The good samaritan with Professor Mark Wilson

In episode #50, the season 2 finale, Paul talks with Professor Mark Wilson who is qualified in both neurology and pre-hospital care and works at the Imperial College Healthcare NHS Trust and for Kent, Surrey & Sussex Air Ambulance Trust. He is also the co-founder of the GoodSAM platform and app and this is what we talk about today.

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Professor Wilson takes us through the inception of the platform as a way to reduce deaths from cardiac arrest and it’s take-up by many across the UK and further afield. The platform has gained additional services and responsibilities and is being used to manage the NHS Coronavirus Volunteer responders programme.

In just a few years the GoodSAM team have built an enviable platform and reputation and Professor Wilson takes us through what it can do to help those in cardiac arrest and beyond.

Available to listen on the link below or Spotify, Apple , Google, YouTube and your favourite podcast player.

#050 The good samaritan with Professor Mark Wilson

Paul Swindell: [00:01:23] Hello, and welcome to another episode of the life after cardiac arrest podcast with me, your host, Paul Swindell

Today, I'm delighted to be joined by Professor Mark Wilson, who is dual qualified in neurosurgery and prehospital care. He works at the Imperial college healthcare NHS trust group, which is five London hospitals, and also the Kent, Surrey, and Sussex air ambulance trust.

And he is also the founder or co-founder of GoodSam, whose mission statement is to save life and stop harm through technology and I understand the original aim of the App or system was to help those in cardiac arrest. Hence my interest or someone experiencing a similar trauma. But it's also grown impressively and expanded it services, including recently being used to manage the NHS volunteer responder�s initiative for the Corona virus.

So that�s fantastic, what you've been doing, Mark, welcome to the show.

Professor Mark Wilson: [00:02:28] Hello Paul, thanks very much.

Paul Swindell: [00:02:30] I hope that was all accurate what I said there.

Professor Mark Wilson: [00:02:33] Yeah, I think you've covered everything now, so we can probably close it,

Yeah, I very much started with cardiac arrest and it's still very much core what GoodSam does. but it has got a lot bigger over the last few years.

Paul Swindell: [00:02:46] How did you actually come about with the idea and what was the inspiration for it?

Professor Mark Wilson: [00:02:52] So, if you have like about six, seven years, In our ambulance or pre-hospital care world, we were noticing that we were getting quite a lot of patients who would have a head injury and stop breathing, and they'd have a hypoxic brain injury as a result of having a head injury. and this is a phenomenon called impact brain apnea, which is well known in animal models of head injury.

If animals get a whack on the head, they stop breathing. but it also occurs in humans, but often we don't get there quick enough to see it. When we arrived, people stop breathing and their pupils dilate, and they die. They haven't died of their brain injury per se, they died of not breathing because of their brain injury.

And what we want to do is set up a system whereby people who are qualified, who had experienced in first aid, , off duty doctors, nurses, paramedics, police department could actually go and support the airway during that period. So it was really around trauma to start with, what we set up was the system that actually has a much bigger role in cardiac arrest.

And our sort of modeling was like, you're never more than five meters from a spider. You'll probably rarely more than a few hundred meters from an off duty doctor, nurse paramedic, policeman, fireman, someone who's trained or first aider.

So, we set up a system, basically it was a platform, people refer to it as an app, but it's a platform really, which involves an app, whereby people can be registered on the system in a highly governed way, which we could, they can be checked to know who they are.

So, that's what we set up was a system that would connect those who are in need, to those who can provide. So, the platform has now many, many thousands of these doctors, paramedics, policemen, firemen, first aiders on the platform, ready, and then they are triggered by the ambulance service.

So for example, if you are in, the UK or large parts of Australia or New Zealand now, and, someone with you has a cardiac arrest and on does nine, nine, nine, or the equivalent number anywhere else and says certain words, such as not conscious, not breathing. Then, that will, those determinants will trigger the good Sam platform to whatever algorithm the ambulance service has set.

So, they are their algorithm. They may have said it was maybe say two or three. First aid is within the, within a few hundred meter, a few hundred meters, and then maybe two professionals within a one-kilometer region, for example, depending on where you are urban or rural. and that response is entering into that whilst the ambulance is on route, someone who is good at high quality CPR can be doing that and hopefully getting an AED as well and using that. So, and that saved many, many, many lives now in the well in the hundreds now. So, it's pretty, it's pretty quite a positive platform. Yeah.

Paul Swindell: [00:05:20] Yeah. That's amazing that you can say already that you've saved hundreds of lives.

You mentioned about the medical professionals, but I believe, lay people can be involved in its use as well.

Professor Mark Wilson: [00:05:33] Yeah. So, well, yeah, absolutely. the system is highly governed and you've, and this is one of the big things to consider we've. one of the biggest achievements I think GoodSam has had is actually affecting cultural change.

So, if you go back six years going to an ambulance service and saying, Hey, why don't you dispatch people into other people's homes? When they're the most vulnerable person they can be. I.E. unconscious. they were there. Absolutely not. That was not considered a possibility because it just went against everything.

You know, all staff at DBS checked and they know exactly who they are learning. So to be able to, alerts on, they'd never, that wasn't even employed by them to a, an emergency or something. And just, they made a lot of ambulance services wouldn't consider it.

However, because we set the system up in a highly governed way where people had to upload their ID, their work ID.

If they're a doctor get checked off this GMC register or a paramedic against the HS patient register, or if they're a member of the public, they have to upload that sort of driving license or, or passport or similar, proof of identification identification. And the first aid certificate.

Its highly governed and therefore that gave them confidence to be able to deploy these people.

And they also have complete control. So, they can say deploy staff over a wider radius than public who can be, for example, deployed only over maybe a hundred, 200 meters. So literally the public is being alleged to, their next door neighbour.

