June 12, 2016 12:00am

JENNY Mulder should be dead. Instead, she owes her life to a “mechanical plunger” that pounded her chest for 57 minutes, keeping her heart beating — and her alive.

The 65-year-old went into cardiac arrest while in the emergency department at Royal Prince Alfred Hospital but luckily for her, the hospital was equipped with a LUCAS machine, which performs CPR at 100 pumps per minute.

The machine, which is also installed in six rapid response ambulances in the Sydney CBD, is part of a new clinical trial between St Vincent’s Hospital, RPA Hospital and NSW Ambulance.

Nurses Ashleigh Dolton (left) and Megan Moudawar inspect the Lucas 2 device.
“We have moved from ­resuscitating the alive to ­resuscitating the dead,” RPA Hospital Emergency Department acting director Dr James Edwards said.

“It’s the concept of people who (we) previously said ‘no, they have died, we can’t actually bring them back’, to now where we can bring them back.”

The LUCAS machine, combined with a second ­device called an extracorpor-eal membrane oxygenation (ECMO), have been hailed as the future of CPR and cardiology treatment.

The ECMO replaces heart and lung function for up to weeks at a time.

The combination of the two machines buys doctors crucial time to diagnose and treat the underlying cause of the cardiac arrest, and also gives the heart time to recover.

Art shows the Lucas function. Bottom left: Jenny Mulder thanks Brett Simpson.
Both hospitals had been using the technology for about 18 months before the clinical trial, with health officials now assessing how they would be of greater use in a co-ordin-ated approach.
Since February the devices have also been installed in six CBD ambulances.

Of the 30,000 Australians who suffer a sudden cardiac arrest each year fewer than 10 per cent survive, with 95 per cent of victims dying before they reach hospital.

The trial is expected to ­involve 25 patients over two years, and is modelled on a similar trial in Melbourne which increased survival rates for refractory cardiac arrests from 5 per cent to 50 per cent.

Paramedics and doctors will only use LUCAS on ­patients who are under 70 and have had some CPR ­performed before paramedics arrive.

The cardiac arrest also needs to have been no more than 60 minutes old, been ­witnessed, and been caused by a cardiac issue and not something else.

“It is a very aggressive and experimental approach to a very complicated problem,” RPA cardiologist Associate Professor Paul Forrest said.

Jenny Mulder catches up with paramedic Brett Simpson. Her heart stopped beating for 57 minutes before making a full recovery.
We think if we can demonstrate that there is a survival rate of between 40-50 per cent that’s a huge ­improvement on what is currently achievable. It is a trial but the preliminary results are very encouraging.”

Mrs Mulder was this week reunited with paramedic Brett Simpson, one of the four paramedics who arrived at her Glebe house after she suffered a heart attack in April.

After being taken to RPA, Mrs Mulder went into cardiac arrest. Mr Simpson began CPR and shortly after, the LUCAS machine was strapped on Mrs Mulder. It was then Mr Simpson witnessed something which is almost science fiction.

“Maybe four or five times we actually stopped everything because you were waking up and your arms were grabbing at the machine,” Mr Simpson told Mrs Mulder.

“Blood was going to the brain almost too well.

“We were like ‘crap, she’s waking up again’.”

Traditional CPR increases a patient’s blood flow to the point they are barely surviving. Mr Simpson said people should be unconscious during cardiac arrest because there is very little blood pressure.

“This LUCAS machine was actually giving you enough blood pressure — and it was perfusing your brain enough — that you are actually waking up when your heart was not beating,” Mr Simpson said

“That is how good these machines are.

The Ecmo Cardio Help machine pushes oxygenated blood through a patient’s body. It is used in conjunction with the Lucas plunger.
“The best CPR that you can muster only manages a blood pressure of about 40 or 50, which at that point is barely enough to be perfusing the brain or internal organs.

“For a person to come from no blood pressure, as Jenny had, to then become awake her blood pressure would have had to have been about 80 or 90, which is physically ­impossible with regular CPR.”

Mrs Mulder was then taken to the intensive care unit where she was placed on an ECMO machine for 24 hours. She left the hospital nine days later fully recovered.

Dr Forest said Mrs Mulder could not have been any ­closer to death.

“It is pretty dramatic in the sense that you’ve got people who would almost certainly die otherwise can be brought back. It was an absolutely spectacular result,” he said.

