First Aid Toolkit

This week I am on a three day First Aid at Work training course, so that I can be our office First Aider. I really enjoyed day 1, as I loved learning new and practical skills such as CPR, the recovery position, the Heimlich Manoeuvre and then some bandaging skills. We arrived as 14 strangers, who sat in silence, looking at our mobile phones in the morning, and by the end of the day we were laughing together as we bandaged each other up and shared horror stories of accidents that people had had , or witnessed, at work. I am not sure what we will be covering today but I know that there is assessment on Wednesday, but it is an interactive course where we are all trying out the new techniques, not just watching the teacher demonstrate. In fact it is almost a full week of first aid training as I am also enrolled on the parents course at school on Friday afternoon, that was set up because of Joshua’s seizure in the bath incident in January.

Although this course is designed for First Aid at Work, I could see lots of skills that will be useful at home when taking care of Joshua. We were shown easier ways to roll the patient into the recovery position if you are alone and I now know what I should do in the event of a choking incident or if CPR were necessary. So these are valuable life skills and I am very grateful to have the opportunity to learn them , even though I hope never to have to put them into practice, of course.

Working in an office environment, we do not have too many hazards to deal with, but a choking incident or a trip down the stairs could happen anywhere, but we heard some pretty gruesome stories from someone from the army and a butcher too. Fortunately I am not squeamish at all, and I am not phased by blood – although I am not comfortable with vomit. When Joshua was younger and having full tonic clonic seizures that threw him across rooms, he had several head injuries, despite wearing his epilepsy helmet. He cut his head open on the brick hearth one time and he split his chin on a ceramic public toilet  on another occasion. I think his seizure must dull the sensitivity as he did not really react to the amount of blood or the cuts at the time and with both, we had to go to A&E to be checked over , X-rayed and to be glued back together . Now I would be able to bandage his head up, but would of course still take him to the experts. And the First Aider role seems to be about doing the best thing to keep the patient comfortable and safe while somebody calls  for an ambulance. I hope that my experiences with Joshua over the years, will help me to cope well in an emergency situation. I find that I can remain calm during the incident itself, and then I tend to react and agonise over the ‘whats ifs’ after the event.

So let’s see what today’s lessons will bring….

This is what it feels like…

I would like to give you some insight into what it is like to live with someone with epilepsy, as it might not be a familiar experience to everyone. So, we are on holiday, Joshua has woken up happy and we have pottered about the house until late morning, enjoying a leisurely bath and getting re-acquainted with everything. We go out for a beach walk with the three dogs, and Joshua delights in throwing stones into the sea, then walking along the wet sand, helping me to push his wheelchair. We stop for lunch at a restaurant and its sunny enough to sit outside, with the dogs tied up next to us, and Joshua drinks his orange juice and devours his scampi and chips. The day has been perfect so far and we walk back to the house, where my husband lights a fire to keep us cosy, as we snuggle up together on the settee.

Joshua and I are enjoying a siesta together when suddenly, without any warning, I feel his body tense up next to me. I wake up from my doze with a jolt and he is mid-seizure – his face is contorted and his arms and legs are straight. His socks have come off so I can see every toe bend out of shape. I rub his back and try to reassure him, telling him that he is not alone and that it will all be over soon. His poor body relaxes, just for a moment, then another wave comes and he has gone again – his eyes disappearing upwards in their sockets and his mouth gurgling with a terrible sound. For the next five minutes, he goes and out of these seizures and rather than slowing down, they seem to get shorter but more frequent. Joshua’s face flushes as he gets hotter and  he looks exhausted, in between the seizures, worn out by their violent impact on his body.

These seizures are not going to stop on their own, as they are still coming quickly after five minutes and so my husband fetches his changing bag that contains the rescue medication. I wave the syringe in front of Joshua, warning him of what has to happen next unless he can re-gain some control. But several rapidly follow each other and so, I have no choice but to administer Midazolam. It goes into the jaw cavity , where blood circulation is good. Initially, it would take instant effect, but these days it can be up to another ten minutes before the seizures release their hold on our son.  That wait for effect seems forever as, if it does not work, then it is necessary to call for an ambulance as we are not able to give a second dose, due to the risk that Joshua’s breathing may be compromised ,so he needs to be somewhere with oxygen and with monitors.

Thankfully, after an agonising few minutes, the seizures start to slow down, there are longer gaps between them, and eventually they stop all together. Joshua now looks not flushed, but deathly white, but with dark rings under his eyes, and he is exhausted by the whole episode. He stares around, looking dazed and then he curls up on the settee and he goes into a deep sleep for around an hour. Our happy, lively son has been attacked by epilepsy, once again, and leaves him battered and bruised by the battle. We know that this is not a one off, we know that he will have many more battles just like this one and they can strike at any moment, when you least expect them and often at that least convenient. Most cruelly, they can strike when he is excited, as well as when he is unwell or over-tired. They rob Joshua of his sunny personality and they suspend time while they are happening.

Joshua has suffered from seizures all of his life, but has been on anti-epileptics for 14 years now, so you would think that we were all used to them by now, but each episode is still frightening for all three of us. We know the routine, so onlookers will often comment on how calmly we respond, but believe me, that is all an act for Joshua’s benefit. He needs to know that he is in safe hands and I do not want to pass on my fear to him, so I play it cool, even though inside I feel sick. I too am exhausted once Joshua finally gives into sleep, but I am then on guard for a repeat performance, so I cannot simply resume my siesta – that moment has gone.

First Aid

I have spent a lot of time re-living the events of Saturday morning in my mind and the inevitable imaginings of ‘What If….’ have been playing on my mind over the last few days. I was determined not to be afraid of Joshua having baths anymore, as he loves them so much, so we got back on that particular horse,  but I will never leave him alone in the bathroom again, not even for 5 seconds. So in that way, I have learnt from my mistake and I am very lucky that I did not pay a higher price for that mistake. But I kept pondering how else it could have been a calmer, better experience.

I identified my own lack of basic first aid knowledge; most of my first aid education has come from films and television; that is how I knew to lie Joshua on his side, but I was unclear what I was supposed to do next. Last year, Joshua had had a couple of choking incidents – he had got crisps stuck in his throat and had been unable to clear it himself so had stopped breathing. On the first occasion, my husband had stood him up and squeezed his ribs and the Hula Hoop had come flying out. I was home alone on the second occasion and I had stood him up and slapped him on his back and eventually, after a lifetime had passed, he coughed and breathed again.

So I feel vulnerable due to my ignorance when I am on my own, we live in a remote location, I cannot simply shout for neighbours’ assistance. So my only solution is to gain the necessary skills to give myself more confidence in these emergency situations. I emailed school and asked if they would be willing to set up a First Aid training course for parents, as I cannot believe that I am the only one who does not know the basics. I received an instant positive reply and was asked to call the training company to see what they could offer. I had a long conversation with  the company and found out that they could run a three hour course at school, for a fee. I reported back to school management on what I had been told and I asked, via a parent Facebook group, what the level of interest might be. I was overwhelmed by the immediate and positive response and I learnt that the course has been booked for March, all in the same day.

I was delighted, as it felt as though something positive would come out of our frightening incident and that not only could I learn from it, but other parents who might find themselves in similar situations could do too and potentially, lives could be saved.