Becoming a CFR
How to become a CFR
What is the process
what happens after training
is there more to do after
Whats it like being a CFR
Can I help, will i like it
Here Lee describes what a shift looked like when he booked on over the Christmas period. Lee usually books on duty on a Friday and Saturday night and starts his tour of duty from about 7pm.
I have been a CFR for 2 1/2 years now. On the way home from normal work I will pick up the marked responder vehicle from where it is kept, I always check that it is roadworthy and has enough fuel in it to see me through the shift.
I get home and usually have 40 winks before having something to eat, catch up with the other half if she isn't still at work and chill for a bit before i get myself ready. I get changed into my uniform and if its cold outside will usually start the car and let it warm up for a bit, the patients don't usually appreciate cold hands!!
When I am ready I will book onto the Mobile Data Terminal (MDT) inside the car which is how we receive our jobs from the Emergency operations Centre (EOC) and then shout up on radio to book on giving the EOC my callsign and PIN number so they can show me on duty and ready to respond. I'm not one for sitting at home and waiting for a call, some do, but I prefer to go and sit up somewhere and wait for a job to come through.
I booked on at 7pm and whilst driving to one of my standby points the MDT springs into life, only 16 minutes after booking on, a fall with no injury and I am 1 mile away from the address. Although our scheme cars have blue lights and sirens, we don't use them, we don't break the speed limit and drive to normal road conditions. The blue lights are only there for when we attend road traffic collisions to warn other road users of any hazards and to protect us.
I get to the address and the patient who I have have been out to before is sitting on the floor, as I walk in he greets with "not you again", I apologise with a smile on my face and we start to have a bit of banter. The patient knows I have to do some checks on him so start off with taking his temperature, followed by checking his pulse rate and oxygen sats and his BP. I ask him if he is in any pain anywhere and he isn't. Talking to patients is the biggest thing I have learnt, putting them at ease as sometimes there is a bit of a wait before a DCA (double crewed ambulance) arrives. We have to fill out paperwork, luckily our scheme cars have EPR's (Electronic Patient Record) which is a tablet in which we can pull up the job we have been sent to and record what has happened and put our observations on, when a DCA arrives we can then transfer the details to their tablet to save them from going through the same details. I record whats happened, the patients past medical history and what, if any, medication they are prescribed. The DCA arrives and with the help of the Manga ELK, which is an inflatable lifting chair, we get the patient back onto his bed and the job is done.
I get back into the car and go and sit at one of my standby points to awaiting the next call. It isn't long before the MDT springs into life again, a Cardiac Arrest at a care home. I make my way there and I am first on scene. I walk into the patients room and there is a carer doing chest compression's, I check the patient isn't breathing and has no pulse, he hasn't, so with the help of the carer the patient is put on the floor, I get the carer to continue with the chest compression's whilst I attach the defibrillator and establish an airway using an OP and a bag valve mask, I take over the check compression's and give 30 compression's and 2 rescue breaths, the AED tells me to pause whilst it checks to see if there is a shockable rhythm, there isn't so I continue CPR. The DCA arrives and they can give advanced life support to the patient, I continue with CPR whilst they are doing what they need to do, establishing IV access, securing an airway with an IGEL. Sadly, after 25-30 minutes of advanced life support the patient has died so we stop what we are doing. The DCA have to break the news to staff and I gather up my kit and replace what i need to from the ambulance and clear. I always park up round the corner after attending a job like this, just to reflect on what has happened and to take 5 minutes before I book clear. The EOC always ask if we are OK which is nice as they understand that attending an unsuccessful cardiac arrest is upsetting, but i book clear and wait for the next job.
My next job is to a patient with breathing problems. They suffer from COPD (Chronic Obstructive Pulmonary Disease) a progressive lung disease which the sufferer can find it hard to breath. I arrive and take the patients observations and record them on the EPR whilst waiting for the DCA to arrive. I haven't had to administer supplementary oxygen as the levels are fine, but having listened to their chest, they are wheezing so may have the start of a chest infection. I pass on my findings to the DCA and after they have listened to their chest they administer Salbutomol through a mask, similar to a inhaler but this is in liquid form that is put into a mask and the patient breaths in the mist it makes. I clear not long after and sit and wait for another job.
My next call is to a patient that is bleeding from a burst varicose vein. When I say they can bleed a lot is not an exaggeration, there is blood on the floor, in the bath and some on the wall. It isn't my first one I have been to and after putting on gloves and removing (very carefully) the towel that has been put over the leg I can still see it's bleeding with some force so i basically stick my finger over it and apply pressure, something I was shown to do when i attended the last one. 5 minutes later the bleeding is stopping and the DCA arrives, some wet pads and a couple of bandages later and there is enough pressure to move my finger and get the patient down to the ambulance and a visit to A&E.
Time for a cuppa I think, so it's off to the only place that is open in the early hours of the morning, McDonald's.
It isn't long before the MDT springs into life and it's off to another job. Male patient with breathing difficulties at a care home. I get there and can see that the patient isn't well, they suffer from dementia so can't speak to me. I take there temp and it's 40.1, I remove all the blankets and quilt that he is wrapped up in and check his sats, they are low at 85, usually they should be 94 and above or a patient with COPD between 88 - 92, this patient hasn't got COPD so I administer some supplementary oxygen to get his levels back up, his respiration rate is high, his blood pressure is low and his heart rate is high, I radio up and inform the EOC that I suspect the patient has sepsis which is a potentially life threatening condition caused by the body's reaction to an infection. The DCA arrives and I inform them of my observations and findings and they take over the care of the patient. i assist the crew getting the patient onto the trolley and down to the ambulance and he's off to A&E.
By this time its nearly 4am and time to head home. Not every night is like this one, sometimes it can be more busy and sometimes less busy. The DCA's that have backed me up tonight have been great, allowed me to get involved and hopefully I have helped in the best way I can.
I enjoy being a CFR, it's the sense of pride in helping the local community. The sense of relief on the patients face when you walk through the door or that of their relatives and loved ones when you start taking their observations and talking to them to get a history of whats happened, it sort of feels like they are getting a bit of relief and can focus on other things, for me sometimes my tummy is churning thinking come on DCA hurry up but you do what you have been trained to do and let the clinicians take over when they are there. Would I recommend anyone else becoming a CFR, YES I would. I have a very understanding partner than knows I enjoy what I am doing, she is used to it, I spent 4 years as a blood biker and 17 years as a special constable in the police before, she thinks I'm mad but perhaps that's why she loves me, or so I think anyway. You need the backing of your loved ones to do this, it's important.
I park the car up outside home, log off with EOC and it's off to bed ready to do it again tonight if it's Saturday.