Kimberly Felton; Donnie Woodyard contributing | Sep 17, 2008
SRI LANKA - "As I was running to the ocean my mind was racing--airway, breathing, circulation--CPR, that is all I was thinking. I shouted for someone to call for the Hikkaduwa Ambulance as I dove into the water." The man would not be able to save this life--but he would prove that the system could work.
“As I was running to the ocean my mind was racing—airway, breathing, circulation—CPR, that is all I was thinking. I shouted for someone to call for the Hikkaduwa Ambulance as I dove into the water.”
The man would not be able to save this life—but he would prove that the system could work.
Janaka in front of his scuba shop on a beach in Sri Lanka. (Photo by Donnie Woodyard)
Two months ago, a scuba dive master named Janaka stopped our EMS manager in the southern coastal town of Hikkaduwa. He knew we train the emergency medical technicians (EMTs) that staff the local ambulance. With his shop right on the beach, he’d even witnessed the crew at work, saving lives.
“I want to know what to do if someone gets hurt in the ocean in front of my shop, until the ambulance arrives,” he said.
Our manager invited him to our next EMT training in March. Despite March being the last peak month of scuba season, Janaka was at the class—every day, all day, for three weeks.
On the first day of class, Donnie Woodyard, our EMS manager and trainer, explained the concept of the "chain of patient care": A trained community first responder attends to the injured; someone nearby calls the ambulance and EMTs. The ambulance takes the injured person to the physicians at the hospital—and finally, rehabilitation care is provided as needed.
In Sri Lanka, Donnie explained, the "chain of care" is still only theory. Ambulances have just started responding to emergencies in select communities. Community members are not yet trained to provide treatment until the ambulance arrives, and often the general public does not know how to call for an ambulance.
But this scuba diver was about to change all of that.
Janaka came faithfully to class each day, working particularly hard to understand the medical terminology and concepts. Unlike many training as first responders, he had no background in biology or life sciences.
On March 29, 2007, he graduated as a registered emergency medical technician level 1 (in the USA, this is the equivalent of a first responder).
On Sunday, April 1, while relaxing outside his scuba shop on the beach in Hikkaduwa, Janaka noticed a commotion near the water. A group of local teenagers ran up to the shop saying a boy was drowning in the ocean.
Janaka yelled for someone to call the ambulance as he ran to the ocean and dove in.
Janaka is one more person ready to give medical help in an emergency situation--in a place were emergencies can often happen. (Photo by Donnie Woodyard)
"I pulled the lifeless 15-year-old boy to the surface and quickly gave rescue breaths," Janaka said. "Once on the shore I think I was in some type of automatic mode. I remember opening the airway—no breathing. Two breaths—good; they went in. Feel for a pulse—no pulse. Starting CPR.
"There I was, doing CPR on a beach, surrounded by more than 100 people, and no one else knew what to do. The ambulance came quickly and the guys helping with the class took over patient care and rushed the boy to the hospital. That is why I took the class, but I really didn’t think I would have to use it my first weekend back!"
Unfortunately, Janaka and the ambulance crew were unable to save the boy's life. Not even training gives every story a happy ending.
But this heroic rescue attempt will be recorded as an historic event in the development of a pre-hospital care system in Sri Lanka. For the first time, the "chain of care" was followed:
- Recognizing an emergency
- Calling for help
- Providing community-based CPR
- EMT/ambulance response
- Transporting with care provided while enroute to a receiving hospital physician
Janaka proved that the process can work.