Waking the dead
I’m lying on a rug in a graveyard. Kneeling over me is a paramedic. Behind him is a ring of five anxious people and at the Church gate a knot of concerned onlookers has gathered near the ambulance.
It is a gorgeous day in late June and the sun is blazing. Mercifully, the sole danger I face today is sunburn. Lying in the graveyard, I am a ‘volunteer casualty’. Our location makes it all rather surreal and a touch spooky.
We have enrolled as unpaid volunteers on a ‘First Responders’ scheme designed to augment the Welsh Ambulance Service based in Wrexham. I am Jo, married to wife Janna, and with neighbours Alan, Julie, Mags and Debs and this is our first session of a scheduled six. We all live within 100 yards of each other on narrowboats on Whixall Marina.
An ambulance may be called at any time of the day or night for a huge variety of reasons and the maximum target response time for a 999 emergency call is 20 minutes; early treatment of some life-threatening emergencies is crucial. Should the regular ambulances be busy, particularly at ‘peak’ times, the ‘First Response’ team would be called to give emergency assistance prior to the arrival of the ambulance. It's also a very rural area and the nearest ambulance may be a considerable distance away.
‘Peak’ times include ‘chucking out’ times on a Friday or Saturday night. Alcohol is invariably involved. Excess drink can lead to hyperventilation, fights and broken bones or bashed skulls through falling over. One drunk even rung 999 to get a lift home.
We have enrolled on the scheme because of my next-door neighbour, Alan, who trains people professionally in advanced first aid and basic life support. A former fireman and military policeman he now instructs groups that include the North Wales Police. Through a colleague he came across First Responder schemes in North Wales and suggested that we could set up a local team. It all sounds well and good as a topic of conversation in the pub but within a few weeks I am on a blanket on the ground in a graveyard, very sober, and the whole thing means something rather different. We are taking the first steps towards helping real people with real problems. Our allocated response area is within 15 minutes of the Marina. (By car – not boat)
Why a graveyard? Well, the village hall wanted to charge so the church opened its doors to a cash-strapped offshoot of the NHS.
Our instructor is to be Ian, a 35-year old ‘veteran’. He is to train us outside his hectic schedule as a paramedic on both the regular and air ambulance. ‘Paramedic’ always invokes in me a person who is among the first on the scene, calm, skilled and compassionate - a true knight of the road (as opposed to a bloke who could fix your fan-belt). It turned out that Ian was a member of a support crew for a Rally Team in his spare time so he could probably mend your car as well.
Our first session is in the vestry of Whixall Church. Where’s Whixall? Well, even some of the folk that live here are hard pushed to locate it exactly. It actually appears to be a collection of parishes spread over a significant area of North Shropshire often linked by the type of road that has grass growing up the middle. We live two miles equidistant from the Horse and Jockey, The Bull and Dog and The Waggoners Inn. Mm. So why are we training with the Welsh Ambulance Service? I don’t know. Except that Alan works primarily in North Wales. And we are only 5 or 6 minutes from the Welsh border. Our ‘patch’ is to be the area spanning the Shropshire / Wales border - but more in Wales than England. Anyway…
Despite the sweltering day the church was chilly. Ian had brought with him a mountain of kit: a training dummy on which we would learn CPR (cardiopulmonary resuscitation – a combination of chest compressions and rescue breaths) and a full mobile kit in a huge red rup-sack. It was the replica of the one we would eventually carry including: oxygen cylinder, masks, oral-phallangial airways, gloves, towels, dressings, scissors, razor, assorted plastic tubing, suction kit, blanket, torch, map and an AED (automated external defibrillator) – used to restore normal heart rhythm following a cardiac arrest.
Bloody Hell!! It was like someone had dumped the component parts of a spaceship on a launch-pad and asked us to assemble it.
Despite an hour spent filling in forms and assessing suitability (criminal record check request form, general fitness) it appeared the most important prerequisite to our enrolment was our willingness to have a go. For which Ian and the Welsh Ambulance Service seemed truly grateful.