The LUCAS was conceived in 1991 by a Norwegian paramedic and has been in UK and European hospitals since 2006.

Mr Simpson said the LUCAS could be revolutionary for the ambulance service in NSW.

“We have had it ingrained in us from day one this is how you do cardiac arrest and CPR,” he said. “Now all of a sudden that is being flipped on its head with LUCAS. Quite often, out of hospital, we will run a cardiac arrest with four people and everyone has a role to play. Now in the same situation we have an extra person.”

Mrs Mulder said she had been ready for death, with the last thing she remembered seeing the bright lights of the defibrillators.

“I feel that life now is just another door that closes,” the mother-of-one said.

“Everything is OK when you leave. You take a lot of what you carry with you. You leave a lot behind and it is just a beautiful feeling.

“The fear of dying is not there any more. It is just ­another door that you pass through. I reached a point, when the ambulance came through, that I do not have any resources to know what to do now. I had to completely surrender so I just let go.

Jean-Paul Nicolazo, 69, at a family christening. He survived a cardiac arrest which lasted one hour thanks to paramedics and doctors at St Vincent’s Hospital and the new clinical trial.
“I don’t want to just thank the robot, but it performed miracles. The doctor said that years ago I would not have survived. So to have that facility is amazing. I feel lucky just to be alive.”

Her incredible recovery is not isolated.

Jean-Paul Nicolazo, 69, was dropping his two-year-old granddaughter at daycare in Centennial Park on April 5 when he had a cardiac arrest.

Three people, ­including his 37-year-old son Olivier, ­performed CPR on him before paramedics put him on the LUCAS ­machine.

The Parisian was in cardiac arrest for 60 ­minutes, but Dr David Roy and his team at St Vincent’s Hospital staff were able to bring him back to life. He has made a full recovery.

French tourist Eric Bruyer, 49, suffered a cardiac arrest at the Novotel in Darling Harbour. His son, Max, fetched help while his wife, Katty, attempted CPR. He was put on the Lucas machine at the scene and then the Ecmo machine at St Vincent’s, where he made a full recovery.
In another case on April 1, French tourist Eric Bruyer, 49, went into cardiac arrest while staying at the Novotel in ­Darling Harbour.

His 10-year-old son Max raised the alarm and wife Katty Valpromy, 41, performed CPR before paramedics arrived and put him on the LUCAS.

Despite 50 minutes of cardiac arrest, Mr Bruyer made a full recovery.

“I felt like I was seeing ­myself from above as if I was floating above my body,” Mr Bruyer said from his home in New Caledonia.

“Thank you to all the staff for saving my life.”

Health Minister Jillian Skinner said the technology looks promising, with the hope of rolling it out across the state.

BEFORE:

■ Paramedic-generated CPR on patients while they are being transported by ambulance, which is inferior to CPR done by the LUCAS machine.

■ No transfer of cardiac arrest patients within hospital to the Catheterization (cath) lab, where crucial heart diagnostics can be done.

■ Mandatory 20 minutes of CPR done at the scene by paramedics; only then would living patients be transported to hospital. Vital time is lost.

Result: Most people died in the field.

NOW:

■ LUCAS machine gives perfect CPR at 100 strokes per minute, regardless if patients are in motion or stationary.

■ Cardiac arrest patients transported to hospital immediately (no 20-minute delay)

■ CPR can now be done while other treatments/tests are being carried out. Previously this was impossible because a person had to be manually giving the CPR.

Result: Combined with ECMO, patients have a greater chance of survival.

Wow what a device in CPR first aid. We look forward to seeing the benefits this machine will hopefully have in society in the future. Make sure you book in to a Canberra first aid course before summer so that you can help out in an emergency. We provide first aid courses to the public and also private courses where we come to your venue.

October 18, 2016 2:57pm

A DEADLY snake was seen slithering along George St, Sydney sending people into a panic.

Snake handler, Harley Jones from Snake’s in the City, was called to George St around 2.20pm with reports of a red-bellied black snake on the loose.

Mr Jones was contacted by police and two other witnesses to remove the snake from the busy area outside a hotel.

After taking the full grown red-bellied black snake to a Crows Nest vet, Mr Jones said the snake has a good chance of survival despite having blood on its head.

“The snake’s injury is as much of a mystery as why it was there in the first place,” he said.

“There was quite a lot of blood on the footpath, it could be a lung injury.”

