FOOTBALL REFEREE SAVED ON FIELD CPR + AED = A Winning Combination by Ken Patterson   The American football match had ended at the Cherryvale Playing Fields in Belfast, Northern Ireland, on Sunday, March 6, 2005, and the British Red Cross Ambulance Crew on duty packed up. Neil McKelvey, Jennifer Watson, and Andrew Caddies were ready to leave when they heard the players shouting.   They turned the ambulance around and saw Steve Stacher, the referee, lying on the ground about 100 yards ahead of them. Stacher was unresponsive but was breathing. The players reported that Stacher was a diabetic. McKelvey, Watson, and Caddies suspected that Stacher had suffered a hypoglycaemic attack but was too unresponsive to take any glucose, so they placed him on a stretcher and were preparing to load him into the ambulance when he stopped breathing. McKelvey and Watson placed him in the ambulance and immediately started CPR and, after 2 rescue breaths, found that he was pulseless and attached the AED, while Caddies phoned 999 (emergency assistance number in Ireland) for a cardiac unit.   The AED delivered 1 shock, which eliminated the shockable rhythm, but a perfusing rhythm did not return. McKelvey and Watson then performed CPR for 1 minute, after which the AED performed a second check.   The AED was still detecting a nonshockable rhythm, so McKelvey and Watson continued CPR for 10 more minutes, after which VF was detected and a third shock was given.   This time a perfusing rhythm was established but Stacher was still in respiratory arrest. McKelvey continued rescue breaths until the cardiac team arrived. Stacher was then stabilized before being transported under police escort to the Royal Victoria Hospital.   Stacher made a good recovery, although he has no recollection of the event or indeed of a 4-week period following it. He now has an ICD implanted and is waiting for cardiac bypass surgery. He is still refereeing American football matches and is very grateful for all that McKelvey and his 2 colleagues did for him.   This is the first time that Red Cross volunteers in Northern Ireland have used a defibrillator, and we are so glad the outcome was successful.