I was out on SJA duty this afternoon at Selhurst (Crystal Palace vs Sheffield Wednesday). It was fairly quiet from a first aid perspective, but it was also surprisingly cold/windy. Bearing that in mind, I was surprised to see one of the away fans with nothing on from the waist up; apparently he's been doing this for quite a long time. Personally, I was wearing a shirt, jumper, coat, hat, and gloves, and I was still a bit chilly, so I'm surprised that he wasn't freezing to death. This may be a case where a heavy build is beneficial...
Meanwhile, we've been doing a lot of CPR practice at class nights recently, and I've been thinking about a couple of personal anecdotes which expand on the standard advice from the first aid manual.
Quoting from the
Basic Life Support guidelines:
Basic life support consists of the following sequence of actions:
1 Make sure the victim, any bystanders, and you are safe.
2 Check the victim for a response.
* Gently shake his shoulders and ask loudly, "Are you all right?"
(There are additional actions after this, but these are the relevant ones for my purposes here.)
Shaking someone's shoulders is convenient, because you will normally be kneeling (or crouching) near their head anyway, so that you can lean in and speak into both ears; this is useful if the person is deaf in one ear. However, there is also a hazard to be aware of. A few years ago I did some volunteer work with
CRISIS, when they set up a temporary homeless shelter over Christmas. I did night shifts, so we had to wake people up in the morning and clear all the camp beds away. Normally I'd wake a friend up by shaking their shoulder, but the shift leader advised us to wake up the "guests" by shaking them near their feet. (It's hard to tell in a sleeping bag, but I'd aim roughly for their ankles.) This is because sleeping rough can be dangerous, so they'd be used to having to defend themselves if they were disturbed. This turned out to be good advice, because one of the guys did take a swing at me when I woke him up; fortunately he missed, because I was out of reach, and he apologised profusely, so I was happy to forgive him. Still, it's something to bear in mind if you come across someone who appears to have collapsed on a public street or at a station: safety first.
The resus guidelines also say that if someone is unresponsive (presumably unconscious) but breathing normally then you should turn them into the recovery position and call 999 for an ambulance. The issue here is that you want the person to continue breathing, so their airway needs to remain clear. In particular, if someone is drunk, and they vomit while still unconscious, they could choke on it.
This reminds me of something that happened back in my undergrad days, just before my finals. A group of us were sharing a house, and we were all dealing with exam stress, so we decided to blow off some steam by having a drinking game. We got hold of
Flash Gordon on video, and went along to stock up on some beverages from the student bar, so I got a six-pack of Diamond White cider. We then established a set of ground rules, e.g. "every time Brian Blessed waves his stick, everyone has to take a drink". Another one was "every time you point out something in the film which is physically impossible, take a drink"; this affected me more than everyone else, and may explain why I'm more mellow about turning a blind eye to dubious plotholes nowadays! Anyway, there were a couple of things which gave me a slight disadvantage compared to everyone else:
a) I was drinking cider, which has a higher alcohol content than lager/bitter.
b) Back then I hadn't mastered the technique of drinking out of a bottle (I've since got the hang of it), so I decanted the cider into a glass first, which meant that each of my gulps was bigger than everyone else's.
Anyway, it was a fun evening. I don't think I got through all six bottles, but I was certainly a bit blurry by the time the film finished. I remember when the phone rang, and I went to answer it (as usual), and everyone else shouted "No, John, leave it!" I ignored them, so I think that the person who the call was for had to do some fast talking to his parents. After the film finished, we started watching
Buck Rogers in the 25th Century (another classic!), although we didn't get too far through it. I do remember pointing at the TV screen and saying "Look, it's Princess Ardala!" and other people saying "Yes, John, we know!", which may mean that I'd mentioned it a few times already by that stage. I also asked people how many eyes Ardala had (it turned out to be just the normal two).
So, after that we all called it a night. One of my friends kindly put me to bed (e.g. telling me to lift my arms so that she could pull my T-shirt off), and I slept quite soundly. When I woke up the next morning, one of the first things I was aware of was that my face felt damp. More specifically, the pillow felt damp, and my face was in the damp patch. In fact, the pillow was also stained red. It turned out that I'd thrown up in the night, to such an extent that I'd removed some of my stomach lining (hence the red). I normally sleep on my back, so it's a good thing that I turned my head to the side; I don't know how much of this was autonomic reflexes, and how much was just dumb luck. The thing is, I'd done this in my sleep, without waking up, so if I'd kept my head in my normal position then I think it's very plausible that the vomit would have come up into my mouth and then fallen back down into my throat, blocking my airway, and preventing me from breathing. Nobody would have know anything about it until my housemates came to check on me the following day and found my corpse.
This is of course a worst-case scenario, and thankfully it didn't come to pass, but it's something to be aware of if you take someone home after they've been drinking heavily. My friend meant well by putting me to bed, and I'm grateful for her help, but if you're in a similar situation then you'd be better off putting your flatmate into the recovery position instead. As a rule of thumb, I'd say that if they're not sober enough to move out of it then they're too drunk to be uncomfortable. If you can get them to drink large quantities of water before they go to bed, so much the better.
Nowadays I tend not to drink to excess. I also rarely drink Diamond White; I've heard other people say that you lose your taste for the first drink that you really overindulge in, which may be true, so my cider of choice is Strongbow. I may have a pint of cider with friends at the pub, or a glass of white wine with my dinner at home, but I know my limits.