A girl passes out: What do you do?

Nikon AF-S DX Zoom-Nikkor 18-55mm f/3.5-5.6 ED

05/06/2013 09:48:09 AM · #1

I was at work, wedding chapel. It's beach side, front of the chapel is all glass. Here's a pic:

The Chaple I worked in

I was at the right side at the front, very hot, very bright. A video girl was moving from front to back. Near the back it gets cooler, near the front it's hot. The cooling doesn't exactly reach most of the front and it gets really really bright. Near the end of the service I hear a big BANG. I thought someone dropped their camera or someone fell...not sure. As the bride and groom go down the aisle, I thought I saw someone on the floor. Wasn't sure.

The bride/groom exit the back (Front bottom of the picture) and everyone else exits the glass part of the chapel, leading outside. As I go to the back of the chapel to congratulate the couple, I see that someone is being held in the video room at the back. As the couple go to the front I see someone is holding another person. They are both sitting on the floor at the back. Once I realize that the video girl is not responsive I take charge because nobody else is (Can't blame anyone, they are all young, early 20's, not sure what to do). I get her on her back, laying flat on the floor, ask to have her feet put up, unbutton her shirt, loosen her belt.

She was breathing weird, shallow. She looked like she was having mini seizures. All I could think of, focus on, was 'is she breathing and do I have to do CPR? Do I remember how to use the AED?" I was panicking on the inside. 2 of the younger girls got control and started talking with the video girl. I said "Call 911 (Or 119 in Japan)" BUT, for some really messed up reason, it had to 'go through management. It took 4 or 5 times of me saying "Get an ambulance." before someone actually called.

Was she having a stroke, a heart attack...I don't know. I had beta-blockers in my bag for anxiety issues...thought about breaking those out just in case, but too much running through my mind. Would she even be able to drink the meds? She was still passed out 5 minutes into it all. People were talking anemia, a big problem in Japanese summers. But I've seen anemia before and people usually bounce right back. She wasn't. When management was called I asked that they make sure to bring an AED. Not sure that was going to get used, but better safe than sorry.

What made me most frustrated about all this was that those 'in charge' weren't actually taking charge but rather sitting back. I'm not saying they could've done anything better, but it really came down to 2 other girls sitting at this girls side that made a difference. Even when the head of video came along he seemed to be 'distant'. Only the 3 of us seemed to be on track with asking questions before the ambulance came.

10 minutes in she was back. She was cold, she was scared but mostly she was worried about the wedding. Very Japanese of her. Told her not to worry. Once the ambulance people got there, it was all on them. 2 minutes later I had another wedding that I had to do as if nothing had happened 15 minutes before. Also very Japanese. As we're leaving at the end of the day I'm getting grilled as to what I know and what I saw and what I did. Not sure why except for it to go into a 'report' for the venue.

So, if there are any doctors out there, what do you do in this case? Would you ever give a beta-blocker to someone? She had cold hands, and when she came to she said her hands were a bit numb which, to me, sounds like a blood pressure problem. But I am certainly no doctor. I just think that this is going to happen again and was wondering what is the WESTERN way of doing things. Is the Japanese way bad...honestly, I think that sometimes it is, personally. I'd rather be wrong, in trouble and have someone alive than right and have someone dead.

Message edited by author 2013-05-06 09:49:07.

RyanW

Nikon D7000

05/06/2013 10:18:54 AM · #2

Scary situation for sure.
For myself, i'd never give someone anything if i wasn't 100% sure what the reaction would be. I'd have a few questions i'd run through first to find out if anybody knows this person and has the answers: Is her breathing at least regular in it's shallowness? Is this person already on any sort of medication? Would it cause complications? Are the EMT crew on the way and how fast til they arrive? Would giving her anything cause complications for any potential treatment even if there were no complications at the time you gave it to her?
Without having medical knowledge of the person, the effects (and side-effects) of beta blockers and what is used to treat what she is going through, it's impossible to know if you made the right decision, and never will be unless you talk to the doctors or emts who worked on her.

For what it's worth, I think you did the right thing in not giving her anything for a few reasons: nothing new was put into her system to potentially complicate matters, you're not liable in the event of something happening to her, and she had come to by the time the EMTs came, which means that she did get better from the point you initially assisted, through your (in)actions.

Nikon AF-S Nikkor 17-35mm f/2.8D IF-ED

05/06/2013 10:26:42 AM · #3

I totally agree...kinda...weird huh...

I have no problem accepting responsibility for something I did do...but for something I didn't do, that's something else. Again, I have to ask my doctor about this, but would something like a beta-blocker really cause problems. From the little I know (I say little, cuz I'm not doctor) I would say that it wouldn't complicate things but could help if it was a heart condition or stroke related problem. I'm SURE my doctor will say NEVER give your meds to anyone else. BUT it SUCKS to know that you MIGHT know what's happening and MIGHT be able to help BUT lawsuits are preventing you. A 'damned if you do, damned if you don't.' kind of situation.

She woke up. She was responsive. That made things clearer. How far out EMT's were and other possible drugs involved were not parts of the equation that had answers. I'll talk to my doctor and HOPEFULLY the venue will teach their staff how to react to these situations.