Mr Jones said he was pleasantly surprised by the amount of people concerned for the snake’s welfare.

“People were more curious than scared, which is really fantastic to see,” he said.

The venue manager at the Morrison Bar said staff rushed to close the doors and call police as soon as they saw there was a snake out the front.

He said the snake appeared to be injured and distressed, with a large amount of blood on it’s head.
“The staff couldn’t believe what they were seeing and covered the snake up straight away,” the venue manager said.

“You don’t expect to see a massive deadly snake in the city while you are relaxing and having a drink.”

He said none of the patrons appeared to be injured or stressed by the situation.
A picture of a one-month old baby red-bellied black snake. Picture: Jono Searle
Mr Jones said finding a snake in the CBD was far from a regular thing for him.

“It is very unusual to find a red-bellied black snake in front of a hotel, in the middle of the city,” Mr Jones said.

The venom is poisonous and symptoms include bleeding and or swelling at the bite site, nausea, vomiting, headache, abdominal pain, diarrhoea, sweating, local or general muscle pain and weakness, and red-brown urine.

Although there are a number of bites each year, very few human deaths have resulted and most deaths were in earlier times.

Often bite victims experience only mild or negligible symptoms but some end up in hospital.

But there is a greater risk for children and pets.

The snakes grow to an average size of 1.5 to 2m, with males growing slightly larger. But they can grow up to about 2.5m.

Yes folks its that time of year again. Snakes are coming out to look for food. Make sure you are ready in case a family member gets a snake bite, learn first aid in a nationally recognised first aid course in Canberra. We are the best first aid course in Canberra and we offer training with a defibrillator top all participants. Book now for a day you wont forget. 

He was on the operating table by the time he suffered cardiac arrest — and his life was saved by a colleague.

Victor Chang Cardiac Research Institute researcher Mr Kesteven is an expert in echocardiography and measuring heart function and knew what the feelings of “a burning tennis ball” in his chest and bruising on his left arm meant.

“The classic symptom of a heart attack,” he said.

Within minutes wife Susan was driving the father-of-two, 55, to Hornbsy Hospital where he was given clot-busting drugs and rushed by ambulance to Royal North Shore Hospital.

There his institute colleague Professor Gemma Figtree was on hand to re-start his heart and ­insert a hi-tech stent into a blocked coronary artery.

Mr Kesteven’s quick action in seeking help meant Prof Figtree was waiting in reception to reassure Susan her husband was OK.

Two weeks later, Mr Kesteven has gone public to raise awareness of the need to recognise heart attack symptoms.

“I can’t thank (Prof Figtree) and the team enough for saving my life,” he said.

“It is all down to the speed of action at Hornsby and RNS hospitals, it comes down to minutes and seconds in situations like this.”

Coronary heart disease claims the life of one Australian every 26 minutes, but up to one quarter of victims have no obvious risk factors.

“We still don’t understand the complete biology of our biggest killer,” Prof Figtree said.

While smoking, diabetes, high blood pressure and high cholesterol are major contributors to coronary disease and heart attack, Mr Kesteven was a fit and seemingly healthy man.

Until a fortnight ago he cycled 250km a week to and from the Victor Chang Institute. Now he takes daily medications, including beta-blockers and statins.

“Heart attacks can happen in anyone — even the fit without risk factors,” Prof Figtree said.

“Don’t ignore symptoms of chest pain.”

Partly funded by Heart Research Australia, Prof Figtree’s team operates a world-leading 24-hour surgery service to open blocked arteries in heart attack patients.

Their work became more poignant when their research collaborator Mr Kesteven was admitted.

Mr Kesteven took just one week of sick leave and was now feeling “100 per cent” — even considering getting back on his bike this weekend.

And his research has taken on new meaning.

Lucky the man new the signs and symptoms. It is very important that you always consider pains in the chest as a scenario that is linked to a heart attack. Please make sure you can help one of your family or friends in the case of an emergency by booking in to a first aid course with Canberra First Aid. We have courses running every week and we offer the cheapest first aid course rate in Canberra with gifts included. Book in now.

October 13, 2016 11:29am

SWIM coach and surf lifesaver Graeme Carroll has implored people to learn resuscitation skills, after a chance encounter saw him save the life of 16-month-old Bella Taylor.

Mr Carroll had considered staying home during unsettled weather last month but was cajoled by his wife into walking his dog at Ettalong Beach.

