This blog reminds us of the importance of running through a simple, structured approach when managing an unconscious casualty. It can happen at any time – not just in work!

The structured approach was used by Lynnette Marshall, a dental nurse from Pontcanna Dental Care, Cardiff, to save the life of a lady on a bus. She had attended her annual CPR update training only weeks prior. This example focuses primarily on the importance of checking (or clearing) an airway.

Lynnette was on her way home from work on the bus where she noticed some commotion from the seats opposite. Another passenger was becoming distressed whilst trying to rouse their relative who had apparently lost consciousness.

Adopting the “D.R.A.B.C.D.E” approach, Lynnette recognised that the situation was dangerous due to the moving bus. She immediately alerted the driver to the situation. He ensured the bus was stopped and all other passengers were asked to get off.

Lynnette then tried to see if the lady was responsive, she was not. With the help of another passenger Lynnette was able to get the casualty onto the floor where she could carry out the rest of her assessment.

She then assessed the casualty’s airway. She couldn’t see any fluid or blockage. Recognising that the tongue could still be causing a problem, she used the “head tilt – chin lift” technique to move the casualty’s tongue off the back of the airway. With this the casualty took a deep breath, started breathing normally and the colour returned to her face. She soon regained consciousness just before the Paramedics arrived.

HEAD TILT CHIN LIFT

By assessing for danger, response and airway in a structured approach, Lynette prevented further injury to her and anyone else trying to help.

By using the “head tilt chin lift” technique, Lynette prevented unnecessary CPR. Had she not assessed and opened the casualty’s airway, the casualty would have continued to be unable to breathe and would have required CPR.

Lynnette later said that during this situation she reverted to her training without thinking about it too much. It was only after the event that she felt ‘shaky’ as the enormity of what happened became apparent.

There is no doubt that a life was saved on the bus that day. Well done Lynnette!

This example shows how the simplest techniques, when used effectively, make all the difference. The need for regular training (as provided to Lynette by her employer) in first aid and basic life support should not be underestimated. These situations can arise at any time so make sure you’re prepared!

Many thanks to Lynette Marshall and Pontcanna Dental Dare for giving us permission to use the above information in our blog.