Still,

RyanW, thanks for chiming in. Feel free to add, or anyone else to add. It's been a hell of a day...

tanguera

Nikon D750

05/06/2013 10:40:22 AM · #4

Very impressed you were able to keep such a calm demeanor about you, especially with another wedding coming up right behind this one.

I agree with what Ryan said. Never administer meds to someone if you don't know. You have no way of know their allergies, what they're on, if they took drugs, etc.

RyanW

Nikon D7000

Nikon AF-S DX Zoom-Nikkor 18-55mm f/3.5-5.6 ED

05/06/2013 10:41:27 AM · #5

wasn't sure exactly what beta blockers were, so i did a search.
there are a few adverse reactions to beta blockers. given the outcome of the event and having read through this, i really do think you did the right thing in not giving her any.

Adverse drug reactions (ADRs) associated with the use of beta blockers include: nausea, diarrhea, bronchospasm, dyspnea (shortness of breath; gasping for air), cold extremities, exacerbation of Raynaud's syndrome, bradycardia, hypotension, heart failure, heart block, fatigue, dizziness, alopecia (hair loss), abnormal vision, hallucinations, insomnia, nightmares, sexual dysfunction, erectile dysfunction and/or alteration of glucose and lipid metabolism.

Adverse effects associated with B2-adrenergic receptor antagonist activity (bronchospasm, peripheral vasoconstriction, alteration of glucose and lipid metabolism) are less common with B1-selective (often termed "cardioselective") agents, however receptor selectivity diminishes at higher doses. Beta blockade, especially of the beta-1 receptor at the macula densa, inhibits renin release, thus decreasing the release of aldosterone. This causes hyponatremia and hyperkalemia.

Hyponatremia (American English) or hyponatraemia (British English) is an electrolyte disturbance in which the sodium ion concentration in the serum is lower than normal.
Hyperkalemia (hyperkalaemia in British English, hyper- high; kalium, potassium; -emia, "in the blood") refers to the condition in which the concentration of the electrolyte potassium (K+) in the blood is elevated. Extreme hyperkalemia is a medical emergency due to the risk of potentially fatal abnormal heart rhythms (arrhythmia).

Message edited by author 2013-05-06 10:42:39.

Hussar1812

Nikon D7500

Nikon AF Zoom-Nikkor 70-200mm f/2.8 VR DG IF-ED

05/06/2013 10:46:32 AM · #6

I'm a certified First Aider with St. John's Ambulance in Hong Kong. Here we're advised to never give a victim medicine due to unknown allergic reactions. The only exception to this is Aspirin (which can be administered with a suspected heart attack). However, if you cannot confidently asses the symptoms, it's best to stabilize the victim until ambulance / First Responders arrive. You did well in taking charge of the situation. Also, it helps to know the good Samaritan laws in the country you're in...as some may hold you liable in event of mistakes regardless of your intentions.

Message edited by author 2013-05-06 10:47:39.

Canon EF 100mm f/2.8 USM Macro

05/06/2013 11:29:33 AM · #7

Originally posted by Hussar1812:

Good to know. I will ask about Samaritan laws in Japan. I'm sure they are the same as any other place in the modern world, stabilize as best possible until EMT's arrive. Maybe I'm just projecting my own hypochondria onto the girl...go with what I think is best regardless...but I didn't...and it worked out, this time.

Aspirin is something else I have in my bag but never thought about giving. Not sure how well that would actually work. From experience, taking a beta-blocker does work (At least one me). I should note, I was given beta-blockers as a way to rule out hypoglycemia (Not very conventional IMO). Definitely took the edge off of the anxiety of my symptoms but still left me faint and weak when I had my 'episodes'...so definitely not anxiety related (Still don't know what the problem is).

After all was done, 2 minutes later, I really felt faint and like throwing up. That WAS anxiety kicking in a bit late in the game. Held back, came home instead of going to the gym, took a nap. With summer coming around, I think I'll be in this kind of situation a few more times. Maybe not at the chapel but definitely out and about. 3 times last summer...every time a good Samaritan stepped up and took charge. I think it's my turn...

Spork99

OM System OM-1

05/06/2013 11:54:54 AM · #8

Good job staying calm and taking control. It's amazing how many people will just stand there gobsmacked when someone needs help. They'll willing to help help, but unsure of what to do. They need to be told what to do. Another thing I've found is that you can't say, "Someone call 911." because everyone will assume someone else is doing it. You have to single someone out and say, "You, call 911!"

You, as a non-doctor, should almost never give an unconscious person medication, at least not without the guidance of a doctor. The possible exception would be someone experiencing anaphylactic shock who is unable to administer their own epi-pen.

I had a similar situation at work. I was in the lab working on a test, talking with one of the engineering interns when his eyes suddenly rolled back and he just dropped. I was able to control his fall and keep his head from hitting the floor. I made sure he was breathing and had a pulse, got him into the recovery position and called for help. He had a brief seizure which kinda freaked me out, but it stopped and he regained consciousness before the First Responders arrived. I never found out what the cause was, I didn't ask either. He got a change of clothes and a free ride to the ER. He was back at work the next day... embarrassed by the situation, but otherwise OK.