He caught sight of his friend and fellow surf lifesaver Jenni Darwin out running and was all set to have a quick chat before getting back in his car to go home.

That was until the pair saw Corey and Nicole Taylor racing outside their home screaming that their child had stopped breathing and they needed help.

Mr Carroll and Mrs Darwin didn’t think twice in assisting the toddler, who it’s believed had suffered a febrile convulsion.

“Jenny held the baby and I gave her a couple of quick breaths,” Mr Carroll said.

“I could sense there was a blockage and I did one more puff a bit harder and could feel there was flow.

“I lifted my head and colour had come back to her face and I said to the parents ‘she’s breathing, she’s breathing’.”
“My wife knows CPR but she froze and I panicked,” Mr Taylor said.

“When it’s your own child you don’t think rationally. I can’t explain how I felt.”

The Taylors said Bella was taken to Gosford Hospital where she remained for five days, after which Mr Carroll went on holiday, putting a reunion of the two rescuers and the family on hold until this week.

Mr Taylor described the pair as “our angels”.

“It was raining that day and no one was around and they just appeared,” he said.

Mr Carroll said they were just doing what they were trained to do.

“With the training I’ve done, I had the confidence to know that what I was doing was the right thing,” he said.

“You never know when it might happen. Everyone should do a rescue course.”

That last quote is correct. “You never know when it might happen”, great on the spot thinking from these guys. Luckily they were trained in first aid. Make sure you are prepared for when an emergency happens to you. Sign up to a one day first aid course in Canberra with Canberra First Aid Courses and we will guarantee to give you the training you need. We will also provide you with a first aid course that gives a free first aid manual to take home, a cpr facemask and a quality education. We look forward to seeing you in one of our first aid courses soon.

September 22, 2016

THROUGH a collaborative effort with ER24, Jacaranda FM, CTM and medical supply company MedDev, 205 Kruger rangers, including section rangers and the Air Wing, underwent ER24’s Tactical First Aid Course.

This was part of the StopRhinoPoaching.com project and 145 specialised trauma packs kitted for managing gunshot wounds and heavy bleeding were deployed and each person on the course was given a tourniquet.

“For the first time ever, there is a tactical first aid capability across Kruger National Park. The first Kruger ranger was shot by poachers earlier this year. He and his fellow rangers had attended the ER24 course and as a result, knew how to manage the gunshot wound. The group had the right kit to do so, which saved the ranger’s life,” said founding director of StopRhinoPoaching.com, Elise Daffue.

StopRhinoPoaching.com, founded in 2010, initially meant to be an independent web-based platform dedicated only to raising much-needed awareness and support for the war against rhino poaching.

“I had a gnawing feeling for some time that there was something I was supposed to be doing to help rhinos. I just did not know what it was. After a particularly horrific poaching incident, the idea of the website hit me. At the time, there was little information available on rhino poaching and what was happening in South Africa. What started off as a web-based platform focusing on credible content and awareness, soon turned into a full-time responsibility of managing donations and supporting rhino reserves,” said Daffue.

All the organisation’s projects are focused on rhino protection, starting with the basics and then, helping to build capacity.

“For example, it does not help to buy specialised technology when rangers are not adequately trained or do not have basic equipment with which to work. It also does not help to spread assistance so thinly that it is rendered ineffective, which is why we carefully selected reserves that we support. For the most part, we keep channelling funds to these areas to make them a hard target,” said Daffue.

Daffue added that the organisation’s biggest strength lies in the fact that they have strong and trusted relationships with the majority of key rhino reserves and security initiatives around the country. “This network has meant that we have been able to support strategic requirements in these areas. We have a respected work ethic, an excellent understanding of the evolving poaching threat and we are informed about our selected stakeholder’s requirements. We have the ability to scale projects according to available funding through strategic partnerships and we have a quick turnaround time in putting tangible support on the ground,” she explained.

To date, StopRhinoPoaching.com has sponsored various types of training for more than 420 rangers and 50 reserve managers. A total of 29 rhino dogs have been deployed with another four currently being trained.

“We also do a lot of networking, relationship building and information sharing. One of the projects close to my heart is Project Embrace, a ranger wellness project that we are funding in the Kruger together with CTM and the International Rhino Foundation. We sponsor specialised psychological support for the rangers and their families, a critical intervention to curb stress levels and help prevent burn out,” said Daffue.

