Kickatinalong Courtroom where a Lifeguard has been in the witness box for just over an hour during questioned by Counsel Assisting the Coroner.
Counsel Assisting: So can you tell us what did you do once you realised that this was an emergency?
Lifeguard: Well, I ran to the first aid room, grabbed the oxy bag, the AED and spinal board and ran up to the BBQ area.
Counsel Assisting: When you reached the location what was happening there?
Lifeguard: There was people standing around this old guy on the ground and Steve, the other lifeguard, was doing CPR on him. There was one lady who was really hysterical. It could have been his wife.
Counsel Assisting: What did you do?
Lifeguard: I assumed the role of Lifeguard No.2. I squatted down on the other side of the man, opened the AED, tore open his shirt and put the pads on. Then the machine said “analysing” and we stopped. A few seconds later it said to shock him so I called “clear” and look to Steve. Then I pushed the button.
Counsel Assisting: Did it have any effect?
Lifeguard: No there didn’t seem to be and then the AED said we should recommence CPR so we did. A few moments later we shocked him again, and then did CPR again. Eventually the ambulance arrived and they fitted their own AED; a more complicated looking one.
Counsel Assisting: Was the casualty showing any signs of recovering?
Lifeguard: No. Not that I noticed.
Counsel Assisting: Based on your observations, what did you think had happened to the man?
Lifeguard: I thought he’d had a heart attack or something.
Counsel Assisting: And when did you realise you were using the training AED instead of the real AED?
Lifeguard: Umm.., after we got back to the first aid room. The ambulance had left and we were cleaning up.
Counsel Assisting: Now you’ve already told the court that you’re a lifeguard of some eight years and consider yourself an experienced lifeguard. How could you make such an error?
Lifeguard: At first I thought it couldn’t be right; I thought it must be a mistake. So I checked again. Then I suddenly felt sick, really, really sick. We keep our training module in the cupboard. The real AED is in on a shelf above the cupboard.
Counsel Assisting: I will ask you the question again. How could you, as an experienced lifeguard make such an error? How is it that you could grab the wrong one if they are kept in entirely different locations?
Lifeguard: During training we’ve always grabbed the one in the cupboard. I guess in my panic I just automatically did the same thing.
The court adjourns for a short recess.
While the account above is entirely fictitious, it’s not that much of a stretch of the imagination to see it happening. The military and many emergency management organisations use the term “as we train, as we fight”. Meaning exactly that; when the adrenaline hits the blood stream you’ll just do your training.
There are many well documented cases of this. In one Police were required to pick up spent bullet cases after each firing sequence at the firing range to keep the place neat and tidy. The problem was they discovered that during real fire fights they would unconsciously do the same. Some Officers were found wounded or even dead with pockets full of spent brass.
If you train well then things become automatic. And so it becomes important to train to do the right things.
AEDs are a fantastic piece of equipment to have during a cardiac arrest. That we also have access to realistic training versions is also a bonus… ever used one of those cardboard cut-out versions? It’s just not the same. But this realism brings with it some inherent risks.
The first thing is that the training version is usually in a different coloured case. This is the visual distinction the designer includes to help you distinguish between the two; to avoid the horrible scenario described above where you turn up at a cardiac arrest with an AED loaded with AA batteries instead of the real thing.
The problem can be though, that during high fidelity scenario training you are grabbing a blue bag, as in the model pictured. During the real event your brain is also going to be automatically looking for a blue bag.
This is where position becomes important. For scenario training always put the training AED where the real one will be. Hopefully grabbing something from the right position will override your brains desire for a certain coloured bag.
Other than the bag, often the real version and the training version are almost identical. After training always check and then get someone else to cross check that each is in the right bag. While it may not be obvious, the training version is clearly marked and often doesn’t have a continuously blinking light on the front. Once you’re happy the respective units are in the right bags… put the real one in the right place and take the training version to the office and lock it in the safe.
Not only would it be sickening to think your error had taken away any chance of survival for a person but it would also be a very uncomfortable time in court.
Train as you fight, fight as you train.