Defibrillators are a vital matter of life and death
The collapse of the Danish footballer Christian Eriksen was harrowing for all who saw it – and highlighted why it is vital for trained people and equipment to be on hand when such crises arise.
A few years ago, far too few us knew the importance of defibrillators and the number with much clue what to do with one, even in the unlikely event of it being accessible, was even smaller.
The good news is that the Western Isles has led Scotland in changing that state of affairs, working closely with the Portree-based charity, Lucky2BHere, a remarkable organisation which has made a huge difference arising out of one man’s experience.
Lucky2BHere was founded Ross Cowie – a well known figure in the shinty world – after his own life was saved through the inadvertent availability of a defibrillator close to where he had his heart attack.
“From my perspective,” he says, “watching the Christian Eriksen episode happen was quite emotional. It brought back memories. On the other hand, if he was going to have a cardiac arrest anywhere, that was the place to do it”.
It was no off-chance that every Danish player knew exactly what to do when the emergency arose. Ross has long quoted Denmark as the model Scotland should follow in educating children about how to respond in exactly those circumstances.
He says: “Every talk I have given, I have used Denmark as the model to aspire to. The players’ response was spontaneous. They weren’t wandering around wondering what to do because every one of them would have known exactly what needed to happen”.
He has no doubt thousands of lives could be saved if every Scottish pupil was similarly educated to be a potential responder. Yet Comhairle nan Eilean Siar is the only local authority that has responded to this challenge. They have, says Ross, been “fabulous” to work with.
Every school in the Western Isles is fitted with a defibrillator. Prior to the pandemic, every pupil from primary five onwards received training in CPR and use of defibrillators – the latter being crucial to the prospects of survival.
Saved by a fluke
Just before Christmas 2006, Ross was at a quiz night in Skye Camanachd clubhouse. The last thing he remembers is answering a question before suffering a cardiac arrest. From that moment on, he was “lucky to be here…”.
Ross’s life was saved by a fluke. The only ambulance in the north end of Skye happened to be two minutes away. “They got me back with the defibrillator. I was 46 and pretty fit at that time”. He came from a sporting family but with a history of heart disease and early deaths.
He was helicoptered to Raigmore where his life hung in the balance for weeks. Ross suffered another 13 cardiac arrests but survived to tell the tale. The specialist who led his treatment, Professor Stephen Leslie, is now a trustee of Lucky2BHere.
As he gradually recovered, Ross always came back to the single thought that if the ambulance with the defibrillator on board had not happened to be two minutes away from the Skye Camanachd clubhouse, he would have died.
His first venture was to encourage friends and relatives to participate in a half marathon which raised enough to install a defibrillator in the clubhouse itself. Ross also started to take a wider interest in the subject – and was shocked by what he found.
“In Scotland,” he says, “the chances of surviving a cardiac arrest are as little as one in 20. In Denmark, they are one in four. The key difference is Emergency Life Support Training, which means that, in Denmark, anyone can do something before an ambulance gets there.
“In fact, you can’t even get a driving licence in Denmark without learning how to do CPR. Here, the great majority of people would not know what to do, even though they wanted to.
“A huge part of the problem is for people to understand that everyone can be a responder. So I thought – how do we create awareness?”.
He understood from his own experience how important defibrillators are to being able “do something”. By 2009, he had formalised his determination to make a difference by creating the charity, initially focused around his home area.
“At that time, there were hardly any defibrillators in the whole Highlands and Islands. Even ones in places like bus stations and public halls were locked and you had to phone someone for the key – which largely defeats the purpose”.
One of the first defibrillators supplied by Lucky2BHere was to the village hall in Poolewe. Shortly afterwards, a well-known local Gaelic singer collapsed on stage and was saved by the recently-installed device. It was a highly effective illustration of what Lucky2BHere was about.
From the outset, he set three rules for supplying defibrillators which the charity continues to adhere to. First, the initiative must come from local groups. Second, they must raise funds to make a donation and third – critically – they must undertake to train people in their use with help from the charity’s network of volunteers.
Overheads are kept to the minimum with Ross running the operation from Portree with one assistant – a sharp contrast with many larger charities. Louise Jopling, a charity consultant who has worked with Lucky2BHere since its early days, says: “It’s simple and it works. It has been hugely successful in getting defibrillators out into some of the remotest areas of Scotland.
“The critical part of the model is that we don’t just put defibrillators out without following-up. If you don’t support the community, there’s a fair chance they will end up in a cupboard gathering dust”.
Lucky2BHere’s network of volunteers share their skills for free and are all trained through the charity’s own training programme, using the Resuscitation Council UK Guidance. It is an ever-expanding operation with huge reliance on the commitment of volunteers.
So far, Lucky2BHere has supplied almost 1000 defibrillators and there are new teams of trainers and volunteers forming around Scotland. It is a most unusual structure for a charity and one that has proved particularly effective in the circumstances of the past 18 months.
“Fund-raising for big charities has collapsed during the pandemic,” says Ross. “Our model does not rely on fund-raising so we have not been affected at all. Administration costs are kept to an absolute minimum. All the people involved do it because they believe in it”. The British Heart Foundation – which focuses mainly on research -has run its own Heartstart programme for years but it came to an end this week.
‘Educate the country’
This makes the work of Lucky2BHere more important than ever but Ross knows they are still nibbling at the edge of the bigger challenge – to educate the country in how many more lives can be saved and to make availability of defibrillators universal.
He believes it is crucial to get Emergency Life Support Training into every Scottish school. He recalls: “We took pupils from Portree High to Holyrood in 2011 to give a demonstration and everyone was supportive.
“I met Nicola Sturgeon who was Health Minister, and Mike Russell, who was Education Minister, and they seemed enthusiastic but there was no follow-through,” he says. “I don’t know why – I can’t think of a better use of two-and-a-half hours in the entire school careers of every Scottish pupil”.
There is still no national policy and it is left to individual schools to decide what if anything to do - unless a local authority intervenes. Ross has given talks in schools throughout Scotland and some have adopted the policy he is urging but they remain a small minority.
In 2018, Comhairle nan Eilean Siar showed it could be done by becoming the first – and so far only – local authority to create a policy for all of its schools. “If Glasgow or Edinburgh had done the same thing,” says Ross, “it would have been national news”. Prior to the pandemic, Highland Council was progressing towards a similar policy.
In one of its higher profile expansions, Lucky2BHere received an approach in 2019 from Inverness Caledonian Thistle who have since made it the rule to give Emergency Life Support training to everyone on their staff, including manager and players.
The Caley Thistle manager at that time, John Robertson, described it as “a life skill that can prove hugely important. The partnership is massive for everybody because it does what it says on the tin – it saves lives”. The Christian Eriksen episode certainly bore that out in the football context.
Such high events raise public awareness of the issue and in recent days the “Danish model” has seemed more relevant than ever. However, it remains puzzling that the Scottish Government has not adopted this as an initiative that could make a real, life-saving difference.
Ross’s immediate focus is on getting Emergency Life Support Training into schools – and that is his challenge to the Scottish Government, all political parties and local authorities as a policy to adopt as, quite literally, a matter of life and death.
Lucky2BHere has now installed 140 defibrillators across the Western Isles and local awareness has been heightened not only by the schools campaign but also several high profile episodes in which lives were undoubtedly saved. In Lewis alone, Ross is aware of 13 episodes with seven of the victims still alive.
There is a simple test for each of us to apply. Would we, like the young Danish footballers, know exactly what to do? Or would we be wandering around wondering what happens next?