She added that rangers live with incredible stress, endure all kinds of hardships in the bush and sacrifice a great deal. Rangers have had to become soldiers, which is not what they originally signed up for when they chose a career in conservation, as a lot of the poaching groups now carry firearms.

“Rangers are the ones who stand between a rhino and a poacher and we need to be doing everything we possibly can to support them. They are doing their level best out there. Poaching, especially the cruelty and senseless killing, congers up all sorts of emotions. Doing this kind of work means that you do get emotionally involved. You give a lot of yourself and you grow close to the people who are out there fighting the fight every day.”

StopRhinoPoaching.com has channelled more than R12-million to the rhino cause, all made possible by donors.

“StopRhinoPoaching.com has had the pleasure of working with some incredible people and companies, all of them determined to help in some way. People have arranged sporting events and challenges while others have held office collections. Schools have run rhino projects and children have raised funds,” added Daffue.

Trained and ready. Some of the rangers who recently received first aid training pictured with ER24 staff.

• Andrew Buncombe New YorkSeveral things were rather strange about the shark attack on surfer Joseph Tanner.

  The first was that shark attacks off the Oregon coast are rare. The second, was that Mr Tanner, a trained trauma nurse, was able to direct his own medical treatment after emergency crews rushed to help him at Indian beach in the Ecola State Park.

  “He directed his own first aid, what needed to be done, he asked us a lot of questions, what we were seeing, if we saw spurting blood,” witness Jeff Rose told KGW-TV.

  ks Surfer Near Cannon Beachhttp://www.opb.org/news/article/shark-attacks-oregon-cannon-beach/#.V_xCN9az4KA.twitter …

  12:36 PM – 11 Oct 2016

  

  Shark Attacks Man Near Cannon Beach

  Police are investigating a shark attack that seriously injured a man who was surfing near Cannon Beach Monday afternoon.

  “He took a pretty big hit out there. Pretty gruesome injuries.”

  Stephen Craig was getting ready to go in the water when he saw a group of people bringing Mr Tanner up from the beach.

  FindTheHome | Graphiq

  “He was in a lot pain, obviously, and shock,” said Mr Craig. “But he’s going to be alright.”

  Mr Tanner, 29, was attacked on Monday afternoon. He told emergency crews that the shark was medium sized and may have been a great white.

  

  Mr Tanner was able to direct his own emergency treatment (KOIN6)

  He said the creature pulled him from his surfboard, and that he then swam to shore.

  Mr Tanner was stabilised at the scene and flown to a Portland hospital with serious injuries.

  Mr Rose said that a friend of his saw a shark attack a seal in the same spot about three months. Authorities were investigating the incident.

  Shark attacks in Oregon are rare. In 2011, a shark took a two-foot bite out of a surfboard after encountering a surfer off another Oregon beach.

  He directed his own first aid! What a legend. We might need him to join the team in Canberra as one of our amazing first aid course trainers. Our first aid course trainers are the best in the business because we are teachers. We interact with the group in  a friendly  and encouraging manner. Many of our counterparts organise ex nurses and paramedics to train in first aid courses and all they do is throw out lots of jargon and over-complicate the situation. Our trainers teach. We guarantee that our first aid courses are the best in town. So book now.

Updated about 3 hours ago

PHOTO: The app will be able to identify about 230 jellyfish when it launches. (Supplied: Lisa-Ann Gershwin)

MAP: QLD

Scientists behind a new jellyfish app hope it will make Australian beaches safer by reducing the number of stings and providing warnings that the animals are present in the water.

Australian Marine Stinger Advisory Services director Dr Lisa-Ann Gershwin said The Jellyfish App contained information about swimmer safety and scientific information about jellyfish, including photos and first aid treatment.

She said the app also has a search function so users could find out what time of year jellyfish were likely to present.

“This is for anywhere in the world,” she said.

Dr Gershwin said the app would also allow users to identify a jellyfish they had seen by giving a description and their location.

The app is set to go live with about 230 species, with more to be added.

“That does catch, pretty much, most of the dangerous species and visible species that are likely to confuse people,” Dr Gershwin said.

“The idea behind this is to give people the ability to know a bit more about what they’re looking at so that they’re not afraid of every jellyfish.”

Dr Gershwin said not every jellyfish in Australian waters was a box jellyfish or an irukandji.

“Because there’s so little information that puts things into proper perspective, to the typical person any jellyfish is probably a box jelly or an irukandji,” she said.

