The Art of NOT Being a Helpless Bystander : 21


inability to raise the arm or hold it up once raised. Speech may be slurred. It is time to call the emergency services, urgently. This assessment has the acronym FAST and relates to someone having a stroke who is conscious. Other likely symptoms could include severe headache, dizziness and collapse into unconsciousness. At this stage you still need to call the emergency services urgently, but you also need to provide treatment before they arrive.


Would you Recognise a Heart Attack?


Someone suffering a heart attack would be likely to have a combination of signs and symptoms that could include severe chest pain, breathlessness, anxiety, nausea, being drenched in sweat, pain radiating into either or both arms, the neck, jaw and back. The more serious the heart attack, the greater the chance of dizziness and possibly collapse and unconsciousness. The person could stop breathing. Again, there is real urgency for calling the emergency services and treating the signs and symptoms in the meantime.


Assessment of Someone Who has Collapsed


So, a common feature is unconsciousness. As well as heart attack, stroke and anaphylaxis, there are very many other possible causes of unconsciousness, conditions that will sound very familiar, eg, choking, fainting, heat exhaustion (eg, inside a beesuit on a hot day), head injuries, drowning, asthma, epileptic seizures, a diabetic ‘hypo’ and many more. With some of these, the person’s condition could deteriorate and breathing stop. The assessment of a collapsed patient is the same whichever of the above causes is responsible. You need to know if the person


can respond – are they conscious? You need help. You need to know if their airway is clear and whether they are breathing. Before any of this though, you need to be sure it will be safe to go to their aid. On the basis of this assessment you are deciding whether the person is conscious or not and breathing or not and, therefore, what treatment is needed. All this is happening while waiting for the emergency services to arrive and your actions now could literally make the difference of survival or not. For beekeepers, there could be an issue as the casualty may well need to be moved, as rapidly as possible, from the immediate vicinity of the apiary.


Clearly this may not be easy and needs


pre-planning, but is necessary because emergency services (quite rightly) will probably not put themselves in danger by approaching a casualty surrounded by, or covered in, bees. This could delay the handover to professional help.


Unconsciousness and Recovery Position


If you establish the person is unconscious, he/she is at serious risk if the airway is not protected. The recovery position is usually the correct treatment. Simply, this involves rolling the person onto their side, known as the recovery position, such that their airway is maintained. This is necessary because in unconsciousness all muscles relax and cough and swallow reflexes are lost. Additionally, if the person is lying on their back, the tongue muscle can drop into the back of the throat and block it, as can vomit. It is easy to turn someone into the recovery position, following simple techniques that ensure you do not injure your own back doing it. (See any good quality first aid book.) The most important thing is to learn how to do it and practise regularly, so that it is second nature when you need it. When someone collapses this really could save their life. Anyone can do it; everyone should know how! No one should die just because they are unconscious, something I have witnessed far too often in A&E.


Cardiopulmonary Resuscitation (CPR)


As a result of a stroke, heart attack or anaphylaxis (amongst others), the person


May 2015 Vol 97 No 5


could be in even more trouble. If when you assessed them you found they were not breathing, it would be assumed, in an adult, that they had suffered cardiac arrest. Very prompt, correct and effective action is absolutely essential. The person’s life now completely depends on those around them until the emergency services arrive. If there is no spontaneous breathing, all body organs and systems will be deprived of oxygen and will cease to function. We know that, in the UK, someone having a major heart attack out of hospital has only a 6% chance of survival. Their chances are significantly increased by immediate, highly competent (ie, thoroughly learned and practised) CPR (cardio-pulmonary resuscitation) until the emergency services arrive. The casualty’s chances of survival are greater if resuscitation is combined with artificial external defibrillation, AED/Defib, as early as possible.


More to Learn


Please note, there is a lot more to learn about anaphylaxis, administration of antihistamines and adrenaline – why, how, when – as well as about the recovery position and resuscitation. This will be the subject of a further article and, of course, central to the training if you attend a beekeepers’ anaphylaxis course. It could be you that needs the help. Are your loved ones, friends or fellow beekeepers equipped to help you in an emergency? Are you equipped to help them? ♠


Andrea Woolley is a registered nurse with many years’ experience of working in hospital Accident and Emergency. She holds a degree in occupational health and safety and was assistant safety adviser for London University for many years. In 2005, she suffered anaphylactic shock from wasp venom.


Originally inspired by Bedfordshire Beekeepers’ Association, Andrea has facilitated a number of purpose-designed workshops on Anaphylaxis Management and CPR for Beekeepers. So far, she has presented these for Bedfordshire and Surrey Beekeepers’ Associations. She is currently booked to present her course in Buckinghamshire and Cardigan.


Andrea brings a quiet authority to her training as a result of her depth of experience and these workshops have been very well received by over 100 attendees so far.


Any local association wishing to arrange a similar training course should contact Andrea on andrea.woolley@live.co.uk


www.bee-craft.com


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