#Helpless: learn first aid!

First aid. It's all about grazed knees and sprained ankles, right?

Wrong.

First aid saves lives. Thousands of lives every year.

New research by St John Ambulance has found that we're over 4 times as likely to think that more people die of cancer than from a lack of first aid, even though there's compelling evidence to take both equally seriously. Up to 140,000 people every year die in situations where first aid could have saved their lives - as many as die of cancer.

People's reasons for not learning first aid are that they think it would be too time-consuming or it's not a priority to them. A worrying 41% say it would take the death of a loved one to make them learn first aid.

St John Ambulance has launched a new awareness campaign, including a hard-hitting TV advert, Helpless. It follows the journey of a man who is treated for cancer and survives, only to choke at a family event because nobody knows the treatment to save his life. You can view the advert below.

St John Ambulance chief executive Sue Killen said:

Cancer is a serious disease, which kills tens of thousands of people each year. When a loved one has cancer, although we do all we can to support them, over three-quarters of people are consumed by a feeling of helplessness.

‘In situations where first aid could help save a life we don't have to feel helpless, because learning life saving skills is so simple. That's why it's so concerning that fewer than 1 in 5 of us knows even basic first aid. This has got to change if we are to stop up to 140,000 lives from being needlessly lost each year.

'Our message is that first aid is simple to learn – just text HELP to 80039 for a free pocket guide so you can be the difference between a life lost and a life saved.

Please, get the pocket guide, read St John Ambulance's first aid advice pages, or (preferably) go on a first aid course. It's vital knowledge. You never know when you might need it!

Heartstopping football

It's great news that Bolton footballer Fabrice Muamba has been discharged from hospital, following the mid-game cardiac arrest that nearly ended his life.

That he's done as well as he has is a tribute to the expert care he received, on the pitch, in the ambulance, and in the London Heart Hospital, as well as his own youth and physical fitness.

The same day as Muamba's collapse, and more than 400 miles further north, Kilmarnock beat Celtic in the Scottish League Cup. But their celebrations were cut short when midfielder Liam Kelly's father Jack had a heart attack in the terraces, and died soon after in hospital.

It seemed like sudden deaths during football matches were everywhere, though probably they were no more common than more before, just being reported more. Chris Ralph, who was in his late 40s, collapsed and died from a "suspected cardiac arrest" during a veterans' county cup final in Devon. Further afield, 25 year old Piermario Morosini, a former Italy Under-21 International, also collapsed on the pitch, and couldn't be revived.

As I said above, it appears that the media have decided "cardiac arrest at football matches" is the flavour of the month. One thing I've noticed in the many reports is a confusion, even conflation, of heart attack and cardiac arrest. They're not the same. No, honestly.

The heart is a muscle. To do its work, it needs its own supply of blood vessels to bring it oxygen. They're called the coronary arteries, which is why you might sometimes hear a heart attack referred to as a coronary. If there's a blockage in one of those vessels, you get a heart attack. Where that blockage is determines how bad the heart attack is.

If only a small part of the muscle is starved of blood, that's a minor heart attack. The person is likely to have crushing central chest pain (possibly radiating into their left arm, jaw, and/or back), be pale, cold and clammy, and feel sick and dizzy. They need to get to hospital urgently. But their heart is still beating. No cardiac arrest.

Most certainly a more major heart attack can cause cardiac arrest - but so can many other things. Actually, if you think about it, ultimately we all die of cardiac arrest, don't we? And we've certainly not all had heart attacks.

So the take-home message today is: heart attacks and cardiac arrest are not the same thing! Take-home message 2: why not go on a first aid course so you'll know what to do if someone collapses?

Unreality TV - Medicine in Medical Dramas

Immediately before I took poorly and had to give up work, I was teaching first aid and basic life support - CPR and the like. I spent what seemed like the best years of my life trying to stop people doing chest compressions with their elbows bent and the arms doing the work - they should be done with elbows straight, and the body rocking from the hips to provide the pressure.

The reason for the problem? That's how they'd seen it done in medical dramas on the telly. And my street cred clearly wasn't high, compared to Charlie Fairhead's...

There are loads and loads of medical dramas on television. And some more loads. Trying to think and write about them all, and how accurately they depict medicine to the general public, would give scope for a PhD thesis (funding, anyone??) so I'm just going to talk about the ones I watch regularly - Casualty, Holby City and House.

The most overtly "heavy medicine" comes in House. Every week, there's an obscure illness, diagnosed through analysing symptoms, through blood tests, biopsies and scans - and of course through the genius of the eponymous Dr House.

It's a bit unrealistic, compared to the life of a real hospital doctor, though. Most of the time, House and his "team" of four or five more junior doctors seem to have only one patient. Very occasionally, House will see out-patients in clinic - but this is depicted more as a punishment for one of his frequent misdemeanours than anything else.

House's team also seem to be the ultimate multi-skilled staff. As "diagnosticians", they do everything from radiological procedures to neurosurgery. Again, very unlike real life, where different people are highly skilled in these different areas.

Casualty and Holby City are linked programmes, both taking place in Holby General Hospital. Medicine is far less central to the plotlines than in House, though still important. Casualty includes a lot of location filming, with plots leading up to fairly predictable accidents or illnesses. The end of each series inevitably features a major incident such as an explosion, a major car crash, or, in one series, a gun siege in the department. Holby City is set in two of the wards of the same hospital.

In each programme, the staff of the department discuss their personal lives in the most lurid detail as they work - often literally over their patient's abdomen. I don't believe this to be professional conduct: it's certainly not something I've ever experienced, though of course I don't know what's gone on when I've been unconscious!

Then there's the CPR - as I mentioned at the beginning of this post. As you'll see in the photo above, when you're doing CPR for real, your arms are straight (though I'd like to see her more directly above the patient. She's going to break ribs doing it from there. However...)

Thing is, in some of the medical dramas, they do it with their elbows bent. The reason is that they're doing it on real people, actors, and they don't want to put any pressure on their hearts - it can be dangerous, unless they really need chest compressions. The bendy-elbows thing is to look impressive for the cameras without actually putting any pressure on the heart.

So, medicine in medical dramas. The depiction is better than it used to be, certainly - but it's still not a true depiction of medicine. Do we want it to be? I'm not sure we do. An hour's programme of a doctor filling in paperwork might not be the most riveting programme ever....