Fabrice Muamba was one of the lucky ones. On 17 March, 2012, the former footballer collapsed on the field during a match. A cardiac arrest caused the 23-year-old’s heart to stop and for 78 minutes he was clinically dead.
Each year there are an estimated 60,000 deaths as a result of sudden cardiac arrest but thanks to the work of first responders, who administered CPR and used an automated external defibrillator (AED), Fabrice miraculously survived. In the aftermath, he heaped praise on the medics for saving his life and launched ‘Hearts and Goals’ – a campaign to raise awareness of sudden cardiac arrest and money to fund publicly accessible AEDs.
The ripple effect
Fabrice’s close call with death thrust the issue of sudden cardiac arrest and the need to roll out more life-saving equipment and training under the national spotlight. Football fans and non-football fans were gripped with Fabrice’s story and encouraged to take action.
Network Rail project director Brian Paynter was one such person. Brian oversees the renewal of plain line track, which sees thousands of people undertake work for Network Rail’s Infrastructure Projects (IP) division and its principal contractors every weekend.
“I felt this could happen to us,” Brian explained. “And we aren’t surrounded by thousands of spectators with a chance of one being a doctor and our workforce isn’t as fit as professional footballers.”
Following Fabrice’s high-profile story and encouragement from colleague Mark Hayward, a project manager for plain line jobs in London North Western (North), Brian has made AEDs mandatory for all of his team’s track possessions.
Mark, who is on a mission to ensure precautions are in place to potentially save workers’ lives after himself suffering from a stroke, said: “I noticed all these defibrillators were turning up in telephone booths and supermarkets and everywhere else and I thought: ‘Why the hell aren’t we using them on site?’ I thought if we could just save one life it’s worth deploying.”
AEDs are portable machines that deliver an electric shock to stabilise an irregular heartbeat caused by a heart rhythm abnormality, heart disease or a heart attack, for example. According to the UK’s Resuscitation Council, fewer than 10 per cent of people survive if sudden cardiac arrest occurs outside of a hospital but survival rates significantly improve when CPR is performed in conjunction with the use of an AED.
Network Rail has not mandated AEDs across the entire company but they are highly recommended at its depots and worksites and are a requirement at its managed stations and key corporate offices. AEDs are also increasingly being placed in public areas with high footfalls, such as railway stations.
Dave’s legacy
Although the introduction of AEDs across plain line track renewal teams was completed midway through 2017, the rollout came too late for one of Brian’s colleagues. Brian and Mark were in the process of making AEDs mandatory when the death of Dave Curnow following a heart attack in July 2016 put a greater sense of urgency on completing the project.
“We just don’t know whether, if we’d had a defib on site, if we’d have been able to save him or not,” said Brian. “That was what kicked it in for me that, right now, we have to have defibrillators on site.”
Brian explained that AEDs are taken out with the first aid kit and eye wash dispenser during site setup. A number of AEDs are usually deployed because of the size of plain line sites and the fact that every minute counts when it comes to treating someone in cardiac arrest.
The risk
RailStaff approached the Health and Safety Executive, the Office of Rail and Road and the Institution of Occupational Safety and Health to find out how many recorded incidents of workers going into cardiac arrest there are each year in the industry, but none had access to such data.
IOSH railway group member Keith Morey said that rail track workers are less at risk than other industries because a huge amount of resources are put into ensuring their health is good.
“Cardiac risks in the sector are relatively small compared to others,” he explained. “The biggest risk we face is that of slips, trips and falls. We also have a risk from exposure to carcinogens which can cause cancer, for example silica dust and asbestos.”
He added: “Of course, we never want to stand still and we are always seeking new and improved ways of managing risk.”
SIT
Not ones to rest on their laurels, Brian and Mark have gone one step further to roll out a Safety and Immediate Treatment (SIT) programme with the help of colleagues and consultancy Train2Protect, further increasing the life-saving potential of staff. The programme was initially delivered to around 1,000 people in plain line, but is now being rolled out across IP.
The one-day training session covers resuscitation, treating different types of injuries and the recovery position; a beginner’s guide to first aid. One of the most important aspects is how to use an AED. Although they are designed to be used with no training, the SIT training was about better preparing workers for such an eventuality by giving them the confidence to step forward.
“One of my team was on a bus when somebody fainted. He used the training that he’d picked up the day before to put the person in the recovery position until paramedics arrived,” said Brian. “Another lady’s father had a heart attack in the pub and she used the training on him. They said that if it wasn’t for the training then who knows what could have happened. The feedback’s been really positive.”
He added: “It’s highly likely that one day we will have somebody else collapse on one of our sites.
“It is a big responsibility to take on, but I’d like to think the SIT training has increased the likelihood of somebody using a defib.”
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