By Femi Ogunyemi (Dr)

AN incident occurred, yesterday, on the London Underground.

Basic Life Support (BLS) refers to the act of supporting an unconscious patient’s breathing and circulation in order to preserve their life until professional help arrives.

Everyone, especially, healthcare workers, must learn these basic simple skills and facilities such as an emergency numbers and defibrillator devices made available.

Little did I know, as I boarded the Tube on Westminster Bridge Road, that my newly re-certified BLS skills was about to be dramatically tested.

I was confronted by a boisterous man, about 20 years old, wearing headphones and dancing the most vigorous moves I have ever encountered! His violent body moves consisted of a mixture of twerking, martial arts and a traditional dance I last saw in Ondo town! Chubby in his jeans and T-shirt, this 5ft salsa sensation took the entire cabin space as his stage.

The other passengers in my carriage smiled initially and then ignored him.

The carriage doors shut and the train chugged into the tunnel.

The man did not sit. As he marched up and down the carriage two things got my curiosity. I could not find the source of the music, walkman, or iPod; and no sound came from his headphones.

Sensing my perplexity he stopped in front of me. I smelt no alcohol but saw pinpoint pupils. He backed off and sat down, still body popping and breakdancing to his imaginary music.

Seconds later, he let out a loud yell, jumped up,  ran down the isle, grabbed the hand rail in the roof of the carriage and swung upwards to the ceiling like a wild monkey.

In typical British fashion, no one batted an eyelid.

Unfortunately, this belligerent druggie was neither monkey nor chimpanzee.

His gymnastic swing towards the upper part of the cabin terminated with a massive thud to the ground, that must have shaken the fast moving train .

At this point someone glanced from a newspaper but continued reading. Some women tourists started a concerned chatter.

Then my just concluded BLS training kicked in!

First, look for danger. No traffic..no falling debris..no potential injury to yourself.

Second, ask the victim ” Are you all right?” This incapacitated pseudo-gymnast groaned a reply and moved his head in an attempt to sit up.

Had he not responded, the full BLS algorithm would have come into play:

Call for help.

Clear airway.

Look for breathing. If not breathing, call “999” and “Automated External Defibrillator” (AED)

Start chest compressions…..etc.

Causes of unconsciousness is best remembered by the mnemonic: FISH-SHAPED.

Faint, infection, shock, heart attack, stroke, head injury, asphyxia, poisons, epilepsy and diabetes.

Our ” greatest dancer” had none of these.

No BLS needed.

I remained seated.

It seemed he had fractured the arm used  to break his 7ft fall.

As soon as the train pulled into the next station, one of the arguing ladies leapt out of the carriage and ran to the train driver’s cabin to report the incident.

I followed and added ” I think he’s broken his right arm. He will need an ambulance.”

The train driver ignored me.

All he could see was a black man in jeans, trainers and a baseball cap.

I walked off to board another train.

Within the hour the “greatest dancer” will lie in a bed in an NHS Casualty. After many tests, doctors may manipulate his fracture or do some special carpentry with hammer and nails. A junior anaesthetist will have to deal with his obesity, full stomach, and possibly his recreational drug use.

In the next 24 hours, our acrobatic dancer will cost the British taxpayer thousands of pounds.

After a couple of days in hospital he will follow up in clinic weeks later. If his ( acute ) pain is not well treated, he may, months later, develop chronic pain in the form of neuropathy, or, worse, sympathetic dystrophy.

I wondered what would’ve happened to this man in Nigeria.

I wondered if BLS was mandated by Health authorities in Nigeria.

One thing for sure, I will not be taking the Underground again on this trip.