I help?’ Nothing.
Breathing? Is he still breathing? With my ear close to his mouth I listen… Jerking my head back as another loud, gasping breath shudders through his whole body.

Think…

I kick myself, Agonal breathing, CPR time.
More people had arrived in the moments I’d been in the car. Good I’m going to need them.
I turn to the lady on the phone telling her to repeat to the operator that we have an unresponsive, non- breathing casualty and that I’m starting CPR.
To the people standing around I introduce myself, explain I’m a first aider and tell them I need their help to get the driver out the car and on the floor.
The people look pale but nod and move forward.
After some direction, ‘hold the head here’, ‘move around the pillar’, ‘you, help from inside’, ‘you, from outside’, we manage to ease the driver out the car.
As soon as he touches the floor I start chest compressions, concerned about breaths but one went in… Not like a mannequin.
30 compressions, 2 attempts at breaths, repeat.
30 compressions, 2 attempts at breaths, repeat.

The guy next to me wasn’t trained but I got him involved. I needed a rest. We swap a couple of times. I managed to get a couple more breaths into him. Every now and then he would arch his back and take another Agonal breath.
A tap on my shoulder, ‘keep doing exactly what you’re doing.’
I feel relief as a paramedic starts cutting his clothes off.
On with the AED Pads.
‘Keep going, but when I say don’t touch him, don’t.’ …………………….. ‘Stay clear, shock delivered; Carry on.’
I swap with the other chap. And back again. ‘Stopped, clear, shocking.’…………….. ‘Carry on’
A new voice in my ear ‘ok, boys I got this now, well done!’
A second paramedic arrived and took over from us. We moved out of the way and let them work.
It turns out this intense situation had lasted about 20 minutes. I was sweating and catching my breath as I watched the professionals at work.

And that was it… all over…. I had played my part. A police officer asked for my name and telephone number, he wrote them down and just like that I was free to go; in fact encouraged to leave.

Driving along the A14, with no other traffic around, travelling away from the scene was surreal. There I was back at what I’d been doing as though nothing had happened. Just drive home then. Crack on with life. Keep calm and carry on.
Should I be debriefed? Should I talk to someone and explain?
It felt really weird. I rung my wife and told her the story. It was good to share, but unless you were there it’s difficult to explain the whole environment. The smells, the sound of traffic all around, the exposure you feel, the nagging of years of training, the rechecking of your actions. You’re trying to save a life here, get it right god damn it!

2 days later my phone rang. ‘Hi Dave, it’s Cambridgeshire Police, the gentleman is in critical condition but stable.’ That’s it? No more information, I have been thinking about this guy for 2 days.
Ok let’s think back could I have done more? Did I miss an obvious injury? Did I do CPR correctly? What’s wrong with him anyway?
3-4 days after that the phone rang again. ‘Just to let you know his condition has improved, I can now tell you it looks like he had a heart attack. The doctors have said your actions saved his life.’

I later heard from the family that he has been discharged with a pace maker/defibrillator fitted. When he is strong enough a few of us who were at the scene are going to meet him, his wife and children, for a drink. I’ll have a beer but I think he’ll be on the orange juice!

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