Taken ill: the call you have to make

This walk-through contains the answers. It is here to read the situation without playing it, to print it, and to keep the page useful without JavaScript.

Scene 1 · Opening

Saturday, 18.40, at your neighbour's. You have been putting up shelves for two hours.

He puts the screwdriver down, drops heavily into the armchair and stays bent forward. He has gone grey, he is sweating although the room is cool, and he is pressing the flat of his hand against his chest.

Scene 2 · What he says

He says it is nothing, that his lunch is not going down, that it will pass, that the last thing he wants is anybody being put out.

He does not get up.

What do you do?

• Right move : I leave him in the position he feels best in, I loosen his collar, and I do not leave him on his own.
  At rest, in the position he chooses : Let the person rest in a comfortable position: lying down, or half sitting up, or sitting up if that is what they want. They are the one who knows where they breathe best, not you.
• Mistake : I lie him flat on the rug, it is better for the circulation.
  You have laid him down against his will, and he is breathing worse : The position is COMFORTABLE, and the person chooses it: lying down, or half sitting up, or sitting up if that is what they want. A lot of people who are struggling to breathe cannot bear being flat.
• Mistake : I walk him about a bit and get him breathing at the window, that will sort him out.
  You do not walk about someone who has been taken ill : What the guidance asks for is REST, in a comfortable position. Walking about a man with a tight pain across his chest asks him for exactly the effort you have to spare him.

Scene 3 · The questions

He is sitting up, propped, a little less grey. He answers when you speak to him.

The pain is spreading now, down his left arm and into his jaw.

What do you ask him?

• Right move : How long it has been going on, whether it is the first time, whether he has ever been in hospital for it, whether he is on any treatment.
  Four questions, and you hold on to the answers : How long has this been going on? Is it the first time? Has he ever been in hospital for it, or is he on treatment for it? Those answers are for the dispatcher, two minutes from now.
• Mistake : Nothing: I leave him in peace and wait to see whether it settles on its own.
  Twenty minutes gone, and nothing to tell 15 : Do not play the situation down: even if the person insists it is not serious, they need to be seen straight away. Waiting tells nobody anything and relieves nobody.
• Not the best choice : I fetch him a sugar lump and a glass of water, that never does any harm.
  Sugar gets blamed for a lot : It is useful in one particular situation, and this is not it. Put the lump down and go back to your questions: they are the ones that will travel down the phone line.

Scene 4 · Who decides

The dispatcher : “Samu, go ahead.”

Timer: 35 seconds.

He keeps telling you not to call. What do you say?

• Right move : “5 rue des Tanneurs in Nevers, second floor. A man of 58, a tight pain across his chest for the last twenty-five minutes, spreading into his left arm and his jaw, he is sweating, he is sitting up, he is conscious.”
  It is 15 that judges how urgent this is : If the person is talking and feels ill, you must ask them questions and alert the Samu Centre 15, who can judge how urgent it is. Your job is to describe, precisely. Sorting it out belongs to the doctor on the line.
• Mistake : I respect what he wants: I hang up before saying anything.
  Do not play the situation down : Even if the person insists it is not serious, they need to be seen straight away. Calling takes nothing away from him: the doctor may well conclude that no crew is needed. Not calling means deciding in his place, and deciding with nothing to go on.
• Mistake : “Hello, can you tell me whether this is serious? I will describe it and you tell me whether to call.”
  You are already calling : The dispatcher needs an address and a description, not permission. Give the place, then the state he is in, then the answers to your four questions: that is what lets him judge.

Scene 5 · The wait

The dispatcher is sending a crew and asks you to stay with him, not to move him, and to call back if anything at all changes.

What do you do during those minutes?

• Right move : I stay near him and keep checking that he is responding and breathing normally.
  Checking regularly is the last instruction : Check regularly that the person is conscious and breathing normally. That is all you are asked to do in these minutes, and it is what makes the call back go out the second anything changes.
• Mistake : I go down and move my car to free up the space outside the building.
  He is left alone with a tight pain in his chest : The instruction is to check regularly that he is conscious and breathing normally. A parking space is not worth the three minutes when nobody is looking at him.
• Mistake : I lie him flat now, so he is ready when they get here.
  He was fine: you have just disturbed him for nothing : You leave him at rest in the comfortable position he chose. The crew will move him however they want, with their own kit. Your job is to watch.

Scene 6 · The crew

Blue light turns across the ceiling. A crew comes up, kneels in front of the armchair, and talks to him quietly.

They ask you how long, where exactly, whether it is the first time, whether he is on any treatment. You answer all four, because you asked the questions.

He told you nine times not to call. You called. That was the action.