‘He’s still there, we’ve got a chance’
With cardiac arrest survival rates worsening, the Heart Foundation wants students to learn CPR and how to use defibrillators. Nicholas Jones reports on how both helped save the life of retiree Stuart Jones
Reilly Marlow-Jones was returning from football practice when he spotted his granddad, lying face-down by the driveway.
The 19-year-old hit the car brakes. He ran to Stuart Jones’ lifeless body, yelling, “Granddad’s collapsed, call an ambulance!”
Three generations shared the Paraparaumu property on the Kāpiti Coast, and Reilly’s parents, Lance Marlow and Tonya Jones, were working from home that Friday, April 1, 2022.
Jones was on a Zoom call when she heard her father, who was 79 at the time, hit the ground. She assumed it was noise from a neighbour, until her son cried out.
“I looked out the window and saw him racing over to his granddad. I leapt up, interrupted my call with a few foul words, and yelled out to Lance, and pressed 111 on my phone.”
Fortunately, their friends, Tony and Bridget Smith, were staying in a caravan on the property at the time. Bridget, a former emergency nurse, took charge.
“We turned him over, he was cold and grey, no pulse,” said Marlow. “Bridget checked his eyes and his pupils hadn’t fully dilated, so she said, ‘He’s still there, we’ve still got a chance’.”
She began chest compressions, then Marlow took over. On the phone, a 111 operator provided calm, step-bystep instruction that the family say made an enormous difference.
“She’d be constantly saying as she gave instructions, ‘What’s happening now? Are there any responses?’ And when we’d say, ‘Yes, he’s coughed, or something,’ she’d say, ‘Okay now stop compressions’. We never felt like we were left to our own devices,” Marlow said.
“After about a minute and a half of doing the chest compressions, we noticed Stu’s skin changing colour, from grey to pink. Bridget said, ‘You’re getting oxygen around his body’. That really spurred me on — it made a big difference.”
Hearing the “death rattle” coming from her father was distressing, Jones said.
“To the point I had to take out his teeth, because I couldn’t stand hearing that again.”
The AED Locations app that finds defibrillators
Jones’ work in events meant she had the AED Locations app on her phone, which is free and helps people find the nearest defibrillator.
Tony picked one up from a nearby dental clinic, and — with the crucial, calm and reassuring guidance of the 111 operator — Jones shocked her father four times.
Pressing the button the first time was easy, she said, but it became much harder after seeing the force lift her father clean off the ground.
“I ended up saying, ‘Sorry Dad, sorry Dad’.”
All the ambulances based on the Kāpiti Coast were busy, so two were sent from Porirua.
It was a long 25 minutes before help arrived in the form of the local volunteer fire brigade.
Unsure if there was room to park or turn around, they sprinted down the 250m driveway, in full gear and carrying equipment.
“These guys were older than me . . . when they got there I looked up and thought, ‘I’m going to have to work on them’,” Marlow said.
A minute later, the Wellington Free Ambulance arrived. Stuart had regained consciousness by then but doesn’t remember anything of the drive to Wellington Hospital, or much of the three weeks he spent there, including two weeks’ wait for the triple bypass operation.
There were still Covid-19 protocols in place, and the staff — who were terrific and provided great care — were badly stretched, Jones said.
“These people were wrecked, absolutely wrecked — they were literally running. The care that Dad got in there was absolutely first-rate. But I don’t know how they could sustain that.”
She worries that sort of pressure means things can fall through the gaps, particularly a proper plan for when people are discharged home.
An occupational therapist friend told her not to leave the hospital without a confirmed visit from a community nurse the next day, or vital equipment like a mattress wedge, so Stuart could avoid the extreme pain of sitting upright and the risk of pulled muscles if he lay too flat.
“We waited around for probably an hour before we could see the occupational therapist who issues the equipment. Dad, by this stage, was in extreme pain. There was nowhere for him to lie down, every single bed was used, even in the hallways.
“The discharge process was fraught . . . I know people can go home without that assistance. And I don’t know how he would have slept, got in the shower, or gone to the toilet, without those tools.”
Cardiac survival rates have fallen — what could turn them around
The family are speaking to the Herald to support advocacy from the Heart Foundation, which wants a national action plan to address multiple issues including services that are struggling.
Gisborne Hospital cardiologist Dr Gerry Devlin, an associate professor and the Heart Foundation’s medical director, co-authored a recent article in the NZ Medical Journal which estimates almost a quarter of the 10,000 deaths from cardiovascular disease are avoidable, through better prevention and timely access to healthcare.
That increases to half of all deaths among Māori and Pasifika.
Services are struggling, Devlin told the Herald: “The wait times at the moment are as bad as I’ve seen them in my time in New Zealand. And I’ve been here as a cardiologist for 25 years”.
The Heart Foundation wants proven treatments to be funded, including SGLT2 inhibitor drugs for heart failure that would help thousands of people live longer in better health, and keep them out of hospital.
Another problem: Survival rates for people who suffer a cardiac arrest are too low, because often people don’t know CPR (cardiopulmonary resuscitation), and because there aren’t enough defibrillators available in the community.
More than 2300 people had a cardiac arrest at home or in the community in the year to June 2022, and only one in 10 survived to hospital discharge.
That compared with one in seven in 2018.
The foundation wants the Government to set targets, including increasing the survival rate for out-of-hospital cardiac arrest by 25 per cent by 2030.
CPR lessons should be mandatory in schools, the charity says, just as they are in countries including Britain, Germany, China, Norway and Sweden.
Students should also learn AED (automated external defibrillator) skills, the Heart Foundation says.
The slow recovery from a cardiac arrest
Stuart is now 81 and estimates he’s at about 60 per cent of the fitness he had before the cardiac arrest.
He and his wife Dawn have bought watches that can alert Hato Hone St John if something happens within 300m of a home transmitter. They also have GPS necklaces that can send the same call for help when they are out and about.
“Without the family, I would be pushing up daisies. It’s just great to be alive,” he told the Herald.
“The stars must have been aligned. Tonya and Lance could have been at work. Reilly may not have come up the drive at that time. I could have fallen down in the back paddock. Tony and Bridget might not have been here.”
The family have thanked everyone who helped on that day, except the remarkable 111 operator. They hope she reads this article, and that by publicising their experience, they might help save someone else’s life.
CPR was nothing like the sanitised training, Jones said — her dad’s ribs cracked from the compressions — but people should know they could do it if they had to.
“If you can press down forcefully on to something, you can do this. Because the principle is reasonably simple — just keep pressing, keep pumping.
“Your job is to pump the oxygen that’s in the body around the body, until someone turns up with more sophisticated equipment.”