That makes it very, very safe and yeah, so that's one way that the public can get involved. If you've got any first aid qualifications, or you can, or you being able to be trained to do CPR, then, you can register, upload your certificate and then, join the platform and be deployed. It does depend on where you live different ambulance services have different criteria and different models.

If you're in New Zealand, for example, They're really happy to self, to alert self, certifying people. but they were over a narrow radius. So actually it makes it very safe. It literally is to people within a couple of doors of your house. but there there's all kinds of ways you can set the algorithm up.

And the other way that the public can help is, we've managed to create the world's largest AED registry or database. And that's very much through the GoodSam community. and when people see an AED, a defibrillator, they can take a picture of it, upload it through the app. And then that will then go onto our mapping system.

And we, should we give that data out to the statutory ambulance service for the region? we can check is where as we check it, where it is, but using Google earthand various other clever little ways of making sure it really is there.

But, yeah, the good sound community has been not only instrumental in the response to cardiac arrest, but also mapping, AEDs where we are extremely lucky to have found this really amazing group of people.

Paul Swindell: [00:07:55] Yeah, there's a lot of passion about ads on there, but, perhaps we can just come back on to that a little bit, but the actual users or the responders, who are you finding that, takes up this sort of app?

Professor Mark Wilson: [00:08:08] Yeah. So we've got a full breadth of people, everywhere, everything from professors of cardiology, to, you know, many, many NHS staff and police and fire staff who is part of their statutory training to be able to do this, I would say, and then people who have been trained, for example, in shops were being trained on a first date at work course and they'll upload their certificate.

And then many of the third sector sort of bodies such as St John ambulance. Royal Lifesaving Society, Red Cross. many of them are, on the platform as organizations that approve their members and then they can be deployed as well.

Paul Swindell: [00:08:41] So if someone was, wanted to be on this and they sign up, does it mean that they can get alerted at any time during the day or, or do they, clock on as it were

Professor Mark Wilson: [00:08:50] So no, so this isn't like an on-call system or anything like that.

So we do provide that as well, there is an on duty button, for example, which is mostly for community first responders. So if they are looking after their community officially by the ambulance service from 8:00 AM on a Saturday morning, till 8:00 PM on a Saturday afternoon evening, rather they can log on duty and off duty and they will be dispatched to many other types of emergencies, which is shortness of breath, epilepsy, and other things as well.

However, the basic function is to be not dispatched, but alerted to a cardiac arrest.

And if you're logged into the app, that's always on because you don't really want to be on and off duty. If your next-door neighbor is having a cardiac arrest, it doesn't really matter whether you're on or off duty, if you're available, you're going to go.

And so that's always on, only for cardiac rest.

Now, obviously, if you are, there's, there's a code of conduct, which are very much built with our advisory board. If you are drunk, if you are in the shower, if you are, you know, looking after the kids, if you're at work, There's lots of reasons why you might not be able to go to a cardiac arrest, say around the corner and that's okay.

You're only being alerted to it's like someone's shouting for help. And you may or may not hear that shout for help. The ambulance is still on the way.

So, that's alerting as opposed to dispatching, which is where if you are on duty, you are dispatched, and you are the resource that is going to help that.

So, it's really more, this is the function we're describing that it's the alerting function. Maybe people want to be on that and be notified of something that's near them that they can help with then that's fantastic, but there's no compulsion to go.

Paul Swindell: [00:10:18] And you mentioned, being dispatched by the ambulance service there.

So presumably you're integrated into ambulance, trust somehow. Cause presumably people, if they they're with someone and they go into a cardiac arrest, they should still phone nine, nine, nine, should they?

Professor Mark Wilson: [00:10:36] Oh, absolutely. and start CPR and get an AED. and non of that changes. This is just a supplementary thing, but yes, we're integrated with the ambulance services, pretty much across the UK.

and, as I say, I've got all across New Zealand, now large parts of Australia and all the parts of the world as well, and Africa and other places.

Paul Swindell: [00:10:53] And are we seeing any, well, you say you save hundreds of people. Do we see the benefits in the stats in the UK and these other countries at the moment?

Professor Mark Wilson: [00:11:03] So it's always very difficult to determine what cause and effect in this. So, there are many other initiatives going on in terms of, you know, increasing AED, prevalence. And, in other ways we're trying to improve all the way through to on-scene ECMO. So, there's lots of things that's trying to improve cardiac rest response.

And we're beginning to see some effects of that. I mean, it depends on where you look and it depends on how well, implemented the system is. some, some ambulance services are able to implement it a lot better than others. And I think it requires a huge amount of work too, in terms of public engagement to get a really good uptake of responders.

and then when you've got a high density of responders, that's where you start to see it making a bigger difference.

So if you take somewhere like ambulance Victoria, for example, in Australia, they've had really good campaigns and have got a very dedicated group of respondents on the system, working very well and some part of the UK that's similar to.

But in other parts it just takes a bit more and it's a bit more of a process it's just taking time to roll out.

Paul Swindell: [00:12:03] Does it prove to be more effective in, certain types of scenario in, in cities and things like that.

Professor Mark Wilson: [00:12:10] So, we haven't had the data to really be able to analyze it in any kind of confirmatory way.

And part of that is because we rely on ambulance services to follow patients up, we call it actually follow them up ourselves. And some of them have some very, very good at that. And some of them don't have the capacity to do that.

So, we're working with a number of institutions around the world, to try and analyze that data better.

Personally, I suspect, that it will have, we, we know of survivors in all circumstances, in your, in central London all the way through to very rural areas as a result of GoodSam and someone arriving sooner.

My personal thinking is, is that it probably makes a bigger difference in more rural areas because, they're the ones where an ambulance takes longer to get to.

