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July 8, 2020
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Not just another day at the office… Heart Attack at Construction Site!

Colbrow Medics provides Occupational First Aid Medics for onsite temperature checks to various clients including the construction company Fulton Hogan.

On Friday 4th of September Lachlan Diprose was onsite at Fulton Hogan’s Cardinia Road construction site, part of the Victorian Level Crossing removal project. Lachlan noticed people running to the opposite side of the site carpark and was alerted to an emergency when he heard someone shouting, “call an ambulance”. At this stage Lachlan grabbed his trauma kit and made his way safely and hastily across the carpark towards the patient.

“The actions taken by yourself and others on that morning have without a doubt saved Ian’s life and we wish him the best in his recovery in hospital which was only made possible because of the quick reaction and skilled response of yourself and the team.”

O/A

On arrival Lachlan found the patient in front of a grader, laying on their right side, with their airway patent, agonal breathing, nil pulse, nil haemorrhage, nil indication for C-spine injury, and bystander CPR in progress. The patient had the following vitals:

  • Pulse: 0
  • Resp rate: agonal
  • BP: N/A
  • GCS: 3
  • Skin: Pink, warm, dry.

O/E

Patient has agonal resps, nil pulse, skin still warm and pink, recent cardiac arrest.

Immediate History:

Bystanders witnessed Pt walking across car park looking well no less than five minutes prior.

At this stage bystander arrived with an Automatic External Defibrillator (AED), pads were then placed on, rhythm analyses concluded shock advised, the shock was then delivered, and CPR was recommenced by bystanders. Lachlan then performed triple airway manoeuvre (jaw thrust, chin lift, head tilt) and then inserted OPA size 11 into airway, gave two ventilations with a Bag Valve Mask (BVM) and advised bystander of the 30 compressions to 2 ventilation ratio. This continued until the next rhythm analyses, AED advised no shock advised, nil pulse was detected, CPR at 30:2 continued until next rhythm analyses. AED again advised no shock advised, pulse was detected, strong and regular, approx. 60 beats per minute thus Return Of Spontaneous Circulation (ROSC) was achieved.

Patient was then placed in the recovery position, with Lachlan supporting the head and airway. Lachlan remained controlling the airway throughout the resuscitation, two bystanders performed CPR, one at a time, changing every cycle. Approx. 20 seconds after ROSC Pakenham Pumper Fire Rescue Victoria (FRV) arrived. Approx 30-40 seconds after ROSC the first Ambulance arrived. Patient was then handed over to Paramedics, Lachlan remained supporting the head and airway until patient was extricated onto stretcher.

 

Approximate Vitals Post ROSC

No formalised set of vitals were taken on patient, the following is approximations only:

  • Pulse: 60
  • RR: 14, regular, normal effort
  • GCS: 12
  • Skin: warm, pink, dry


Outcome:

The patient (Male, 59 Y/O) was successfully resuscitated, ROSC was achieved, and they were transported to Monash Clayton to receive definitive care the exact extent of which is unknown to Lachlan. It is Lachlan’s understanding that the patient is well, is recovering steadily and will be returning to work in due time.

 

“We are delighted to have engaged such a professional yet honourable service that clearly has the best interest of people at heart.”

 

Final Thoughts:

This case is an example of why all staff of Colbrow Medics must always be ready and have their equipment with them whilst on duty. This case is also an excellent example of the chain of survival (early recognition and call for help, early CPR, early defibrillation, and post resuscitation care) and why its crucial for AED’s to be onsite in all workplaces. This case was also an example of why CPR and first aid training are important for the public, the bystanders performing CPR, delivered excellent chest compressions key to the resuscitation.


Overall an excellent outcome and great work to all members involved. Ian arrived home on Wednesday 16th of September after a quadruple bypass heart surgery at Monash Medical Centre – Clayton. We are looking forward to meeting him. Please stay tuned for another update!

 


 

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