Emergency Procedures

I must be aware of all class participants who have a GTN spray or inhalers for co-morbidities such as asthma or COPD. They must have them with them at the class.

I have access to emergency contacts and addresses for all class participants.

I will immediately place the class on hold should any of the following acute emergency situations occur during an exercise class:

  • patient collapse

  • patient has angina, chest pain or chest symptoms that may be or may not be angina

  • patient feels dizzy or faint

  • patient loses balance or is unsteady

  • patient becomes acutely breathless

  • patients' Internal cardiac defibrillator (ICD) shocks

  • any other unforeseen acute event where patient become unwell

I will explain that one person is not feeling too good, and tell the class to either:
- stop the exercise they are doing but keep their feet moving (maintaining venous return), or,
- stay standing or sit down, or,
- have a drink and wait until I can resume the class with them.

I will attend to the patient.

The Collapsed Patient

  • Place the class on hold immediately (see above).

  • Call 999.

  • If the patient is responding and has someone with them instruct them to call 999 immediately.

  • Stay with them while they deal with the patient but keep an eye on the class too.

The Patient with Angina

  • Place the class on hold immediately (see above).

  • Ask the patient to sit down and keep their feet moving.

  • Take one spray of their GTN (Glyceryl Tri-Nitrate).

  • Wait 5 minutes.

  • During this time ask them to relax and breathe normally and try not to panic.

  • If there is someone else in the house ask that they be called to be with the patient.

  • Make sure your class are all okay and are still keeping their feet moving.

  • After 5 minutes if they still have symptoms.

  • Take a second spray of GTN.

  • They should stay sitting unless they start to feel dizzy in which case they should lie down.

  • Wait 5 minutes.

  • If they still have the same symptoms.

  • Call 999.

  • If their symptoms resolve after either dose of GTN use your experience, knowledge and skills to decide whether they may resume exercise at a lower level or not.

  • If they have someone with them they may exit the class. If not they should remain online but stay resting and contact someone to be with them if possible.

The Patient with Chest Symptoms

  • Place the class on hold immediately (see above).

  • Ask the patient to sit down and keep their feet moving.

  • Quickly ascertain the cause of the symptoms and if the patient is having Angina.

  • If they have someone with them in the house they should call them to stay with them.

  • Use your experience, knowledge and skills to decide on and advise on appropriate action if angina eliminated.

The Patient Feeling Dizzy or Faint

  • Place the class on hold immediately (see above).

  • Tell the patient to stop exercising and sit or lie down keeping feet moving (flexing and pointing feet or at least wriggling toes.

  • Assess the situation.

  • Ask if patient knows a reason this might have happened.

  • If they have someone with them in the house they should call them to stay with them.

  • Use your experience, knowledge and skills to take appropriate action e.g. record blood pressure if possible.

Patient Loses Balance or is Unsteady

  • Place the class on hold immediately (see above).

  • Tell the patient to stop the exercise they are doing and either walk on the spot or sit down and keep their feet moving.

  • Assess the situation.

  • Ask if patient knows a reason this might have happened.

  • If they have someone with them in the house they should call them to stay with them.

  • Use your experience, knowledge and skills to take appropriate action.

Patient Becomes Acutely Breathless

  • Place the class on hold immediately (see above).

  • Tell the patient to stop the exercise they are doing and either walk on the spot or sit down and keep their feet moving.

  • Assess the situation.

  • Ask if patient knows a reason this might have happened.

  • If they have someone with them in the house they should call them to stay with them.

  • Use your experience, knowledge and skills to take appropriate action or allow to resume exercise.

Patient’s Internal Cardiac Defibrillator (ICD) Shocks

  • Place the class on hold immediately (see above).

  • If the ICD shocks twice or more call 999.

  • If the ICD shocks once stay calm and reassure the patient.

  • Ask patient to rest and not resume this exercise class but stay online so you can see them.

  • If they have someone with them in the house they should call them to stay with them.

  • When the class is finished, discuss what instructions they have been given for this event.

  • If they felt unwell before the ICD delivered its shock, or feel unwell after recovering from the shock, you or they should call 999.

  • Clinics usually want to know when devices shock.

  • If patient does not know, they should contact their hospital clinic.

Any other unforeseen acute event where patient becomes unwell

  • Place the class on hold immediately.

  • Ask this patient to stop the exercise they are doing and either walk on the spot or sit down and keep their feet moving.

  • If there is someone else in the house ask that they be called to be with the patient.

  • Assess the situation.

  • Ask if patient knows a reason this might have happened.

  • Use your experience, knowledge and skills to take appropriate action.

As soon as possible after the event contact Dr. Robin Van Lingen or Christine Benson to report the event and debrief.