Dr Gershwin said the app would help people identify harmless species that were not capable of stinging.

“It’s really about saying this is when and where I need to be careful, this is what I need to do to be safe,” she said.

“I hate to see people so scared that they’re afraid to go into the water.”

The app is scheduled to be released in the coming weeks.

Sounds like a pretty cool little app. Make sure you book into a first aid course with Canberra First Aid so that you can learn about not only the jellyfish but how to treat other animal bites and stings. We hold the best first aid course in Canberra and we are now the only trainer giving free certificates, free parking, free first aid manual all as a part of your first aid course for $100.

Carrying a first aid kit in your car is a jolly good idea. But making it legally compulsory would be daft. Especially if the law didn’t specify what had to be in it.

An aspirin? A sticking plaster? Some antiseptic cream perhaps, and pills in case someone in the vehicle gets the runs? A safety pin, a needle, some cotton thread, a pair of scissors, and a bandage? Some eyewash and antihistamine? By all means pack all of that, and more, to help deal with all the little troubles that can arise on a safari.

But that’s your choice. Not a legal issue. No one is going to die if you don’t carry these remedies (and anyone with severe toothache might rather be dead anyway).

Where first aid could and should have legal status is when dealing with life-threatening injuries from an accident. And when that happens, the only kit you might need is rubber gloves. Beyond that, anyone who knows what s/he is doing won’t need a first aid kit, and anyone who doesn’t know what s/he is doing shouldn’t try to use one.

AVOIDABLE DEATHS

Basic first aid “knowledge” is the essential and arguably only thing that might help keep someone alive until an ambulance and paramedics (second aid) or a fully equipped operating theatre (third aid) arrive … with oxygen, defibrillators, blood transfusions, adrenalin …

Emergency first aid is what you can do before that to prevent an avoidable death. For the full details, talk to an expert. But for the cardinal principles, it is axiomatic that to avoid death you need to sustain the essentials of life.  The essentials are breathing, adequate blood supply, and a pulse to pump it. If breathing is not happening you need to get it started or substituted with all possible haste, and to do that you need to know how to position the patient, how to prevent choking, and preferably how to administer artificial respiration and/or cardiopulmonary resuscitation (CPR). The value of a first aid kit in those respects is zero.

If there is major blood loss you need to stop it immediately by applying pressure to the wound. If there’s no pulse, CPR is urgent. Again, the absolute need for a first aid kit is nil.

Though some sterile pads and a bandage to hold them can be helpful, their job can be done with all sorts of other materials that will be at hand. Start with your shirt.

Consciousness is a good sign, and can be helpful to managing the patient, but it is not essential and, again, you will not find it in a first aid kit.   Beyond those most basic things, it is more important to know what you should not (repeat not) do, than to know what you might try to do (usually the less the better).

When breathing, bleeding, pulse and consciousness have been attended to, priority attention should be given to managing the scene – getting someone to call for expert help, others to warn on-coming motorists, etc – and keeping the injured person warm, calm and reassured.

What the law could consider is to insist these principles are taught and tested. Knowledge of them should definitely be carried in every vehicle. They are immeasurably more important, and more likely to save a life, than any first aid kit.

Not only carrying a kit but doing a first aid course is so important. Book in to a first aid course with Canberra First Aid today so that we can get you trained with all of the skills needed to save a life. Our first aid courses are fun, fast and cheap. We have great trainers who have been taking first aid courses for years and know all of the up to date information when it comes to the industry. Book now and get the best first aid course in Canberra.

While off on an adventure trip, you would very often be in remote areas, usually far away from medical help and most certainly on difficult terrain. There would be a guide or trip leader and he/she would, if the trip is organised by a reliable, reputed and conscientious provider, be trained and qualified as a first aid responder.

Does this mean that you should not bother to learn the basics of First Aid? I would think not.  In my own experience when I was on my first hike in the mountains, with my buddy along, I was somewhere in the middle of the group who were scattered over a 2 km stretch. The leader was out in front and coming up last was his assistant. My buddy suddenly tripped and twisted his ankle. Not knowing what to do, I started massaging his ankle. Now I know that it wasn’t the right thing to do and had inadvertently caused more damage. I’ve had several such incidents over my learning years and these prompted me to develop a good understanding of how to deal with medical emergencies in the outdoors.

