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Flight, fight or freeze?

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Jessica Sinclair is a student who found herself in the middle of a health emergency… in a bar. Here, she explains what the experience was like, and what she learned about herself. 

jessica sinclair

My heart sank instantly – I’ve just gone into second year and never properly been involved in a crash call in a hospital, never mind a bar. The first thought that entered my head was the word ‘Heimlich’, the second was a very loud internal expletive.It was 6:30pm in a busy train station bar.

I had just ordered a glass of white wine whilst waiting for a train that had been delayed for an hour when I heard the shout ‘he’s choking’.

In that split second, I froze. The call came again, ‘he’s choking, we need a doctor’. I stopped thinking and moved.

I was the second person to reach him, and helped lower him to the ground. There was a mouthful of food leaving his mouth and it didn’t seem like he was able to breathe. I glanced around at a big space that had formed around us and called for someone to phone an ambulance while mentally preparing to start CPR (for the first time on a real person).

“I had a second of clarity and pulled up his sleeves to check for a medalert band. There was nothing – I asked Romano if he thought it was stroke”

I turned to whoever was next to me and said ‘we can’t do the Heimlich manouvre like this’ - my thought process consumed with the steps of resuscitation after choking.

In that moment, I didn’t think to do an ABCDE assessment of my own (or the fact that he was not showing the universal choking gesture). Luckily, the first person that had reached him had a bit more experience than I did.

“My name is Romano, I’m a doctor, I think he’s not choking – it might be an intracerebral haemorrhage or an epileptic fit”.

“My name is Jessica, I’m a student nurse and I don’t really know what to do!”

Romano proceeded to find a pulse and check his level of consciousness by lifting the man’s arm over his face and letting go. There’s maybe a good reason why this isn’t a step in our OSCEs, but it was effective at the time.

“Look, we can see because he didn’t hit himself in the face, his reflexes are still intact, he is not fully unconscious”.

The random doctor in the busy train station bar was taking this as an opportunity to teach. I had a second of clarity and pulled up his sleeves to check for a medalert band. There was nothing – I asked Romano if he thought it was stroke.

Another body appeared at my side. ‘I’m a doctor, what happened?’. The question was directed at me – I would love to say I was able to give a perfect and professional SBAR handover, but the events up until this point had probably taken all of 60 seconds.

“Everybody in that situation introduced themselves, and automatically assumed we were working as a team”

“I’m a student nurse, and he’s a doctor, I don’t know what happened, I just saw him go down. I thought he was choking.”

In hindsight, this was not particularly useful information. The man then started to shift and try to roll out of his position on the floor, slurring the words ‘blood sugar’.

A third person arrived (“I’m a doctor, what happened?”); a glass of Coke was brought over, and what seemed like a crowd of people in uniform descended on us. I kneeled back and had a very surreal conversation over the collapsed man about which university I was studying at. Internally, I was still terrified, but glad that there were more people around me to take control of the situation. 

So what did I take from this experience? Mostly, that I still have a whole lot to learn, and I am thankful for all of the nurses, doctors and healthcare professionals who have more experience than me.

In any situation (especially an emergency), always start with your own ABCDE assessment, and never base judgment on what someone else has told you. Two, or three or even five heads are better than one.

I am also extremely proud to be doing my training within the NHS. Everybody in that situation introduced themselves, and automatically assumed we were working as a team. It’s ok (and probably safer) to say when you don’t feel confident, if the situation allows it.

When we received our CPR training, we were told that at some point, we were likely to have to use it outside of our normal working environment. This sounded scary and unrealistic at the time, but it turned out to be true.

Learn and study and memorize the steps of emergency care because there might come a time where you’re the only person available to give it. 

Jessica is a currently a second year adult nursing student at the University of Dundee.

 

 

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