And often in a village, for example, you might have a, I know policemen and off duty dentist, you know, dentists and other people around who can go and help look after that patient as an AED and local village postbox. or phone box rather. So, it can work in those sorts of areas. whereas in say central London, actually, there's a very fast, paramedic response unit that's going to come pretty quickly anyway. So I suspect the benefit is probably greater in more rural areas, but I don't know that.

Paul Swindell: [00:13:14] It would be interesting to find out when you get your data analyzed. Because I was speaking to professor Terry Brown of the out of hospital, cardiac arrest, registry outcomes, outcomes registry, sorry.

And he, he, they had a sort of sub project and, they found that AEDs placed within 300 meters of a school, I think it was, 40% of cardiac arrest cases could have been reached by that AED, which was quite a staggering sort of statistic, really, when you realize how many or how few of AEDs that are out in the public actually get used.

So, if they were placed better, we could use the more

Professor Mark Wilson: [00:13:54] There's a, I mean, it is, there is a balance about placing those in about an element of universality of them. So, for example, you take Heathrow airport, you know, your chance to survive that and Heathrow airport portrait over 80% because there's an 80 every other gate as opposed to 9% on the streets of London.

So, it's not just about placing, but it's having them cheap enough so that, so that they can be more liquid. They can be all over the show and that's going to happen over time and it definitely can happen.

Paul Swindell: [00:14:21] Definitely. earlier on my, our series, I spoke to, a maker of an AED called heart hero and then in the States, and they're hoping to bring one out, for about five or 600 pounds later this year.

And I've also since then spoken to another person who's producing a low-cost AED, which they hope to have for around. 200 pounds. So, when they start hitting that price point, I think we're going to start seeing them everywhere. And people will have them as her at domestic appliance as it were.

And I believe your system can cater for that?

Professor Mark Wilson: [00:14:57] Yeah. Yeah. So, we've mapped, we've met many, many thousands of AEDs. not only do we map them in terms of, static AEDs, we also track AEDs where people have an AED on them. They can see that they've got an AED with them and then. Our system will know where they are. And so I've mapped many sort of police cars that carry AEDs and buses that carry AEDs, we can do all that.

Paul Swindell: [00:15:17] Okay. How many AEDs do we have on your database and how many in the UK? Because I'll take it, your databases worldwide.

Professor Mark Wilson: [00:15:25] Yeah.

So, I haven't looked recently to give you the exact numbers, but we're talking in the sort of, it's not quite as a hundred thousand plus mark, overall. But I haven't looked exactly.

And also, it changes all the time because some people have them on them and some people don't have them on them. So the mobile one goes up and down a bit.

Paul Swindell: [00:15:42] You have got some other impressive stats on your website. I'm not sure if you're quite up to date with them or whether they are actually up to date, but you got almost one and a half million users and one and a half million alerts, I guess that's per year or was that overall?

Professor Mark Wilson: [00:15:58] What you're seeing there on the website is for everything.

So, as I said to you before, we're doing cardiac arrest is one thing we're doing a lot of other stuff.

In terms of cardiac arrest, we probably trigger to a cardiac arrest worldwide, probably once every three minutes whereas, there's a lot more other things going on.

So, the, probably the biggest thing we are doing is the three quarters of a million people who are volunteer responders for the COVID response, which you mentioned at the beginning.

So, we are deploying many, many thousands of people each day to, help other people provide either food or, collect pharmacy, pharmacy stuff, or check in and chat volunteers or deliver patients, hospitals.

So, we're doing lots of other things, connecting those in need with those who can provide in addition to cardiac arrest. So that, so it's not that what one, whatever it was is not all just cardiac arrest alerts.

Paul Swindell: [00:16:44] I can imagine that I was going to come on to that NHS responder. Now I can imagine, that was quite a challenge for you, to bring about a system like that in a very short space of time,

Has that been the challenge or were you already set up for that and did it have any impact on your current sort of systems?

Professor Mark Wilson: [00:17:03] No. So, so there's a couple of things going on. So, the NHS approach, they approached us because as far as I'm aware, we're probably the only geo locating volunteer system out there, as I say, to match those in need with those who can provide in a geolocatable manner. So that's why we were approached.

And our system was really around. Doing a cardiac arrest, but, and a few other things as well. so what they want to do is us to modify our platform, to be able to do, other responses specifically around COVID. And, so yes, we very had to very rapidly provide some functionality around that, but the system went live, and we've done any of these been absolutely fine.

And just to give you an idea, when we had the people the 3/4 million people, what was actually more than 3/4 million people that applied, the maximum rate of application, there were 4,000 applications per second of people trying to join the volunteer army. and we handled all that and put that through to Royal Voluntary Services who, who is your checkoff people and make sure there are, Any of the DBS checked or have uploaded their passport or driving license and that's how they got on the platform.

But so it was, it was busy. Yeah. We had to do a lot of work to get it all working, but it will work absolutely fine. If we go back three months, we didn't quite know which way COVID was going to go.

And in that, in the peak that's happened, there has been a huge amount of, volunteer effort and support of communities around them.

And some of that is going away a little bit now in terms of what people need. But actually its going to carry on, A, because COVID is not going to go away and also because people still going to need to shield if they're going to go into hospital or anything like that.

So, the system is still extremely active.

Paul Swindell: [00:18:37] I can imagine it provides a sort of a win, win scenario as well. For these people perhaps who have been furloughed or made redundant, it gives them a purpose to be able to help someone else. And, it gives them a way of giving back to society.

Professor Mark Wilson: [00:18:51] Yeah. And, and, and obviously I turned on where you are, because if you live in an area where there are, there's many community services, then actually this national kind of deployment thing isn't needed so much.

If you live in an area where there isn't much community services, then this is used hugely. So you do see a spread of people saying sometimes like, why haven't I been, why haven't I been used? Well, actually it's probably because either there isn't enough people around you, you need help or that you've got good community service around you, which is just fantastic.

