When he went into cardiac arrest, Paul Fox’s wife was able to administer life-saving CPR, starting off the crucial chain of survival before medical help arrived…

Many miracles happened to me, both in the lead-up to my cardiac arrest and over the following days, explains Paul. “I had been suffering with indigestion for quite a few months and been taking Rennie, which seemed to help. At the end of January, I started getting some chest pains, so I went to the doctors. There, I was diagnosed with acid reflux because the chest pain wasn’t on exertion and I was prescribed a stronger antacid, which seemed to do the trick.

Two weeks later, on 9th February, my wife Jane was going to go shopping (I don’t do shopping as supermarket trollies and me just don’t see eye to eye), but I began to feel very unwell; the chest pain had returned and it was radiating to my jaw. Jane suggested I sit on the sofa and she rang for an ambulance. The last thing I remember was feeling so, so hot. I took my sweatshirt off and suddenly went into cardiac arrest.

Jane phoned 999 once again and updated them on my condition. She apparently grabbed my feet and pulled me off the sofa, bumping my head. I still have the bump to prove it, but in the scheme of things, it didn’t matter. She started CPR…

Jane says that she just went into autopilot and remembered her training (being a nurse). She stayed calm and knew what needed to be done. She also said the call handler was brilliant; counting as she did CPR and helping her not to feel alone, which really helped.

I believe that God put everything that I needed in place that day; we had two community first responders (CFRs) at my side within four minutes, one of whom was also a paramedic. The ambulance, already on blue lights, was in the area and arrived within about six minutes. The air ambulance had been tasked from their Henstridge airbase. Their Critical Care Team took only 15 minutes to arrive and as they walked through the door, the hard work of those already working on me paid off, as they managed to get a pulse.

I started to come around, but cardiac arrest protocol suggested that I needed to be put in an induced coma, which they did. They then discussed how to transport me to the best hospital, by road, or by air. It was decided that the Critical Care Team would travel with me by road and I was quickly taken to Royal Bournemouth Hospital (RBH). There, I went straight to surgery and had a stent placed in one of the arteries in my heart. The consultants thought that I may need further stents, however, a couple of days later I had a scan, which showed everything to be normal, so no further surgery was needed. Another miracle!

I was kept in an induced coma for three days, with cooled fluids administered to keep the temperature of my heart, brain and other organs down. Jane was asked to come to the hospital early on the Tuesday as they were going to slowly wake me up. She was given three possible outcomes, either I could have suffered brain damage, I wouldn’t wake up at all, or I would wake up and be ok.

Together with our daughter Michelle, they headed to the hospital and while on their way joked and said, “I bet he is awake already.” Sure enough I was and the first thing I said was “I love you.”

Dr Dave Martin was on the air ambulance the day I needed it. He is also a Consultant at RBH and came to see me when I woke up. I really don’t think he could believe his eyes. I started to eat, became mobile around the ward and was discharged on the Thursday of that week.

Thereafter, Jane took a couple of weeks off so she could look after me. It wasn’t until she went back to work that I began thinking about what happened. I contacted the Charity via their Facebook page originally and had some wonderful messages and texts. I broke down several times, basically I think it was survivor guilt, as I know how low the survival rate is for those who experience an out-of-hospital cardiac arrest.

I have subsequently had the pleasure of meeting everyone who attended my incident. It helped me so much, because before I met them, I only remembered the events that happened before my cardiac arrest and waking up in the Critical Care Unit. It also helped me process everything, put a timeline together and everyone was able to tell me the part they played on the day. It was truly inspiring.

I’ve now joined Slimming World and have been going for three weeks; I’ve already lost nearly half a stone. I’ve also joined the gym and do circuit training once a week to keep my cardiovascular fitness up. I have no doubt that the fantastic team effort involving the CFRs, Ambulance Service personnel and the Critical Care Team at Dorset and Somerset Air Ambulance saved my life and I would not be here without them. You all do a brilliant job and I can’t ever thank you all enough!

A View From The Crew Dr Dave Martin

In the management of cardiac arrest, some things definitely make a difference to a patient’s outcome; these are often referred to as components of the chain of survival. Perhaps the most significant element is early commencement of basic life support; chest compressions and ventilations, usually delivered by a witnessing bystander.

Unfortunately, our brains are poorly tolerant of periods without oxygen and nutrients, so when the heart stops, with every passing minute, there is the potential for progressively worsening brain injury.

So it was Paul’s wife, Jane, who provided the first links in the chain – she recognised Paul’s cardiac arrest, called for help and delivered vital early care to keep blood circulating and his brain (and heart) perfused, until the arrival of the CFRs and land paramedic teams. For Jane to have remained calm under the unimaginable pressure of a situation like this is a remarkable achievement; her actions were unquestionably life-saving.

The CFRs and paramedics worked to deliver the next critical element of care in the chain of survival, which is early defibrillation. Additionally, they ensured continued effective chest compressions, controlled Paul’s breathing and called for our Critical Care Team to assist.

Our team can provide the same post-resuscitation care one would receive in an Emergency Department, including elements of advanced airway management, circulatory support and sedation – primarily focused on optimising continued brain and heart function. We also provide additional diagnostic and decision-making support and have the ability to take the patient to the hospital that best meets their needs.

However, all of this is really only beneficial when the patient has a beating heart. In Paul’s case we sedated him, gave him drugs to support his blood pressure, placed an endotracheal tube and put him on a ventilator. We also decided to give him clot-busting medication in order to try to re-canalise the blocked coronary artery and restore his heart’s normal blood supply. By the time Paul arrived in hospital, his ECG (heart tracing) had returned to normal and his circulation was requiring no extrinsic chemical support.

The cardiologists are obviously crucial to the whole process and we engaged with the team at Royal Bournemouth Hospital to ensure swift coronary intervention and stenting before undergoing a period of recovery on the ICU.

Paul’s case is a great example of seamless transition between phases of care with everyone contributing positively; the benefits of this are clear. We are delighted that he has done so well and it was a total privilege to be able to get to know him and Jane since his discharge from hospital. I know everyone involved that day feels the same.

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