Nigel Sillis

Fairly recently I was in my very late forties, I’m married to my wife Debra and we have two teenage children, Gabrielle and Liam. We are a fairly active family, we try and eat healthily, take exercise and look after ourselves. We have busy lives but we are a normal busy family doing all the normal kinds of things that normal busy families do.

It was 19 May 2018 and my last recollection of the events of that day was having breakfast with Debra, the television was on in the kitchen and we were watching guests starting to arrive in Windsor for the royal wedding. The Beckhams and the Clooneys arrived within a few minutes of each other – I don’t remember anything else that happened that day. Everything that I’ll tell you from this point onwards is mostly pieced together from Debra’s recollection, from witness accounts or from the operational reports of EAAA.

Debra had said that she wanted to watch the wedding on the TV, I wasn’t that interested. So we decided that I should go out on my bike and that we’d meet up later on in the day. I’d planned a route of approximately 50 miles. At 13.25 the bike computer recorded my speed falling to 0 mph. Without any pre-existing medical conditions or warning signs, I’d suffered a cardiac arrest whilst cycling along.

This is where my ‘chain of survival’ started. Depending upon exactly which organisation is describing the chain it has 4 or 5 links, it is a set of pre-conditions, activities and interventions that are all essential in ensuring that a patient suffering from a cardiac arrest survives their experience.

Link 1: Early access – the importance of early identification of the problem and immediate attention to the scene.

By an incredible stroke of fortune, and despite being in a very rural area, there was a group of pedestrians on the road close to me. One of these pedestrians was a qualified doctor. Dr Pete Hodkinson. Dr Hodkinson immediately diagnosed what had happened, disentangled me from my bike, and called upon another bystander to make a 999 call.

Link 2: Early CPR – the critical importance of the earliest possible commencement of CPR

Pete commenced CPR and the 999 call was made at 13.26. Whilst CPR was continuing, land ambulance services were despatched to the scene. Assistance from EAAA was called at 13.29. The helicopter lifted at 13.33 and arrived at the nearest safe landing site in an adjacent field at 13.38. Pilots Andy Wray and Dave Surtees were at the controls that day.

Link 3: Early defibrillation – CPR alone cannot revive a patient that is clinically dead. Defibrillation is required to restart the heart into a normal rhythm. The earlier that this takes place, the higher the patient’s chances of survival become.

Dr Sarah McNeilly and Critical Care Paramedic, Tim Daniels, were by my side at 13.41 only 15 minutes after the first 999 call was made. Dr Hodkinson had successfully maintained me with a shockable heart rhythm for almost quarter of an hour, I now had all the expertise and advanced life-saving equipment I needed by my side. Dr Hodkinson continued CPR whilst Dr McNeilly prepared for defibrillation. I was revived with two shocks.

Link 4: Early advanced care – the hand-over from on scene Emergency Services personnel to in-hospital critical care providers. The sooner a stable patient can be transferred to hospital the higher their chances of survival are.

After defibrillation, Dr McNeilly prepared me for transfer to hospital. From the helicopter’s onboard inventory she had access to electrocardiogram and ultrasound equipment, she commenced intravenous administration of medication and intubated me in order to be able to control my breathing. A general anaesthetic was administered. Dr McNeilly liaised directly with Papworth Hospital before I left the scene. Papworth was not the nearest hospital but it was the best choice for direct access to post-arrest care.

I was maintained in an induced coma for 36 hours. Oxygen starvation had caused me some modest liver disfunction, I had also suffered from a collapsed lung. I woke up with the most excruciating chest pains from the cartilage damage on my rib cage that is an inevitable side-effect after experiencing effective CPR. But my rapid progression through the ‘chain of survival’ ensured that I suffered no permanent vital organ damage and importantly no neurological disfunction.

Since then I’ve undergone two cardiac procedures during a seven day spell as an in-patient at Papworth, completed out-patient cardio rehab and started to return my life back to normal.

My bike survived its fortnight in the care of the lost and stolen bike store at Cambridge police station (which is a real Aladdin’s cave of treasures as you can imagine). It’s now fixed up and I’ve been back on the road, albeit maybe at a gentler pace and with less ambitious mileage than I previously undertook.

In the Cardio rehab department at Papworth there is a CPR demonstration poster. The strapline at the bottom of the poster is disarmingly to the point. It says; “Start CPR – you can’t make things worse.” Remember the first three links in the chain of survival are activities that any bystander to the incident can complete.

The more members of the public that you pass by, the more colleagues that you work with, the more volunteers in the community groups that you associate with, that have had CPR training will mean that if you encounter a cardiac emergency, the patient is more likely to successfully pass through the first three links in the chain of survival. And, by keeping the East Anglian Air Ambulance flying, those patients can benefit from the promptest possible deployment of the expertise required to complete link 4.