Dr Sabiha Ali reflects on what she learned when her deanery sent her on a simulation training day to learn how to treat a cardiac arrest
There are two words that inspire fear in the hearts of junior doctors – “cardiac arrest”, so it was great to have the opportunity to practise reacting to a cardiac arrest at simulation training, before being confronted with the real thing. At the training we had to react to emergency scenarios, while being video recorded. My patient was a robotic mannequin that had chest movements. From this experience I learnt:
1. Stay calm – Check your own pulse before the patient’s. If you are flustered you will miss important information and make a mistake.
2. Communicate effectively – With everybody. Nursing staff usually know more about the patient, especially if you are seeing them for the first time. Listen to the patient and get a complete history to aid your diagnoses.
3. Take charge – Someone has to. By delegating jobs appropriately, teamwork becomes more efficient.
4. Know when to call – The answer is early: it is better to be safe than sorry.
5. Know who to call – I struggled with this as a junior. Depending on the scenario, this could be the medical/surgical registrar or the anaesthetist. Be sure of what you want to ask before you call. Either you want them to come and review the patient or you want advice on what to do next.
6. Practise using mini-jets – Many people do not know how to assemble these correctly: practice makes perfect.
7. Remember guidelines – You are not expected to remember everything, so make use of posters on the ward, trust the intranet and carry a handbook.
8. Utilise your skills – Be confident and remember the old saying “see one do one”. I was given the scenario involving a tension pneumothorax. Having seen one before in ITU as a medical student and being given the chance to insert a cannula into the patient’s chest, I knew what to do.
9. Go on courses – Simulation training, immediate and advanced life support give you a chance to have a practice run and keep up-to-date with national guidelines.
10. Nothing compares to real life – attend as many emergency situations as you can to get used to how things run. One day it may be you leading an arrest call.
Dr Sabiha Ali is an F1 in general and GI surgery at Charing Cross Hospital in London.