How shock tactics came to Britain

January 14, 2014

When someone goes into cardiac arrest, every minute without CPR and defibrillation reduces their chances of survival by ten per cent.

Because of this, defibrillators that anyone can use – also known as AEDs – now decorate the walls of most of the UK’s big public buildings and transport hubs. This vital piece of kit can be used by virtually anyone – as long as they can follow simple spoken instructions. But this wasn't always the case...

Doug Chamberlain

The history of defibrillators

Just over 25 years ago defibrillators were the special province of medical professionals – and even they were a little suspicious of them. This was despite the fact that the newest machines could only deliver a shock to the heart if it was absolutely needed.

So while the United States invented the automatic defibrillator, England was the first nation to put them to the test – but even then only by a small number of medical professionals.

This wasn’t the way it was supposed to be. These machines had been invented so that anyone –medically trained or not – could help resuscitate someone in cardiac arrest, but the medical profession didn’t want to let them out of their sight.

Some were not afraid to prove that public access to these defibrillators was not just desirable, but absolutely necessary if more people on the street were to survive a cardiac arrest.

A legendary pioneer

Founder of the first paramedic unit in Europe, Douglas Chamberlain has dedicated his career to pioneering the resuscitation techniques that now save lives every day.

Some were not afraid to prove that public access to these defibrillators was ... absolutely necessary if more people on the street were to survive a cardiac arrest.


Hitting on the idea of using the British Transport Police at Victoria and Brighton railway stations as guinea pigs for his defibrillator scheme, Dr Chamberlain and his colleagues set up a scheme in 1989 that saw dozens of police officers trained in using a defibrillator – with the help of the British Heart Foundation, who donated £18,000 for the purchase of the units. During the two year programme, five people with cardiac arrest survived to leave hospital when they otherwise would not have done.

So far, so good. But the plan to get more defibrillators in use stalled when a series of freak accidents, including a lightning strike that destroyed a computer storing valuable data and its backup, prevented the results from seeing daylight.

As the police they trained moved away to other posts, the defibrillators at the stations fell into disuse.

Back to the future

Tom Quinn

About a decade later while walking through Victoria station with an American colleague, Dr Chamberlain decided to ask a duty officer if the defibrillators were still in action.  They found one and it was covered in a thick layer of dust.  He decided then and there that the scheme should be brought back to life, but his quest was to take more twists and turns than a Hollywood thriller.

First, Dr Chamberlain faced a series of bureaucratic rebuffs from a reluctant Chief Constable.

Undaunted, he turned to his friends for help. Tom Quinn (right), a CCU nurse  who worked in the Department of Health was one; he happened to meet the Chairman of an Ambulance Trust and learned that he had recently been on the Board of Network Rail and thus had links at senior level to the British Transport Police.  John Nelson agreed to join forces with them and requested that the Chief or his deputy should meet with them.

Shock tactics

The plan was simple: shortly after the meeting began, John Nelson clutched his chest, groaned, and collapsed to the ground.  Dr Chamberlain rushed into action.

He was immediately convinced and got on board with the plan.


‘Quick! He’s dead. Do something!’ he cried, handing the defibrillator he had brought with him to the deputy Chief Constable.

With some trepidation, this gentleman opened the device and followed the spoken instructions the defibrillator gave him.  He undid Mr Nelson’s shirt and placed the electrodes on his chest. Just as he was about to press the button, Douglas intervened. ‘Stop, that’s fine! Oh, and John, you can get up now’.

John Nelson had been faking it, but the deputy Chief Constable had just set up a defibrillator in 55 seconds – and he’d never seen one before. He was immediately convinced and got on board with the plan.

The end of an era… and the beginning of a new

It was a slow start. A grand total of six new defibrillators were donated for the new programme. But before they could be delivered, Tom Quinn intervened again.  He was asked to write about the concept of public access defibrillation for the White Paper “Saving Lives”.  This, and the influence of his colleague Stephen Waring, influenced Frank Dobson, then Secretary of State for Health to instruct his Parliamentary Private Secretary to telephone Dr Chamberlain to tell him that he would be receiving 300 defibrillators, enough for all the railway stations in England.  In vain, Douglas protested he didn’t need that many and had nowhere to put them, but he was told that Mr Dobson would not be deterred.

After some urgent phone calls to the Resuscitation Council, the Department of Health, and the British Heart Foundation – the National Defibrillator Programme was born in 2004. 

A happy ending?

From 300 the numbers of defibrillators needed rose steadily – first 672, then 3,000. By the end of the programme, more than 5,000 life-saving machines were ordered.

Now, thanks to the hard work of Douglas, Tom (now a Professor at the University of Surrey), and their colleagues, defibrillators have a place in virtually every transport hub and large public space in Britain, giving people who have a cardiac arrest a much greater chance of survival.

The British Heart Foundation alone has helped place more than 10,000 defibrillators, and more are being installed all the time. Find out if you’re eligible for help with funding a defibrillator in your area.

Douglas Chamberlain and Tom Quinn would like to thank the following people who helped to make the widespread adoption of defibrillators possible:

Acknowledgements

The original defibrillator scheme depended also on Dr Richard Vincent, Dr Thanyani Mariba, Matthew Saunders of the British Transport Police, the late Dr Denis D’Auria of London Ambulance, and the late Mr Dusty Millar who helped with training. 

Mr John Nelson not only played a vital personal role, but also chaired a committee to choose pilot sites and formulate other aspects of the National Defibrillator Programme that was run with impressive expertise by Sian Davies (now Mrs Sian Block MBE) and her colleagues, not least. Professor Sir Roger Boyle.

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