A cheap way to provide emergency cover? I suppose, in a way, it is. Ideally we would all have a paramedic each. But you can’t blame these professional guys and girls who turn up at any hour, when we are often very poorly and very frightened, for a funding shortage. They are highly trained (yet not highly paid) and do a wonderful job but as there is a niche for a group like us to fill, we’ve decided to try and fill it.
My only experience in this field was 20 years ago. I did a course on ‘navigation and seamanship’ in Gibraltar during which we learned basic first aid. At the time I played the trumpet and had hardy lungs. During my first attempt at giving rescue breaths I blew all the internal tubes off our dummy. The dreadful sound it made as it imploded, like the release of half a dozen untied balloons, will stay with me for life. That noise now filled my soul as I stared at our next 'victim'. Then mirth – now apprehension.
During the morning, the vestry had warmed to an uncomfortable degree so the afternoon session was conducted outside. It is the first time we have ever been warm in a church. So here we are in the graveyard. Ian was demonstrating a top to toe examination of an unconscious, breathing patient. I was the 'casualty' lying on my blanket. Ian wasn’t rushing, carefully explaining each step.
The onlookers at the gate watched in silent, wrapped attention. You know when you arrive at the scene of an accident, there’s that adrenaline rush and shock? That’s how they must have felt.
When I got up after a few minutes, sat on a chair and lit a cigarette, there was an intake of breath. A miracle. I suspect that Whixall chapel had a few more punters that weekend.
Subsequent sessions were undertaken (unfortunate word) in a friend’s conservatory and over the following 6 months we learned much. We ‘role-played’. We gingerly examined one another and, using various pieces of equipment, treated a variety of conditions. During one incident I knelt over Debbie (single white female) to examine her for a possible head injury. I suspected concussion but she subsequently re-diagnosed it as ‘astonishment’ - she took my wife aside later and quietly suggested it may be a good idea if I wore underpants beneath my shorts! On another occasion I got cramp in my hamstring while trying to reassure a suspected heart-attack victim who miraculously recovered and nearly died laughing. My wife, Janna, got hiccups while doing chest compressions on the dummy. She completely lost her rhythm and ended up bouncing about like a space-hopper plugged into the mains.
The kit is now at least vaguely familiar, we have been issued with identity cards (although the name is wrong on mine) and passed all necessary police security checks. We have each been assessed on our new-learned skills and passed. (And issued with an official ‘well done’ like the one that hangs on the wall in my psychiatrist’s office – I have seen mine regularly since my graveyard slot). We have a final refresher with Alan and we’re ready.
It is the morning of our agreed start date – 22nd December 2004 - today we are ‘on the run’. I haven’t slept at all well. Awful dreams about lost kit and blue flashing lights. I wake at 5.15am drenched with apprehension and turn on the radio. Gloria Gaynor – ‘I will survive’. Unbelievable but absolutely true – I wouldn’t dare joke about it. I spend a couple of hours reading my notes and familiarising myself again with the kit.
It’s now 9.00am. All the equipment is in the car and, in addition, yellow ‘First Responder’ (road menders) reflective jackets, maps and sun-visor clip. We must now ring ‘Ambulance control’ to log on. So with trembling hands I dial the pre-set number on one of our two special-issue miniature mobile phones. It was answered after six rings:
“Hello” (Indian sounding male voice)
“Hello. First Responders ambulance control?”
“Pardon me.” (definitely Asian)
“Is that the Welsh Ambulance service?”
“Do you want an ambulance?”
“No. I AM the ambulance – well, sort of”
“Sorry. I must have the wrong number”
“Look, if you need to call an Ambulance you have to dial 999”
“Yes. I am aware of that, thank you.”
“Sorry. Uh … Goodbye”
Terrible start. Anticlimax. Nerves impossibly taught. Goodness knows what will happen when I arrive at a casualty. One of the most important weapons in a responders armoury is reassurance. Someone who is ill is likely to be panicky so they need to be calmed. The way I feel that is going to be a challenge. I remember what Alan told us. ‘Relax and follow procedure, the training will kick in.’
Boy, I hope so.
A trawl through the phone directory and we finally contact our ‘control’ via a switchboard that has never heard of us. Whixall First Responders team is go.
I stare at the phone – and wait.
(Our friend Alan died a couple of years ago. He was a bright star during a wonderful time for us. RIP mate.)