The nurses, who all work for Aneurin Bevan University Health Board, were hosting a recruitment day in Abergavenny, when a member of the public rushed in to say a man had been taken ill outside, explained experienced critical care nurse Sally Heal.
“It was quite obvious to us very quickly that the man was in full cardiac arrest”
One of four nurses who rushed to the man’s aid, she told Nursing Times how instinct kicked in as the quartet worked as a team to respond to the emergency.
Finding the man in full cardiac arrest they performed cardiopulmonary resuscitation (CPR) and used a portable defibrillator before ambulance crews arrived – prompt action that may well have saved his life.
Ms Heal, interim assistant divisional nurse for scheduled care, explained the nurses were in the middle of the day-long recruitment drive at the historic Tithe Barn venue in Abergavenny town centre when the incident occurred.
“It was about half past two when a member of the public ran in. She’d actually been into the recruitment drive previously, so knew there were nurses there,” said Ms Heal.
“She ran in and basically asked for some help because a man was collapsed in the road outside.”
“It was just instinct to be honest. Three of us got down on the floor and started resuscitating”
Together with three colleagues – Jade Matthews, Sharon Pritchard and Sarah Lewis – she raced to the stricken man’s aid.
“The four of us ran out. It was quite obvious to us very quickly that the man was in full cardiac arrest. He was in the road and people were standing there stopping traffic,” said Ms Heal.
“There were quite a lot of members of the public there and a few people had even put towels and things down because he was bleeding at this stage,” she said.
“They were on the phone to the ambulance and we heard them as we arrived saying: ‘Yes – he is breathing’, but actually the type of breathing he was doing was not the breathing of somebody that had an output.”
Ms Matthews is a ward sister on a gastroenterology ward at the Royal Gwent Hospital and Ms Lewis is a band 7 nurse for continuing healthcare in the community, while Ms Pritchard is a ward sister at St Woolos hospital in Newport.
Despite never having worked together before, they immediately swung into action with Ms Heal to resuscitate the patient.
“It was just instinct to be honest. Three of us got down on the floor and started resuscitating – I took the head end and Sarah and Jade were taking it in turns to perform CPR,” recalled Ms Heal.
Meanwhile, Ms Pritchard attempted to find out the man’s identity and other vital information.
“The biggest thing for me was that this was the first time all of us had actually been together”
Three other nurses – Jules Murphy, who was involved in the recruitment event, and Geoffrey Wills and Jessica Agate who had dropped by – were also on hand to provide support and assistance.
“I have absolutely no idea of what was going on around us at that stage,” continued Ms Heal. “I was given a pocket mask by someone and I still to this day don’t know who gave me that.
“And then somebody asked us did we want an AED (Automated External Defibrillator). We said ‘yes’ and again that arrived.”
She had no doubt the AED, which was fetched by a member of the public, was key to the successful resuscitation, she said.
Ms Heal teaches advanced life support, including showing nurses how to use AEDs, but said she had never used one in a real-life situation before.
“My background is critical care so we always us the full defibrillator. But I am absolutely certain this AED in the community is what helped us save his life,” she said.
“We popped him on the AED very quickly. He was in a shockable rhythm which meant we were able to deliver the shock immediately.
“The ambulance came very quickly but there would have been a delay of a few minutes if we’d had to wait to deliver that shock.”
She later learned that the device was kept at the Abergavenny One Stop Shop at the nearby town hall.
“Somebody that was stood there must have known it was there and the next thing I know someone comes running down and hands it to us,” she said.
Ambulance crews and a rapid response vehicle were soon on the scene and the patient received further treatment
“They took him off the AED and put him on their defibrillator and we delivered another shock and actually at that point he started moving. His output returned pretty much within seconds of that second shock,” said Ms Heal.
The patient was initially taken to Nevill Hall Hospital in Abergavenny, run by Aneurin Bevan and then transferred to the University Hospital for Wales run by Cardiff and Vale University Health Board.
“By the time the gentleman got in the back of the ambulance, he was asking where his wife was so was awake and talking to us,” said Ms Heal, who works between Nevill Hall and the Royal Gwent.
She said she was incredibly proud of the calm and efficient way the nurses dealt with the incident.
“The biggest thing for me was that this was the first time all of us had actually been together. I had never worked with them before, but it was that instinct of knowing what you know and just doing it,” she said.
“What made me feel quite proud really was the fact that we are taught it, we are trained in it but when it came to it is just instinct and you get on and do it.”
“We went back to the recruitment drive feeling as though we had really achieved something”
The fact she was with fellow nurses made all the difference, she added.
“Having worked in critical care for 30 years, I am used to emergency situations but they are usually in quite a controlled environment,” she said.
“When you take yourself outside of that, then I think you perhaps start to question ‘Am I doing the right thing?’ and I think having other colleagues there really helped.”
The team then went back to the recruitment event to continue speaking to nursing students and nurses before packing up at 6pm.
“The fact the man survived made quite a horrible situation very positive and we went back to the recruitment drive feeling as though we had really achieved something,” said Ms Heal.
“Obviously success for out of hospital cardiac arrests is not good. We were all experienced in what to do but I think it was definitely that community AED that made the difference.”
According to Ms Heal, the patient, who is believed to be in his late 1960s or early 1970s, was said to be doing well a few days later.
She told Nursing Times she believed the incident was an example of nursing and the health service at its best.
“It was a really good moment,” she said. “The NHS as a whole gets so much negative press at the moment, so to be able to show some good work that just happened very spontaneously and outside of everybody’s comfort zone was really positive.”