But other people are being used extensively because actually they, they, there's not necessarily such a, such a, an availability around them as it is being used for all kinds of things are probably the biggest thing it's being used as far as just helping people who are lonely, check-in and chat, calls, to make sure that people just have a general chat and make sure that people who have been isolated for many weeks and months now, actually are at least, getting to socialize and, you know, just be active from a mental point of view.

Paul Swindell: [00:19:43] You talked about the other services, community volunteer services. Can you see this being a hub for all of those and bringing them all together so that there's just one place where volunteers are disseminated from.

Professor Mark Wilson: [00:19:55] So, yeah, that's happening in many, many ways. and it's. And yes, I can see that.

And there are some things that it's suitable for, and there are some things that it's probably not so suitable for.

So, I would just try to get an example and say, there's, you know, they're, there's still actually just looking off your neighbours, which you know, is a thing that everyone should do, but the world has changed somewhat over the last 20, 30 years.

And maybe. We haven't been looking after our neighbours as we probably did. in years gone past.

It may be that technology now is a way of doing that in the same way that Tinder is out there and who was out there.

Maybe, GoodSam is that the third sector?

And certainly, we've got many organizations on the, on the platform now, as I say, across the whole third sector, really who are providing, some of their services through this.

Paul Swindell: [00:20:39] You're not going to have the option on there to swipe right or swipe left on a cardiac arrest though?

Professor Mark Wilson: [00:20:45] It's not going to be either it's. So I mean, the thing about this is, is that it's a, it's a voluntary thing. So if you are able to get whether it is, whether it be cardiac arrest or whether it be helping someone, you know, collect their shopping or anything like that, it's all voluntary and the way the system is set up is that if you're able, you can go, well, that's fantastic.

If you're unable or you ignore it or you're in the shower, so you don't hear it or whatever it might be, then within 20 seconds, the next person closest will get an alert. So we'll keep moving through. So, it's not the end of the world. If you can't go there. We now have from a car from a point of view of, volunteers.

We have probably someone on virtually every street in the UK or in England, at least. So, actually you don't worry. there's plenty of people around and we're hoping to get that sort of level with cardiac arrest as well, and then that'll make a big difference.

Paul Swindell: [00:21:26] That's excellent. I mean, one of the things thing I see in that sort of cardiac arrest survivor community is, you know, people were saying, Oh, how, how the stars are aligned or everything was really serendipitous that there happened to be a, a doctor or a nurse who is driving by or someone who is near where you're going to make that even more of a reality really aren't you, because those people are going to hear. They're going to know about it.

Professor Mark Wilson: [00:21:50] That's the exact purpose of that is to increase the likelihood that someone will be there early. And if they're there a minute earlier, that's a 10% increase in survival. It's massive. So, and we're talking, you know, huge numbers as well. So even a small percentage of increase in survival, it will make a big difference in terms of numbers.

Paul Swindell: [00:22:07] I mean, you're not only getting people there quicker, but you also got a facility within your system that can do live video streaming, I believe.

Professor Mark Wilson: [00:22:16] Yeah. So this is a separate sort of thing. It doesn't require any apps and it's being used for lots of things other than cardiac arrest was being used by the ambulance services and the police services.

And it's the ability to open up anyone's cameras remotely. On their phone without the need for an app. So no need to download Skype or FaceTime or any of those things or Zoom. You just send them a link. They click the link, they get there when we can see what's going on.

And that has a huge implication for resource dispatch, because you can then see how sick someone looks or how big the fire is or the burglary or whatever it is that's going on.

And then, you know, what kind of resource to deploy.

So that's one aspect of it. It makes me is that you can get that quick. If it's more serious than you might have thought over and over the actual audio call, then you deploy a better, a more advanced resource more quickly and you can save resource for when you need it.

That was one aspect. But the other aspect of it is actually being able to utilise people who are around to provide earlier care. So that can be from anything from, Oh, look, you need to run your hand under the water. It's burned, for example, all the way through to cardiac arrest. And there's been some great work done in Copenhagen, which has shown that by opening up people's cameras, you can do video assisted CPR and you can advise the caller where to put their hands.

You're too high up.

You're too low down and start compression.

No, you're too fast.

You're too slow and play the metronome out loud since they can hear it.

So actually you can improve CPR quality by seeing what's being happening even before you get that. So again, there's lots of exciting stuff around the use of video in these areas.

Paul Swindell: [00:23:46] So you said you just sent the link. Does it, does the person need to have the GoodSam app on their phone already?

Professor Mark Wilson: [00:23:52] No apps. There's no apps and we locate them as well. There's absolutely no apps involved. That's the beauty of it is quick. It's under 10 seconds and you can see what's going on.

Paul Swindell: [00:24:01] That's fantastic. I can see that being a game changer, essentially. Isn't it? Like you say, in terms of CPR,

Professor Mark Wilson: [00:24:08] It very much is. And it very much in all fields of any kind of emergency and not just emergency batch evens or less acute. So people got a rash. Well, let's have a quick look. Awesome. Don't worry about that. That just looks like a, you know, or actually no, that could be meningitis or measles.

What it might be. You can actually begin to make a bit of better diagnosis.

Paul Swindell: [00:24:28] Are there any security concerns around that?

Professor Mark Wilson: [00:24:31] So now everything we've done is like, well, governance is actually top notch. Everything here is highly secure. So it's all TLS 1.2 ASU five, six encrypted GDPR requirements. It is absolutely, and to handle, you know, the many people we've had to handle for the, but the system is, security is absolutely a priority and it meets all the requirements that are out there.

Paul Swindell: [00:24:53] I see on your website; you're saying you're doing 80,000 videos a month. That's pretty staggering.

