This is an update of a previous post, with new material added October 2016.

Rod Stewart had a brief stint working as a decorator before leopardskin-clad superstardom struck: “You learn a lot about yourself from doing physical work”, he said, ” and what I learnt was that I don’t like physical work”.  I was reminded of this when an elderly lady had what looked like a stroke as I was rummaging through clothes in a local charity shop (yes, I’m not proud – I like the variety they offer).   I learnt something very important about myself.  I am not very good in a crisis.  What was even more unbelievable was how similarly gormless just about everyone else was.  The lady at the counter, with her assistant, did the right thing.  She phoned 999, and did her best to comfort and hold onto the lady until the paramedics arrived.  The four or five of us who were customers stood about like morons.  We didn’t offer to help, or leave, or do anything at all. Neither were we asked to.  To be precise, we actually continued to leaf through ragged old blouses, idly scan the shelves of faded novels, cast occasional glances towards the valiant but flustered volunteer and the distressed old lady, and mutely contribute only a surreal silence to the dislocated atmosphere. It was probably several minutes before I found the wherewithal to tentatively suggest that we should stop people coming in.  Someone thankfully flicked the open sign to closed.  (Yes, new customers were still entering the shop to stumble upon the dramatic, but strangely banal scene.)  Then I left, reckoning that I was worse than useless as a presence, the poor suffering lady was entitled to privacy and a bit more dignity, and the ambulance would be there any moment in any case.

1.  Install the St John’s Ambulance First Aid App onto your device.

Someone once told me that the stress response isn’t only fight or flight, you can also add freeze and flock to the list.  Apparently research has concentrated more on the male responses to a threat or crisis (which is the fight or flight bit), ignoring the female responses (freezing and flocking).  Fight, flight, freeze or flock: it is alliterative enough to sound catchy and true.  I have no idea if this theory is evidence based, and I can’t even remember my source – it was someone with a working knowledge of feminist theory – but it sounded plausible and has stuck with me.  Fighting and fleeing are probably a bit too energetic for me as a response to anything; freezing feels more natural and efficient. Yes, I think paralysis is my defence mechanism and seemingly my response of choice to an emergency.  Maybe it’s like playing dead, or because I think doing nothing is better than doing the wrong thing, or because I don’t like responsibility.  Whatever the reason, the shame is that I am a qualified first aider and yet I was unable to respond in that situation.  My First Aid course was excellent, but it was essentially a one day cram about three years earlier, with acronyms galore and stilted rehearsals at doing things in the right order, getting people into the correct recovery position, and struggling to remember what you do differently with a drowning person depending on whether they are adult or child.  I guess some people naturally rise to the challenge in an emergency (scout leaders, firemen, referees, you know the type), or rehearse what they learnt on a monthly basis so it becomes second nature.  But if you are not one of those good people, and like me you would like a bit more external guidance and authority, the St Johns Ambulance First Aid App is what you need.  Let’s face it, if you are in an emergency, just about the first thing you are going to do is call 999 (or 112, but more about that soon).  But this app helps you to know what to do while you are waiting for properly skilled help to arrive.  It has clear, concise lists of major and minor emergencies, and guidance on how to perform techniques such as CPR and the recovery position on infants, children and adults.  Had I known about it in the charity shop, I might have had something to offer.  “Stroke” is there on the list of major emergencies.  Once I’d clicked on that I only had four options.  I could have clicked on “recognition”, probably confirming that it was a stroke we were dealing with, then I could have looked up the protocol for either “conscious” or “unconscious” patient.   In very few clicks from picking up my phone, I’d have known to loosen clothing, to provide comfort and reassurance, not to try to give food or water, and to monitor pulse and breathing.  I’d have known to do something different if she became unconscious. This certainty might have reduced the stress of the situation, and stopped any doubt about if we were doing the right thing. Download it now.  It’s easy.  It’s free. Click on the highlighted link just a few lines above this.  You can download it onto Android and Apple, and there’s even a specialized version for cyclists.  Since I downloaded this I feel more confident and prepared for any emergency. And then spread the word.  Don’t just do it yourself: tell your family, your friends, your patients, your son’s drama teacher and your daughter’s tennis coach.

