Rosie saved Ray from a heart attack on a train because she’d learned CPR. Would you know what to do?
When Ray Thorpe left the office just after 5pm on June 15 last year, he was in a bit of a hurry. ‘If I finish by 5pm, I can make the train that leaves Leeds Central at 5.16pm, but I need to get a move on,’ explains the 58-year-old charity worker.
The half-mile walk from the debt charity where Ray works as an adviser is usually no problem for the keen long-distance hiker. That afternoon, however, he left work late and ended up ‘jogging to the station, ducking and diving past people on the pavements’.
he made the train — just. It was packed and, he recalls, ‘very hot’, but he managed to find a seat. his destination, Pontefract Monkhill, was four stops and 28 minutes away.
Ray’s book that day was narrowboat Dreams, a present from his daughter Jennifer ahead of a canal trip the family were taking to celebrate Jennifer’s 30th birthday.
The last thing Ray remembers is taking out the book and his reading glasses. Within seconds of the train leaving, Ray was unconscious, his life in the balance. he had become one of the 30,000 people a year in england who suffer a cardiac arrest outside hospital.
A cardiac arrest is when the heart stops pumping blood around the body. Very quickly the patient stops breathing and loses consciousness.
The most common cause is an electrical fault causing the heart to flutter instead of beat. It can also be caused by a heart attack (where the heart muscle is starved of oxygen because of a blocked artery) — which is what happened in Ray’s case.
Without oxygen, vital organs including the brain and heart quickly suffer irreversible damage as tissue starts to die. The patient needs immediate treatment with a defibrillator, which delivers an electric shock to the chest and can get the heart beating normally.
These battery-operated machines are carried by ambulance crew, paramedics and volunteer community first responders (automated versions are also increasingly available in public places).
But until a defibrillator arrives, the patient needs cardiopulmonary resuscitation (CPR) to keep their blood circulating, pushing oxygen round the body to prevent irreversible damage.
‘For every minute that passes after a cardiac arrest, if nothing is done, the chances of that person surviving reduce by 10 per cent,’ says Andrew Lockey, a consultant in emergency medicine at Calderdale & huddersfield NHS Trust and honorary secretary of the Resuscitation Council (UK).
CPR alone won’t restart a heart, but it is vital to buy time until the patient’s heart can be ‘shocked’. If CPR is carried out, ‘the chance of survival reduces by only 2 to 3 per cent per minute’. In england, fewer than one person in ten who has a cardiac arrest outside a hospital setting survives, according to figures published last month. experts say this is partly because in only 50 per cent of cases do bystanders attempt CPR.
Luckily there was a woman on Ray’s train who knew the technique. Three carriages away, at the back, was 29-year-old Rosie Brakefield, a trainee medical technician.
Rosie rarely took this train. She normally works in Wakefield eight miles away, but that day she was at Leeds General Infirmary and, like Ray, she had nearly missed the train.
eleven weeks pregnant, she hadn’t managed to get a seat but her station was the first stop. The train had barely left Leeds Central when she heard someone shouting that a passenger had fainted and asking if anyone knew any first aid.
Rosie did. When she was 17 she had trained with St John Ambulance. now she was training and working as a cardiac physiologist, carrying out ultrasound heart scans and other diagnostic tests.
But although she knew about CPR, she had never had to test her skills in practice.
Rosie began making her way through the ‘horrendously crowded’ train to the front carriage, where she found a man with his head slumped on his chest. ‘People had opened windows, thinking he’d just fainted,’ she says, ‘but I immediately thought he might have had a cardiac arrest.’
Ray’s breathing was ‘very laboured, disorganised gasping’ — these were agonal breaths, triggered by the brainstem, the part of the brain that regulates breathing and heart rate.
Such breathing is seen in up to 40 per cent of cardiac arrests and can last for some minutes. The danger is that it is interpreted incorrectly and CPR is assumed not to be needed.
Rosie knew better. ‘I put my hand on his neck and at that point he stopped breathing and his pulse disappeared.’ As his skin started to suffer from oxygen starvation ‘he went grey-blue practically instantly’.
Other passengers helped Rosie to get Ray to the floor and she shouted for someone to call an ambulance to meet the train at the next station.
She also stopped another passenger triggering the train’s alarm. Rosie knew that Ray’s only hope was to reach the next station, where paramedics might be on hand with a defibrillator. ‘CPR is all about buying time until the ambulance arrives,’ explains Dr Lockey.
Ambulances are supposed to reach cardiac arrest patients within eight minutes. But even then ‘the chance of survival is already less than one in five if nothing has been done before the ambulance gets there,’ he says.
Latest figures show that in July this year, ambulances reached the scene within eight minutes in only 67.6 per cent of cases. On the 5.16 train, Rosie was tiring quickly. CPR, where firm chest compressions have to be delivered at between 100 and 120 beats a minute, is ‘absolutely exhausting’, says Rosie. (Basic CPR doesn’t involve mouth-to-mouth resuscitation — chest compressions alone can buy enough time to save a life.)
Then Ray’s luck intervened again. An off-duty A&e nurse joined her and the two took it in turns to do CPR. By the time the train reached the next station, Ray’s heart had stopped for almost eight minutes.
The ambulance had yet to arrive but again, Ray’s luck was in: a community first responder who lived near by had been scrambled by the ambulance service and arrived with the defibrillator.
Rosie recalls the relief when Ray’s heart started beating again and he was carried conscious into the ambulance: ‘Only then did it sink in what had happened.’
Ray recalls nothing of the CPR or the shock that saved his life. his next memory is of apologising to his fellow passengers for the delay and then ‘I can remember flying along in the ambulance to Leeds General’.
Ray’s wife Leigh and their son Craig rushed to the hospital and were relieved to find Ray alive — and a bit puzzled by all the attention.
‘Because I’d suffered no pain I was wondering what all the fuss was about,’ Ray recalls.
The next day Ray underwent surgery to have two stents (tiny mesh tubes) inserted into his blocked artery to open it.
he spent six days in hospital and when he was discharged, he felt ‘great’. Just two weeks later he joined his family on holiday.
Last month Ray and Rosie met for the first time since that dramatic June day. It was, unsurprisingly, an emotional encounter — and Ray also found how lucky he had been.
The Resuscitation Council (UK) would like many more victims of cardiac arrest to be as lucky — today is Restart a heart Day, and the Resuscitation Council (UK), British heart Foundation, St John Ambulance, British Red Cross and all UK ambulance trusts are joining forces to give CPR training to more than 100,000 young people.
Adults are also being urged to get the training. ‘You could save the life of someone in the street, or even a loved one,’ says Dr Lockey.
he adds: ‘If you train a broad cross-section of the population, the chances of someone getting CPR increase significantly — and the best way of doing that is to target people while at school.’
In Demark in 2004 the survival rate was worse than it is now in the UK — only 6 per cent of people who had out-of-hospital cardiac arrests survived. At the same time, in only 25 per cent of cases was CPR attempted by bystanders.
Then in January 2005, resuscitation training became mandatory in schools. The following year, all new drivers had to take a course in it.
By 2013, members of the public were carrying out CPR in more than 65 per cent of cases and the survival rate had more than doubled.
Yet consecutive UK governments have rejected appeals to make CPR training mandatory in schools, which Dr Lockey says is ‘inexplicable’.
‘For every year the Government continues to hide behind “local choice” as an excuse, tens of thousands of people die unnecessarily. All for the sake of less than two hours of school time per year.’