Open heart surgery – by the roadside!

A motorcyclist has thanked the doctor who performed emergency open chest heart surgery at the side of the road, saving his life and enabling him to walk his daughter down the aisle on her wedding day.

John O’Brien from Warrington was involved in a road traffic collision in October 2018 in Delamere while out riding on his motorbike. Firefighters, paramedics and police were first on the scene with a doctor from the NW Air Ambulance and a local CSI BASICS doctor, followed by Cheshire Fire and Rescue Service Medical Director Dr Mark Forrest.

The 47-year-old had been skilfully anaesthetised on scene, by the doctors. However, just prior to loading into the helicopter, John had a cardiac arrest but conventional resuscitation proved ineffective. As he lay in the road things were looking hopeless, as such traumatic cardiac arrests are commonly described as un-survivable in medical circles. The team, which also included two firefighters and paramedics, took up various roles, now led by Dr Forrest as the most senior doctor present, pushed fluid into John through drips and his chest was de-compressed to try and get his heart re-started. When there was no response to this treatment the only option was a drastic one and the doctors realised that they had to operate and open Mr O’Brien’s chest in the middle of the road. 

The team quickly tried to make everyone aware that they were about to do something rarely seen outside of a hospital operating theatre, but few would appreciate what was actually about to happen. John’s chest was completely cut open, exposing his heart and lungs, to allow treatment of his internal bleeding, lung injuries and to massage his heart back to life.

Incredibly within a matter of minutes his heart was beating strongly and the bleeding had been controlled. He was quickly loaded into the air ambulance and flown to the Major Trauma Centre at Aintree in Liverpool, for further life-saving surgery. This is a great demonstration of the standards of world leading emergency care now available in Cheshire.

Dr Mark Forrest is Cheshire Fire and Rescue Service’s Medical Director and is the founder of Internationally famous Anesthesia Trauma and Critical Care Group (ATACC) that promotes and widely delivers medical rescue training and clinical governance. Mark is also an NHS Clinical Director at Warrington Hospital and a consultant in anaesthetics, critical and prehospital care. He responds to 999 emergencies such as road traffic collisions, on a day-to-day basis, as part of his role with Cheshire Fire and Rescue Service. He said: “I arrived at the scene and was managing another casualty, when I noticed that the team where trying to resuscitate John, who had gone into cardiac arrest. Despite the huge effort by the doctors, paramedics, firefighters and police officers, nothing was working and it wasn’t looking good for him. I joined them at John’s side and, after a very quick discussion, we knew that the only chance of saving this man was to open up his chest to manage his internal injuries and to massage his heart until it started beating. This is rarely successful, but we did want to at least try.

“John has undoubtedly played a big part in his own recuperation since then. He has obviously worked really hard to get to the level of fitness he is right now. It will have been a tough road to recovery so his determination is commendable.”

Remarkably, John was able to walk his daughter Amy down the aisle on Saturday May 11 when she married her fiancé Jonathan Evans. He thanked everyone involved in his rescue at an evening reunion at Northwich Fire Station on May 21. Dr Mark Forrest was given a commendation by Chief Fire Officer Mark Cashin for his work that day and the other doctors, firefighters, paramedics and police also attended the event.

John said: “I can’t thank Dr Forrest and everyone involved enough for helping me that day and for doing everything they could to save my life. I was lucky enough to be able to walk my daughter down the aisle recently and that’s all thanks to them.”

On the night Dr Mark Forrest was given a Chief Fire Officer’s Commendation by Chief Fire Officer Mark Cashin for how he worked to save the life of John that day. Northwich and Tarporley firefighters were also given the award for their involvement at a previous event.