Professor Mark Wilson: [00:24:58] So that, yeah, so that's across everything.

So that's across, police, fire, ambulance, and also clinically as well.

A lot of people use this in a system that we run called as a, online consultation platform.

And it's a similar thing, almost the same thing, really. but more for hospital use and more for GP use and so that's, so yeah, it's always busy.

Paul Swindell: [00:25:19] I imagine that the GoodSam brand, as it's getting bigger and taking off is sort of opening up all sorts of other avenues for you. when you started this, did, could you ever imagine the sort of things that you're going to be able to do that you are doing now and also where's it going to take your next?

Professor Mark Wilson: [00:25:36] Yeah, so, I think, yeah, I think we did actually. I mean, we've been planning a lot of this stuff. For the, what we've been running this stuff for a long while the video stuff we've been doing for two years, way pre COVID, it's, culture change. And that's the thing that takes time. So, you know, we changed the culture with cardiac arrest response in terms of deploying or alerting, non-staff members and similarly video, a lot of resistance to video, but now because of COVID actually there�s a lot of enthusiasm for video.

So it's a, it's a, it's a combination of, Of what we develop and people being accepting of it. so, so, so we've been doing what we're doing for quite a while say, and then what we're doing in the future, there's tons of stuff now on, in the world of drones, and other, technological advances that very nicely integrate with what we're with the sort of platform that we have.

And so, yeah, so the future is really, really exciting, always innovating, artificial intelligence stuff. There's all kinds of things going on.

Paul Swindell: [00:26:29] What can you see any obvious wins that you're going to be looking for next?

Professor Mark Wilson: [00:26:33] If you look at, what makes difference in most things in medicine, it's not actually a drug, a magic drug running, anything that issue usually logistics or a system change.

So if you want to save cardiac arrest, patient more cardiac risk patients, it's not about, Adrenaline or a new wonder drug or anything like that. It's about getting people that are quicker to do CPR and to use an AED and then getting to the right hospital quickly to have that angioplasty or whatever it might be.

And so what we need to do is get this kind of platform out more universally, more people on board, improve the response rate so that actually everyone gets someone starting CPR within a minute and a half, two minutes and eighties. And then we can get up to the. Then you're getting into the cardiac arrest survivals that you have in Heathrow airport and things like that.

So, so it's not, it's not just about developing new stuff. It's actually about embedding, making sure that stuff that you have is being used properly and that's for cardiac arrest.

And it's the same for video, its there, people need to use it, people need to come skilled in using it. And then they will be better at deploying people deploying on giving advice over the over video. So, actually embedding some of that stuff is also really important.

Paul Swindell: [00:27:43] Some of the other places where they have got very good cardiac arrest outcome, success rates, like in the Scandinavian countries and Netherlands and Seattle County and in the States are they using technology like GoodSam? Are the other equivalents of it, or you're going to get into those?

Professor Mark Wilson: [00:28:03] There are other people around who are doing similar alerting systems.

Anything, I would say that's different about GoodSam is, is that ours is really highly governed by that. I mean, you know, everyone is on the part when he's know, you know, who they are. So it gives the ambulance services here in Australia and New Zealand and other places, the confidence to use it, not just for public, but for private addresses as well.

And, so, so yeah, but there are other places that are doing, versions of a similar sort of thing.

Paul Swindell: [00:28:29] You talked about all the AEDs that you've got on your system can people is it's a common thing that people want to see where they are on our map.

And I know there is a British Heart Foundation and NHS initiative to, "the Circuit" to build this map. But I think it's only available for the ambulance trusts.

You've got ads on your map, and I know you can see them within the map on your app, but can people see them outside of the app?

Professor Mark Wilson: [00:28:58] So if you download the GoodSam alerter app, which is a way of triggering the platform, if you're with someone who, I mean, cardiac arrest, as well as dialing nine, nine, nine, nine, nine, nine nine for you that displays the AEDs, on a location based way. So you can see the AEDs that are around you.

Like all things do with data, there's governance processes and, consent issues around who owns that data. So I say, I would say we map it all, but actually we gave all that data away to the statutory ambulance services for the region. and then they let us display it.

But we just buy in a location-controlled way. So it's not a massive map that, someone could potentially, for example, then contact all the people who hold AEDs and try and sell them new AEDs and things like that. It's not for that reason. It's is a controlled data. And it's not our data to show you really, as I say its the ambulance services.

And we, our advisory board goes through how we do that. So, yes, you've downloaded the alert. You can see where they are. but it's not a big map of the UK or anything like that.

Paul Swindell: [00:29:54]

And my last question, which you sort of answered, it was going to be..

What is success in 10 years time?

What, what would be a, you know, the champagne popping and all of that sort of stuff for you?

Professor Mark Wilson: [00:30:06] Well, we haven't really thought of like an end point.

It's more just, making sure this gets embedded and used well, and to be honest, we get a shot at champagnes or feeling every time we hear of someone who survived, that's just amazing.

So, the more that happens, the better, I guess. And, you know, when we start seeing big differences in the numbers of survivors, and that can be attributed through the system for cardiac arrest, then that will be fantastic, but there's many more things.

Cardiac arrest is one part, as I say, but actually people who have epilepsy or shortness of breath or people are getting, I know in an assault type situation, they are using video for the police and they stop the assault.

There's many other things apart from cardiac arrest that actually where benefit it can be given as well and lives saved, many lives saved actually through this process, not just cardiac risk, but the cardiac arrest is all is where we started. And, it's always very, very special and core to everything we do.

Paul Swindell: [00:30:58] Fantastic Mark. And thank you very much for your time. And I know you're a very busy man and thanks very much again for letting us know all about GoodSam and I hope many people who are listening will go and have a look at the app and sign up for it if they're qualified or if you're not qualified, go and get a qualification.

