Automated External Defibrillators
An automated external defibrillator is a device designed to take a heart rhythm not suitable for sustaining life and converting it into one that is more useful. They work much like restarting your computer when it crashes: turning it off and on again. Contrary to popular belief, they can’t restart a heart, so they aren’t especially useful when the heart has stopped, but, for a couple of relatively common abnormal rhythms, they can be very effective.
Now I am very much in favour of everyone receiving emergency first aid training. I strongly think the national curriculum should include first aid, and think everyone should consider doing a first aid course at least every three years (they aren’t particularly expensive, if you stick to the basics). I also think public access AEDs are a wonderful idea, especially as it is almost impossible to hurt someone with one. With the emergency services giving instructions, they can become a valuable part of the chain of survival. A lot of research has shown that, along with early effective CPR, the early use of an AED can improve the chances of a patient who isn’t breathing.
In summary, AEDs are great things and I think they should be as widely accessible as possible. However, I do have a bit of an issue with a policy the Organisation is about to bring in.
By the end of the year, all our uniformed adult members will have an AED qualification. This is good.
By the end of the year, all young people over the age of 11 will also have an AED qualification. This I’m not to keen on.
It is all very well teaching these children (and let’s not forget that they are children, not little adults) CPR and other life-saving skills. In my mind, this allows them to approach a scene with the confidence to deal with whatever they find until backup (in the form of an adult, ideally an adult first aider) gets there. Part of the protocol for a patient who requires resuscitation is to summon an AED and someone who can use it.
In principle, giving these young people this extra skill is fine. They can’t really hurt themselves with the AED (short of hitting themselves over the head with it) and it could help save someone’s life. On paper, that’s brilliant, but, if you think the entire scenario through, there are real issues here.
You are expecting this 11-year-old child, who may have never known someone who to die and has probably never seen someone this unwell, to take charge of this scene and deal with it. This includes handling with the emotional family member, the do-gooder who’s just getting in your way and the wanna-be doctor who tells you that you’re doing it all wrong. Not to mention calling the ambulance, working out how they are going to get to the patient, and everything else that needs doing when you are the one taking charge of the scene. And don’t forget, they’ve got to deal with their own emotions, both now and once the adrenaline has worn off, and they probably won’t think to call the youth leader, who has access to the brilliant support structure in place in the Organisation for just such a situation. In some cases, even their parents won’t know anything until someone spots something on Facebook and passes it on.
And what if the patient doesn’t survive? What if the paramedic (perhaps quite rightly) calls the patient on scene. Imagine the harm that could do to the young person, knowing they’ve ‘failed’.
The first step on my plan of what to do if one of my young people present at a critical incident is get them to a safe place as far away as possible from the incident. The next step is to activate that support structure, get the parents involved, and have a good long chat with the young person to ensure that they are okay. If I allowed them to remain at the incident, I’d get strung up, and rightly so. There is a reason we train them all to get help straight away.
I know that this is a bit of a ‘think of the children’ argument, and perhaps you think I’m doing them a bit of a disservice. People die, despite our best efforts, and this is one probably of the hardest lessons to learn when trained to the level we aim for. Thankfully, patients of this severity are rare but it does still happen, and we try to ensure our older, more emotionally mature young people realise this. However, in the main, the patients they see will be fine. They might not be very well, but they’ll recover, and what we do will be useful. This is what I stress to my charges, as I want them to feel proud of what they do, to know that their skills are useful and that their input is valuable. After all, this is why they have joined the Organisation. This is why we all joined the Organisation.
Don’t get me wrong, I think some of my youth members might be able to deal with a resus and come out shining. Unfortunately, they are in the minority, and we have to cater for everyone.
This training will almost certainly go ahead, and despite my misgivings my young members will have the same access to it as everyone else. This has been decided at a level high above my line of management. Hopefully none of my young people will have to use it. Hopefully, if they do, they’ll talk to someone afterwards.