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Ann's train journey takes an unexpected turn

8 Apr 2024

CRANAplus Board member and RN Ann Aitken recently found herself tending to a person with chest pains during a recreational train journey. Here she tells her tale – and pays thanks to having recently undertaken the CRANAplus Advanced Life Support course.

Ann Aitken and her hus­band were set­tling into their car­riage when she was approached by a train stew­ard. Their plans of how they would spend the time cel­e­brat­ing their wed­ding anniver­sary on a leisure­ly cross-coun­try train jour­ney were about to change dramatically.

For the next five hours or so, Ann would be tend­ing to a per­son who was show­ing symp­toms of an impend­ing heart attack.

I fin­ished the Advanced Life Sup­port (ALS) on the Mon­day,” Ann recalls. On the Wednes­day, my hus­band and I board­ed the train, excit­ed about the trip. On the Fri­day, I was in a car­riage with rudi­men­ta­ry med­ical equip­ment putting all I’d learned on that course into action.

One of the stew­ards had heard that I was a nurse and approached me. There was a per­son who wasn’t feel­ing great, they told me. They had chest pains, and would I have a look at them?”

Ann soon took con­trol of the sit­u­a­tion with the sup­port of the CPR and First-Aid trained staff. The train halt­ed in an old rail­way set­tle­ment with a hand­ful of res­i­dents, while Ann liaised by phone with the retrieval ser­vice, two hours away by plane.

Ann had at her dis­pos­al a med­ical chest of the sort found on remote sheep and cat­tle stations.

This wasn’t your nor­mal clin­ic sit­u­a­tion. I wasn’t able to can­nu­late the patient. I was work­ing with a very basic blood pres­sure machine – like the one you might buy at the chemist for home monitoring.”

But I could use the drugs in that med­ical chest, pro­gress­ing the use as the person’s con­di­tion pro­gressed. I could give them mor­phine for the pain and there were also a cou­ple of drugs, in patch and spray form, for heart conditions.

My job was to keep the patient calm and as pain-free as pos­si­ble until addi­tion­al sup­port arrived.”

Hav­ing just done the ALS course was a huge bonus, says Ann.

I don’t gen­er­al­ly work in car­diac sit­u­a­tions and I’ve nev­er worked in a heart ward,” she says.

The main ben­e­fit was that it gave me struc­ture. I had a struc­ture to be able to con­tin­ue to assess and keep them calm, using the infor­ma­tion I was gath­er­ing to decide on the next steps, using crit­i­cal think­ing to make those decisions.

Doing that train­ing refreshed my knowl­edge and reas­sured me I did have the skills to find my way through.”

And what hap­pened to the fel­low trav­eller Ann cared for? The retrieval plane land­ed and a res­i­dent picked up the doc­tor from the airstrip, took them to the train, and then trans­port­ed the doc­tor and patient to the plane.

The patient did have a heart attack in a region­al hos­pi­tal and was then trans­port­ed to a major city where a stent was inserted.

Ann and her hus­band were back in Ather­ton a cou­ple of days lat­er, and the patient was ulti­mate­ly able to resume their planned holiday.

They Googled me to get my con­tact details – and I received a beau­ti­ful bunch of flow­ers in thanks,” Ann says with a smile.

Find out more about the CRANAplus Advanced Life Sup­port course.