So, thanks very much, Mark again.

Professor Mark Wilson: [00:31:15] Thank you Paul.

If you enjoyed this podcast please do leave a positive review on Apple or other podcast providers as it helps us to spread the word.

Presented and edited by Paul Swindell.

Recorded June 2020. 

Saving my father with Mark Holt

In episode #49, Paul talks to son and lifesaver Mark Holt about his father’s cardiac arrest in a remote Lake District pub. Mark takes us through the event that occurred soon after his seemingly fit and healthy father had completed a run and a walk up the Old Man of Coniston.

Just an hour before the event

Mark talks about his work as a carer and how the experience of doing CPR in a medical environment differs from doing it on a family member far away from a hospital. He talks about how it has affected him and his family, his dad’s recovery and how a previous stranger’s cardiac arrest effectively saved his dad’s life.

Available to listen on the link below or Spotify, Apple , Google, YouTube and your favourite podcast player.

If you enjoyed this podcast please do leave a positive review on Apple or other podcast providers as it helps us to spread the word.

Presented and edited by Paul Swindell.

Recorded June 2020. 

When My Heart Stopped

On Sunday 16th March 2008 my heart stopped, this isn’t a romantic story of where I fall in or fall out of love. On this day the hardest working muscle in my body suddenly stopped working, I suffered a cardiac arrest.

We all live life a little blindly, we learn from an early age about death, but for many years we’re shielded from it by our parents, then when we do understand it, we don’t talk about it. We accept that death will happen to ourselves one day, but that day won’t come for a long time so why pursue it?

Our first experience of death for some can be the death of a family pet, some parents may purposely buy a pet with a short life span, for example, a hamster, a rabbit. For the child to grow a bond with the animal for well known in a couple of years that pet will get sick and die, then you can introduce your child to life and death. You can explain that it happens to all beings, we all die and this pain and sense of loss your feeling will dissipate in time but your memories never die. (That too can be a lie!) We can’t control death, even when we put plans in places it sometimes can bite you in the ass before you can say boo to a goose or bury your cat at the Pet Sematary.

I had a different introduction to death, it was through the world of horror movies from the 80s, I watched my first horror film at the age of six, blame it on bad parenting if you must. I wouldn’t go to sleep, my parents tried with all their might, they weren’t going to win this fight, so my dad caved in. He sat me down and explained to me that all this is make-believe it is not real, with that said my dad popped the VHS tape of Friday 13th into the VCR and pushed play “Kill her mommy, kill her.”

Death is not make-belief, death is unforgiving, in the summer of 1992 my grandad passed away after losing his fight with cancer. I remember coming downstairs, my mum was on the phone sitting on the third step from the bottom, she broke down in tears with the handset resting between her head and shoulder, I don’t think she heard me coming down the stairs.

When she realised I was behind her, she wiped her eyes with the back of her sleeve and apologised. I never understand why adults have to apologise to a child for crying in front of them. She then went on to tell me that grandad had passed away, she explained to me that she didn’t know how she was going to tell dad. I didn’t know at the time that my father wasn’t good at handling grief, a couple of years before I was born one of my dad brothers committed suicide after being jilted, this sent my dad off the rails. She was worried that losing his father would bring on a repeat performance and this would be the final straw that broke the camel’s back.

Surprisingly my dad coped well with the news, he did break down a couple of times that I remember, mum also made sure that me and my brother were out playing when she broke the news to him. My dad coped because he had mentally preparing himself for this moment, when you find out someone got an illness you start preparing yourself, you get to say goodbye and bury the hatchet so to speak. With death there is the aftermath, the bringing people together, the fallouts that can follow and the grief, it is a process that we all have to navigate at some point in our lives.

So back to Sunday 16th March 2008, I entered the Hastings Half marathon, the year before I completed the London Marathon, and I vowed never to run again. A few months later an opportunity for the New York Marathon 2008 came through in an email from CF Trust (Cystic Fibrosis), then the itch to run returned before I knew it I had applied and secured my place for New York. I made an oath to myself to take training for the marathon seriously, so I rejoined the job shop running group that ran every Sunday and decided that Hastings Half Marathon would also be good preparation for the marathon. I nearly didn’t run Hastings, I had a cold the week before and I wasn’t feeling the run, but then my manager put me in to work on that Sunday. I had requested to have that day off for the half marathon, so I refused to work, my decision was made.

On that Sunday I caught a lift to Hastings with another runner I met through Brighton Jog Shop run group that was also running that day. I’d never been to Hastings before, it was a warm day, overhead gloomy clouds carrying a mist of fine rain the sky, the perfect weather for a run and not a pre-warning of what was to come!

I remember having to pee on the beach as the portable toilets queue was long and I didn’t want to miss the start. At the starting block, I chatted with fellow runners, then I started to construct a message that I would send to a group of friends. I won’t lie, I’m an attention seeker, I wanted people to know that I was running and when I finished the half marathon I wanted to see who responded. The message was the following…

“Hey Everyone I’m running Hastings half marathon today. It starts at 10.30 and I’m feeling nervous. Not good, something not right so wish me luck”

One hour and forty-nine minutes later I collapsed at the finish line.

I don’t remember running that day.

I don’t remember the crowds.

I don’t remember the St John Ambulance doing compressions on my chest, being taken away from the crowds to a tent to be given defibrillation treatment.

I don’t remember the blue and twos of the ambulance driving me away to my isolation.

I don’t remember yanking out the endotracheal tube.

Through all this mentally I was asleep, and then I was put to sleep.

