As some of you may know, my bike club the Wolds Bikers is a charitable club whose fund raising exploits are mainly in support of L.I.V.E.S the Lincolnshire Voluntary Emergency Services. This group of people provide support to the paramedics free of charge and in their own time, individual members are known as 'First Responders'. Over the years since the club was formed (2003) we have raised many thousands of pounds to support the L.I.V.E.S teams. Last Monday one of the L.I.V.E.S reps came down to our club to tell us a bit more about the way the First responders work. Quite a bit of the information came as a surprise to many of us.

Most of us were under the impression that the Responders were called out to any accidents, in their area, to provide initial patient care until the Emergency Services arrived. To some extent this is true but the prime raison d'etre of the teams is actually to provide vital initial care for people who have suffered some kind of Cardiac problem. In our our county, if I remember correctly, there are something in the region of 100,000 call outs a year. Assuming a heart attack, after the first three minutes there is a 10% higher probability of death for each successive minute without medical attention. First Responders of the L.I.V.E.S teams aim to attend a call out within five minutes of notification and will care for the patient until the paramedics and ambulance arrive.

The scheme was started in 1975 by four doctors who realised that there was a need for some sort of quick response service that could attend a patient in the period before the paramedics could arrive. In their area they provided this service in their own time and free of charge. It was soon realised that a larger coverage would be highly beneficial and so, gradually, the concept of L.I.V.E.S. was conceived and put into effect in Lincolnshire.

There are currently 86 teams of First Responders across Lincolnshire and moves are now afoot to link into similar teams working within other counties on our borders to provide, where necessary, some cross border support.

Some of the things that surprised us;

The prime piece of equipment used by the First Responders is the defibrillator. We have all seen them on the television, cries of 'He/She's arrested, out comes the defibrillator, two pads on the upper chest, 'Stand Clear' two or three shocks and the patients heart starts to beat again, right? - wrong!.

Actually the purpose of the defibrillator is to STOP the heart not START it. The defibrillator does exactly what is says on the box, it stops fibrillation which is where the heart, having suffered a trauma, is quivering erratically (Fibrillating) rather than pumping blood. The shock from the defibrillator actually stops the heart - after a few seconds the brain thinks, 'Hm, I should do something about this.' and sends the appropriate message to tell the heart to start beating again. If the shock pulse was successful the heart will then start to beat, hopefully normally.

Surprise number two was that the two pads are not placed on the left and right breast (As per all the best TV 'Doctor and Nurses shows) but on the right breast and lower down on the left side of the torso. This ensures that the shock travels up and across the body through the heart - obvious when you think about it but why can't the television people get it right.

The next surprise was that children, the most vulnerable of our society next to the old folk, cannot be treated by a First responder unless he/she has undergone a special and additional course of training. Apparently the physiology of a child is so different from that of an adult that adult treatment could kill rather than help.

Our speaker demonstrated the use of the current model of defibrillator. It is fully automated, once the lid is opened all the First Responder has to do is follow the spoken instructions issued by the machine. 'Remove the pads from the pouch', 'Attach the pads to the patient', 'Analysing', 'Shock advised', 'Charging', 'Shocking Now', 'Analysing', 'Shock successful' or 'Shock advised' etc.. I can't remember the exact spoken words but you will have got the idea by now, the machine, once the pads are attached is fully autonomous and automatic. The training courses for the Responders teaches them all about the machine and all other medical knowledge necessary in order to provide the best initial care for sufferers pending the arrival of the ambulance and paramedics. It is estimated that First Responders have boosted the full recovery rate of cardiac call outs from 5% to 35% and, as coverage increases, this rate could well improve.

What about other countries? Do you have similar organisations, how do they work, are they similar to our guys?