2.  Carry an aspirin with you.

Once you’ve done that:  go to your medicine cabinet, or stop by a shop on the way home from work today, or the very next time you go out, get a pack of aspirin (in 300mg soluble form) and put one straight into your purse or wallet.  Congratulations.  You are now much more able to do something really useful in the event of a heart attack.  If you suspect you or someone around you is having a heart attack (ie vice-like or crushing chest pain, just looking really ashen and ill, gasping, sweating, nauseous, sick, collapsing, experiencing pain and or pins and needles in the jaw, neck or arm) you might be able to save a life. Get informed consent – all you have to say is “CAN YOU TAKE ASPIRIN?” and make a note of it later, and give them a 300mg aspirin to slowly chew.  This can HALVE the size of a heart attack, according to the prolific doctor, author, comedian and champion of patients’ rights’ and patient power, Phil Hammond.  He always has an aspirin in his wallet, and since I read his excellent book Staying Alive, I have always carried one too.  It must cost a few pennies.  I don’t want to be flaking out, or watching someone else flake out, while I vainly cast about, Richard III style:  “My life, my life, an aspirin for my life”.   On our first aid course, it was described as “teflon coating” the clot.  Immediate aspirin has been shown to reduce the number of deaths from heart attacks by 23%.  So have one as soon as you even slightly suspect it.  And chew, don’t swallow.  It takes 14 minutes for a soluble aspirin to produce maximal platelet inhibition, but it starts to work, and ease some vital blood flow, in just a few.   (It is nearly double the time if a whole aspirin swallowed with water. You have to emphasize “Don’t swallow”. Those minutes count.)  If you are in an actual high risk category, or if someone close to you is, you can get special easy access “aspopods” or aspirin-holding keychains so you don’t have to fumble about amongst your 20p pieces in a state of distress.  But for most of us, a humble generic dispersible aspirin tucked in amongst our library card and loose change is a way of ensuring that we never have to feel that there was something we could have done but didn’t.  Please do it now, for the sake of us all, and tell everyone you can to do it too.  Just a note, though, never give it to an unconscious patient.  They could choke.

3.  Register for 112 texts

Do you know what the number 112 is for?  Well, I didn’t until yesterday’s First Aid course, run by the excellent Holos Healthcare.  I’m giving them a bit of a plug because Alex turned what could have been a fairly mundane and routine run through some dry material into a really vivid and useful day.  112 is a newish emergency number which will work in about 70 countries in the world.  It will probably replace 999 at some point.  Yes, from Lebanon to Vanuatu, Australia to India, you can call 112.  And if you are in an area where you can’t get a signal, by some magical process your phone will even search for any other network once you dial 112, so it gives unusually good coverage.  You can also register for texts.  Do it now.  It’s a simple process:

1. Text “Register” to 112
2. You will get an instant text back.  Reply “Yes”.  (It says reply to 999 but you can just reply back to 112).

Now you are registered, so if you send a text from anywhere, even if you have a bad signal, the text only needs a momentary signal to get through, and I think they will be able to figure out where you are.

So, these things are worth doing.  I didn’t include “learn CPR” but it’s important.  Alex from Holos says that over the years 22 people who have been on his courses have contacted him to say they performed CPR in real live situations.  20 of those patients survived.  It’s worth it.

And as a reward for doing those few simple things, here’s a reminder of why CPR is important.  Take a few minutes to watch these bronzed Aussie lifeguards bring a drowned young guy back to life.  It’s real footage, it happened by chance on a day someone was making a film at Bondi Beach, it’s dramatic, and it has a happy ending.  If you like Casualty, you’ll love it.