Whilst I was fighting for my life in an ambulance, wheels were set in motions, my emergency contact on the back of my race number was contacted. My sister Debbie was my emergency contact because she is level headed and would know what to do, thankfully on that Sunday, she was visiting my parents. They were in the pub when she got the call, the police informed my sister what happened to me and gave the stark warning by the time that they would get there I could be gone. I am unable to fathom how my sister drove the 1hr 33 minutes to Conquest Hospital with my family in the back of the car, discussions of my funeral were made on that journey, followed by stony silence.

As I write this I get cold at this notion, that those discussions were made, for a moment I was considered already dead.

The police would make their rounds, first visiting my home, my housemates were informed and the police searched my room. They searched my room because they hoped to find a reason to why a 26-year-old had a cardiac arrest if there was a reason to be found.

With no reason found, they escorted my housemates to the hospital blues and twos all the way to Hastings from Brighton. Officers visited my place of work to inform my manager what had happened to me; my manager joked to me at a later date that he thought I’d been arrested when they first approached him.

As I laid in ICU (intensive care unit) for a couple of days, my family would surround my bed, willing me to pull through. Questions were asked, family history discussed, no answers could be given, plenty sleepless nights for all concerned. Warnings were made that I could suffer some form of brain damage, my brain was starved of oxygen for over 7 minutes. If it were not for the fast thinking actions of St John Ambulance delivering vital defibrillation treatment I’d not here.

On Tuesday 18th March specialist decided it was time to bring me out of my medically induced coma and put me on the cardiac ward, my home for the next couple of weeks. Tuesday was a dreamy haze for me as I faded in and out of consciousness. I remember seeing my parents sitting at my bedside, I was wearing a hospital gown that barely covered my modesty. In this druggy haze, I remember this bothering me more than anything, I remember pulling down on my hospital gown several times, I didn’t want people to see my junk especially my parents. That evening sleep was restless, I remember I kept thinking I was in one of those horror movies that I love to watch, a nurse from New Nightmare, surely “One, Two, Freddy coming for you!”

Wednesday 19th March fully awake from my induced coma, welcomed into my New Nightmare with Sweep (cuddly toy) beside me. Having Sweep reassured me that I was alive, Sweep a childhood toy that I have cuddled every night throughout my life and my sister had her senses to get him for when I woke. I was fully aware that I was in a hospital, I had all these wires attached to me, beeping monitors, nasal cannula, catheters in my arm and an intravenous drip to treat ailment (chest infection) brought on by the cardiac arrest.

When I switched on my mobile messages wouldn’t stop coming through, finally getting that attention that I craved before starting the half marathon. Once awake my parents went home, knowing that their baby boy alive to live to tell his tale; I wouldn’t see them again throughout my hospital stay. My sister would visit when she could, though living in Kent and, life goes on even if you nearly lose your brother.

One of the first things I remember doing is calling my place of work to make sure that my manager had sent payroll; payroll was one of my responsibilities. He reassured me that he had sent payroll, that I had nothing to worry about, the company agreed to pay me throughout my recovery. With a million and one worries swimming through my head at least he put one of my worries at ease, still, I didn’t know if I could work again and how far that kindness stretched.

The first few days were a haze of information, it would be explained to me that I had suffered a cardiac arrest and at some point that I would have an operation to have an ICD ((Implantable Cardioverter Defibrillator) implanted in my chest. Before that procedure, they would like to do some investigations on me to understand what happened. They wouldn’t be able to start any investigations until I recovered from my chest infection, so for the time being Hastings would be my home. They handed me pamphlets to read to help me understand what happened, one was happily titled “When a young person dies suddenly”, but I hadn’t died.

People had commented on how I took everything in my stride, how I accepted it, honestly not sure I had, a part of me went into autopilot, happy to be alive, slowly crumbling inside.

Throughout all this time my mind would run through a million and one concerns, would I be able to run again?

Will I be able to work?

What does mean to me going forward?

Will anybody love someone that could suddenly drop dead?

I would question what if in my life, what if I didn’t run the Hastings?

Could I have collapsed on a run on my own?

Why did this happen on that Sunday?

How did my body know to get to the finish line where people were there to save me?

It makes you question everything about life and death.

Questions that nobody can give the answer and sometimes it’s easier not to explore ‘cause otherwise you’d go crazy.

I’d easily get upset, being attached to all these monitors, my independence stripped relying on the nurse’s call button if I required anything. I’d get upset if I needed the toilet and the commode was rolled over to me, especially because nurse Ratchet was happy to unplug me from all these monitors and let me use the toilet on the ward, so why couldn’t nurse Wilkes? Why do I need to leave my bed? She not keeping me here against my will with a sledgehammer to the ankles.

Needing a pee, a pulp disposable urine bottle was brought over, curtains drawn. Sometimes they would wait for you to finish your business, other times they would leave you and not return which felt like an entirety with your business stewing in your private enclosure.

Privacy a luxury, being on a ward curtain closed meant a few things, toilet, sponge bath, or the nurse doing their rounds. Forget self relieving, my little friend popped up a couple of times, yet there was nowhere for him to go, even with the curtains closed, the sounds of the ward are a boner killer.

The nurses would do their rounds every 4 hours like clockwork to take your vitals blood pressure, ECG(electrocardiogram), and sometimes they would take your blood for good measure. On one of these occasions when putting in a new catheter a nurse severed a nerve in my hand, which resulted in pins and needles in the palm of the right hand to this day! Taking vitals were like a ritual for some nurses, some would wake you up in the night to take your vitals, others would let this sleeping beauty sleep.

Being in Hastings I was too far for many people to visit.

Yes, I had other bedfellows, being in a cardiac ward these people were all from a different generation. 12 years on these bedfellows have all surely now moved on! I remember one of my bedfellows passed away next to me one night, I asked the nurse the following day what happened, she said he was moved to another ward, the noises from behind the curtain told me a different story. I befriended a couple of people on the ward, I remember going over to lady that had a room just off the ward, we would play cards and drink tea, these were the things that broke up the days for me.