So it’s really important for everyone in the group to know something about First Aid on Adventure Trips, whenever you are out there doing something adventurous. One also has to remember that improvisation is the key to First Aid and one should be able to utilize whatever supplies or materials that are on hand and depend heavily on common sense.

Where do we start then?

I would think a good place to start is to learn the Three ABCs. It’s a helpful mantra for recalling the priorities whenever you are confronted with a situation where life-threatening conditions such as a blocked airway, severe bleeding and/or cardiac arrest are recognized and dealt with appropriately. The three ABCs are generally referred to as Airway, Breathing and Circulation, but I found a slightly expanded version useful.

THREE ABC’s

A1  ASSESS the scene

A2 AIRWAY (ensure an open airway)

A3 ALERT others

B1 Barriers (gloves, pocket mask)

B2 BREATHING (check for breathing and perform rescue breathing if necessary)

B3 Bleeding (stop bleeding)

C1 CPR (start CPR if the victim has no pulse)

C2 CERVICAL SPINE (prevent unnecessary movement of head and neck)

C3 COVER and protect the victim from the environment

A1 ASSESS the scene

Make sure that the uninjured members are safe. Assess the scene for any more hazards, like rock fall avalanches, wild animals etc. before starting to administer First Aid. Keep in mind that while attending to the victim, you should not become a victim yourself or in trying to reach the victim hurt them (by causing a rock fall for example). Quickly see what materials you have available and who else can help you with the victim. Take charge.

A2 AIRWAY (ensure an open airway)

Speak loudly as you approach, call their name, tap their hands and feet gently to see if you get a reaction. If the victim is unresponsive, find out if they are breathing by taking your ear close to their mouth. If lying face down, turn them over by rolling them over in such a way that head, shoulders and torso move as a single unit without twisting. (See Figure).

If the victim is not breathing, clean the mouth with your fingers, and open the airway. If trauma is not suspected, the airway can be opened by tilting the head back while fingers of the other hand lift the chin. The most common reason for airway obstruction of an unconscious victim is relaxation of the tongue and throat muscles which causes the tongue to fall back and block the airway.

If trauma is suspected, use the jaw thrust technique to open the airway by kneeling down with your knees on either side of the head, placing your hands on the either side of the victims jawbone and pushing the base of the jaw up and forward.

A3 ALERT others

Before you get too involved with the resuscitation or management, call or send someone to inform others about the incident. If possible, give details of where, nature of injury, your proposed action plan, what kind of help is needed and when you would contact them again.

B1 Barriers (gloves, pocket mask)

To avoid getting infected from blood-borne bacteria, it’s important that you create an effective barrier, such as gloves and barrier device for mouth-to-mouth resuscitation.

B2 BREATHING (check for breathing and perform rescue breathing if necessary)

If the victim is not breathing after establishing an airway, start mouth-to-mouth resuscitation.

B3 Bleeding (stop bleeding)

Check the victim for signs of profuse bleeding. Apply pressure with your gloved hand to stop bleeding. If bleeding cannot be stopped, apply a tourniquet. Remember that the tourniquet should not be so tight as to stop blood flow completely. Loosen it from time to time. Beware that if a tourniquet is applied for more than 3 hours it is like that the arm or leg will get severely damaged and may require amputation.

C1 CPR (start CPR if the victim has no pulse)

Place your index finger on the victim’s throat over the Adam’s apple and slide your finger down to the side of the victim’s neck, somewhere between the Adam’s apple and the neck muscle, you will find the carotid pulse. Hold for approx. 30 secs (60 secs if the victim is hypothermic) and feel for any pulse. If you do not feel pulsation, start mouth-to mouth resuscitation. (We will talk about Rescue Breathing and CPR in the next blog)

C2 CERVICAL SPINE (prevent unnecessary movement of head and neck)

The spinal cord is vital for a person’s life and runs down through the vertebrae in the neck. In case the spine is damaged, it can cause permanent paralysis or death. If there is any chance that the victim’s neck is broken due to the accident or if any of the following are present, the head neck and torso have to be immobilized:-

• Unconscious victim
• Complains about neck or back pain
• Tenderness in the neck or back when touched
• Numbness, tingling sensation in the extremities
• Unable to move, weakness in an arm or leg
• Another painful injury, (thigh, shoulder) distracts the victim form the pain in the neck

If cervical injury is suspected, immediately immobilize the head and neck and prevent any movement. If the victim is in a safe location avoid moving him until professional rescuers arrive.

