Ringing Forums

Our (not a cathedral) nearest defib available in the evenings is half a mile away uphill at the railway station, and we have a fairly long and narrow staircase. Getting the defib to the casualty would not be quick, and neither would the arrival of paramedics/evacuation of the casualty (it requires the Hazardous Area Response Team specialists and our practice exercise with them took ages to extract the 'casualty', so not going to help in a heart attack situation).

We've taken precautions, such as signage with the tower with the address of the tower and location of the station's defib, instructions to remind 999 that the HART will be required for casualty extraction, and ensured that the ambulance and fire services have information about the constrained access in their despatch systems. Any visitors are advised of the access situation and to consider any medical conditions they may have before going up the tower.

To be blunt, if someone has a heart attack in many towers in this country, their odds aren't going to be great, particularly if there are not people able to deliver CPR in the tower. However, having a defib in your vestry is probably a better situation than many towers will be in. Defibs are not cheap, so I can understand their reticence, although it would be ideal to have one up the tower.

would involve training for it to be used

This is apparently a common misconception. We were trained at work that you don't need training, as nothing bad can happen from using the machines when they don't need to be etc, and machine will usually talk you through what you need to do.

The fear is that, somebody has a cardiac arrest and nobody uses the AED that is there because they think they need to be shown how to use it. So the patient dies.

I can see why the cathedral would say the cost is too much when they already have one in the building. Not sure what the disclaimer is for that visitors are issued with; you can't indemnify yourself against any issues that would be covered under the Health and Safety at Work etc Act and as long as the number of steps is signed at the bottom, then surely it becomes the responsibility of the person undertaking the ascent to be satisfied they can climb that number of stairs.

I have been involved in the installation of two automatic defib units, one in our small village and one at a local retirement home. Both are mounrted externally and consequently need a mains electricity supply to maintain a 10w heater element that minimises the risk of condensation inside the cabinet. A dry tower with no damp problem may not need this. The units cost £1200- £1500 each.

The units need to be serviced after each usage - check batteries, adhesive pads etc. You need to establish a maintenance routine checking the batteries every few months.

Training was absolutely not a problem. our County Fire Service provided free hour-long training sessions with every installation. Don't be deterred - go for it! It may be worth inviting representatives of your Dean & Chapter to try legging it from the ringing room down those 200 steps and back again - and please ensure that they bring the defib up with them - they'll need it!

Thank you - I have passed your comments on to our Cathedral Head of Estates and asked for our request to be reconsidered. We (the ringers) also conducted an experiment and timed a trip from the ringing room down the steps, across the cathedral to collect the defibrillator from the wall in the vestry and run back up - it took 10 minutes! Not a good prospect for someone suffering heart failure int he ringing room!!

Another option, either instead of or in addition to the installation of a defib unit is to arrange for ALL regular members of the team to attend a CPR course. You will need this expertise to aid the resuscitation of the casualty after applying the defib shocks. Without the defib unit, well maintained CPR may stabilise or conserve the casualty while someone scampers down to collect the defib unit from the nave and professional help arrives.

You should find that your local Fire & Rescue Service can provide CPR training free of charge to a group. And you will still need the CPR knowledge to follow-up the defib shocks and keep the patient alive.

A quick thought: 10 minutes is far too long if someone's heart has actually stopped; 4-6 minutes is the quoted survival time before irretrievable brain damage occurs. CPR is "an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest" and might bridge the gap between heart failure and the arrival of the defibrillator. Can you try to persuade the authorities to fund a basic first aid course? If a requirement for a qualified first-aider is part of your risk assessment then the authorities would be in a very difficult position if they do not comply.