I became a minor celebrity on the ward, the BBC South East News came to interview me from the bed. That evening the nurses on the ward rolled the TV down to the ward so we all could watch the news. I remember the next day a kid came to visit his grandad on the ward and was pointing at me because he’d seen me on the TV. I also made the front cover of the Hastings Observer with my finishing brass medal looking gravely ill; I keep a copy of this edition in my memory box at home.

Back then wi-fi in hospitals wasn’t a thing, Debbie purchased me a dongle so I could go online. I had a bucket load of DVDs including my favoured Friday 13th collection brought to me from home that I watched on my laptop, “Kill her mommy, kill her”.

Lights out on the ward at 10 pm so having to be considerate of others, yes I would plug in my headphone, still fully aware of where I am at. During this time I had to keep myself busy, I posted blogs online telling people what had happened to me. A mother contacted me after reading one of my blogs, she told me about the charity C-R-Y (Cardiac Risk in the Young). Here I am 26 in hospital after having a cardiac arrest and nobody was telling me about the support out there.

I called people, I made an effort to talk to people, I reached out, wanting to be heard.

You learn very quickly during this time the people that matter, or at least you thought that mattered.

I hated missing out on things, I had tickets to the X-Factor tour that I had to give away to my brother, I missed out on watching Wrestlemania with my friend Nick, Easter holidays, life outside this building.

It would be two weeks before respite would come, finally recovered from my chest infection, and the Easter holidays had come and gone, investigations would begin. To get to the bottom of why I had a cardiac arrest, a day trip to the Royal Brompton Hospital in London via a private ambulance was arranged. On the motorway, nurse Ratchet promised that we would stop by a hot dog stand, so I could have a hotdog.

After a couple of weeks of hospital food, that greasy hotdog smothered in ketchup, mustard and onions was like an orgasm in my mouth, small blessings.

At the Royal Brompton the only test that I remember having was an MRI (magnetic resonance image) scan, laying on the bed slowly entering this tube, being told to breathe, hold my breath, as they took scans of my heart. It is very surreal, feels like something out of a scientific film; the technician informed me that I’d fallen asleep.

The next day when back in Hastings I was informed I had a condition called Brugada Syndrome; in the next couple of days, I would finally be transferred to Royal Sussex County hospital to the ICD implanted.

Brugada Syndrome at the time and still is a relatively new disease, founded in 1992 by Spanish cardiologist Pedro Brugada and Josep Brugada who reported it as a distinct clinical syndrome. The genetic basis of Brugada Syndrome was established by Ramon Brugada in 1998. My cardiologist explained that they are still learning about this condition and that they will be learning from people like me. The normal heart has four chambers. The two upper chambers are known as the atria and the two lower chambers are known as the ventricles. Electrical impulses cause the heart to beat. In individuals with Brugada syndrome, the electrical impulses between the ventricles become uncoordinated (ventricular fibrillation) resulting in decreased blood flow. Decreased blood flow to the brain and heart may result in fainting or sudden death.

Brugada syndrome occurs worldwide but is seen more frequently in individuals of Southeast Asia and Japan. Families would usually find out about Brugada after a sudden death in the family, Brugada usually presents itself whilst at rest/ sleeping. I was an interesting case because I hadn’t a cardiac arrest whilst sleeping/ at rest and I wasn’t Asian, for many years I would question my diagnosis.

Sunday 6th April I left Hastings at 8 am for Brighton via another private ambulance. To be back in Brighton was a relief. There was no time to rest whilst in Brighton, my procedure was booked for the following morning. A doctor named Paddy came around, he checked my breathing, and talked me through the procedure, trying to put me at ease. Then he brandished these consent forms for this procedure I had to sign, one bullet point mentioned death. Death wasn’t likely but it was there to sign, like a bullet to the heart. I would have a couple of visitors throughout the day, they all became a distance blur has death loomed over me. I came this far, yet the fear of death and not waking up from this procedure was eating me up like cancer from the inside. I called my parents that evening, I’d hope they would put me at ease, my dad cries and the tumour feeds itself.

Surprisingly that evening I was able to sleep, waking up at 5.30 am so I could have some breakfast, it would be the only food allowed before the operation. Once digested I put my head back down, I didn’t want to be awake, that would leave me more time to stew. At 8 am I would finally rise from my slumber, throughout the morning nurses and doctors came in and check on me, getting me ready for my procedure. I would shower, dried myself off and then I showered again, I felt uncomfortable in my own skin. I tried to call my parents, no answer, maybe that was a good thing, but it wasn’t I was going out of my mind waiting for my time to come.

The porter arrived to take me down to the operating theatre, this was it and I wasn’t ready, I don’t want to die and I didn’t get to say goodbye to my parents. Once in the operating theatre, I had to get onto the operating table, the room was clean and clinical.

A solitary tear rolled down my cheek, fear escaping my tear duct, a nurse tried to reassure me that it was going to be alright. My memories of this procedure are vague, slightly aware because I was only given a local anesthetic combined with sedation. I remember seeing a monitor and on that monitor, I could see a beating heart, my heart. Seeing these two wires approaching, then entering the chambers of the heart on the screen.

Then I find myself awake in my room, it is 4 pm and I wasn’t dead, and maybe for the first time in three weeks, I believed that I will be alright.

My room was full of people, I planned for many to visit because after all these weeks I was starved for company and maybe subconsciously after my operation, I didn’t want to be left alone with my thoughts.

Maybe having so many people visit I overwhelmed myself, after having an X-ray to check the placing of my new gadget, I would throw up my guts in front of a couple of my guests.

That evening I was left with thoughts, it had been over three weeks since my heart stopped; the very next morning I was released from the hospital to start my new chapter!

A couple of day after my ICD implantation