C3 COVER and protect the victim from the environment

If it is cold, cover the victim from above and below. If it is hot, move to a shade and loosen clothing. If in a dangerous place, move to a safer location, maintaining spine immobilization as indicated.

What to do next

Once the primary survey is done, if a life-threatening situation does not exist, do a secondary survey looking for further evidence of injury or illness. Gently push every part of the victim, looking for pain, swelling or deformity. Once you have all the information, it is time to organise a rescue team and develop a plan for evacuating the victim or asking for professional assistance.

Up next in this series, we’ll tell you what to do in life threatening emergencies, CPR, head injuries, shock, burns, fractures, animal bites, cuts and bruises, illnesses and other helpful tips. So while you wait to learn more, stay safe!

First Aid is essential for going out hiking in the bush or on any adventure. First Aid curses can be done in Canberra with us at Canberra First Aid. Book in now.

The federal government will push ahead with a new tender for Australia’s triple-zero emergency call service, despite an official review warning changes should be delayed until location capability technology is implemented and co-ordination problems are resolved.

Communications Minister Mitch Fifield called for expressions of interest from service providers on Thursday, saying he expected a new tender would help Australia keep pace with technological advancements developed since the call-only system was established in 1961.

Communications Minister Mitch Fifield has called for expressions of interest for Australia’s triple zero emergency service.
Communications Minister Mitch Fifield has called for expressions of interest for Australia’s triple zero emergency service. Photo: Andrew Meares
As part of the announcement, Senator Fifield said the government would separately seek a provider who can track the location of emergency calls made from mobile phones.

A government review in 2014 found about two thirds of calls to the national triple-zero operator now come from mobile phones.

More than two thirds of emergency calls in Australia come from mobile phones.
More than two thirds of emergency calls in Australia come from mobile phones. Photo: Paul Rovere
Australian or overseas-based providers could win the contract, but 85 per cent of triple zero calls must be answered within five seconds and 95 per cent must be answered within 10 seconds.

The review found improved speed and accuracy in locating people in need of emergency assistance was required and considered expanding the service into non-voice calls, including SMS and video calls.

Location-based technology to speed up responses could be delivered through existing smartphone applications that send location co-ordinates to operators and responders, but the review found other countries had so far failed to find a reliable solution.

The United States and Canada began work on location-based information for 9-1-1 callers in 2014, while Britain is developing new services to better pinpoint emergency callers using smartphones’ co-ordinate information.

Released in 2015, the review report warned a new tender process would be hampered by Telstra’s “firmly entrenched” advantage as the current operator, as well as concerns about a lack of transparency in the current triple zero cost structure.

“On balance, the review recommends the Commonwealth should seek to postpone the 2016 tender for the [operator] for up to two years while any co-ordinate-based information capability is agreed and implemented, proposed triple-zero governance and co-ordination arrangements are resolved, and there is greater clarity on the desired future directions of triple zero,” the report said.

“Holding the 2016 tender process for the [operator] without such clarity may place at risk the current successful delivery model and could also result in a protracted period of negotiation with the successful bidder, the current operator and other jurisdictions to agree a new model and successfully transition to it.”

Mr Fifield’s office has been contacted for further comment.

“The review of the national triple zero operator had a specific focus on ensuring the triple zero service could keep pace with technological advancements and respond to changing consumer expectations,” he said in a statement.

Australia’s triple-zero service has always been provided by Telstra, currently via funding from the federal government and a telecommunications industry levy.

The review found 91 per cent of respondents who contacted triple zero in the past two years were satisfied.

On technological improvements, 93 per cent agreed specific location co-ordinates should be automatically provided to triple zero, while automated alert devices and smartphone applications both had above 70 per cent support as alternative methods to contact the service.

More than 50 per cent of respondents said they supported SMS or video call capability.

The most calls received by triple zero in any 24-hour period in the past five years was 30,028, coming during severe flooding and winds across south east Queensland and northern NSW in January 2013.

Interesting times ahead for emergency services calls. As you can read there are some great developments occurring around the globe with location co-ordinate technologies. As a first aid course provider here in Canberra we will give you all of the information in regards to 000 dialing.  We have also just launched our new app which will allow you as a first aider to call 000 form. It also has a online first aid manual, you can add a copy of your first aid certificate and much more. Sign up now for a first aid course with us at Canberra First Aid.