A day and a life

That was an interesting cycle to work. At set of traffic lights I passed a car that was rolling along the wrong side of the road with a woman running after it. I got off my bike and saw that there was an elderly man unconscious in the driver’s seat and an elderly women very distressed beside him. Some other people came over and there was a bit of milling about with one person on the phone to the emergency services but no one actually checking out the driver.

So I leant in and started to have a look. He gave a rattling sigh and his head slumped forward. He was drooling slightly. I took his wrist and felt for a pulse. Nothing. I took the other wrist. Nothing. I checked up in his neck. Nothing. I checked the other side of his neck. Nothing. I put my head on his chest. Nothing. I put my hand on his diaphragm. Nothing. No movement. I put my hand over his nose and mouth. Nothing.

You don’t want to drag an unconscious person out of car. Even though I had seen the car come to rest slowly – there hadn’t been a crash so you would hope there were no spinal issues – you want to minimise moving them about. You may just make whatever the problem is worse. I looked at him. What’s the risk? What’s the risk of me moving him? What if I just can’t find a pulse but it’s there and it would be best to leave him? What do I know with any certainty?

I know that I cannot establish that his heart is beating and that he is breathing.

OK, we’ve got to get him out of the car. I ask someone to help me and we get him half out, someone gets his legs and we lay him down on his back. I wanted him on his back because if I still wasn’t able to establish a pulse then I would start giving chest compressions. 15-2 if I remembered correctly, although the recommendations are to not worry about rescue breaths and instead just hammer away at the compressions. I grab his wrist and he gives a shudder and then twitches a bit and moves his other arm and his eyes flicker open. He tries to talk but no sense comes out, but after a while he becomes quite coherent. He tells me that his stomach really hurts but he has no other pain. He is even able to tell me a little of what happened before he passed out.

And then a paramedic appears. Within 10 minutes he is in an ambulance along with his wife.

What happened? I guess I will never know. Hearts just don’t stop then start. His pulse was too weak for me to detect. Its hard enough at the best of times. Perhaps if I had spent longer I would have found something. Similarly with his breathing. Pretty much as soon as he was horizontal he started to regain consciousness. In many instances that’s the thing to do, along with raising the person’s legs. But in others that wouldn’t help at all or even make things much worse. And in general, not moving them until a paramedic turns up is the far better option.

Did I make the situation worse by getting him out of the car? I worry about that. But at the same time the other worry was that this person was essentially dead, and unless something happened quite quickly he is going to stay dead. What should I do? I looked around. People were looking at me. What should I do?

What would you do?

For readers in the UK: British Red Cross and St John’s Ambulance.

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3 thoughts on “A day and a life

  1. I think you did the right thing. Since there was no obvious injury, the main concern would be to get him breathing and his heart beating again (if stopped). It sounds like he passed out and putting him on his back helped him regain consciousness. I would not worry to much, whether or not you did the right thing. Off course you wonder how he is doing now. Everyone in your situation would. I think what is most important is that you responded to the situation and thought about your actions. That’s as much as anyone could have done… and more than most people would have. So I hope you sleep well tonight – you certainly deserve to!

    • Thanks! It took the paramedics about 5 minutes to turn up after someone had called them. And here’s another reason why the NHS can be great:

      I phoned up the hospital as I wanted to see what had happened to the driver after he had disappeared into an ambulance. Patient records weren’t able to help as I clearly had misremembered the driver’s name. But they put me through to accident and emergency. Just that morning alone they had treated 75 males. But they started searching for paramedics called to a particular area at a particular time and some situation details. “Elderly man, collapsed while driving”. That’s him! A pause. Some typing. A longer pause. “He’s been admitted”. Despite the people I spoke to being clearly very busy (can you remember what it was like the last time you visited A&E?) they were extremely helpful and sympathetic. I can’t really find out anything about the driver because of patient confidentiality. But at least I know he is in hospital being looked after.

  2. Sounds to me like you did the right thing. I’m guessing I would have done the same, particularly with the evidence of “No Crash”. Tough call though

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