Work experience often involves little more than tea-making or watching office workers glued to their screens.
But one schoolboy put his placement at Barts Heart Centre to much better use — by helping devise an award-winning system to save heart attack victims.
Ben Wald, 16, came up with the idea of surgeons “writing” a patient’s medical history in code inside their chest after observing open-heart surgery at the hospital, where his father Professor David Wald is a cardiologist.
About one in 10 heart attack patients have previously undergone open-heart bypass surgery but cardiologists at Barts have to operate on many without access to their medical notes, making the new treatment more dangerous.
Ben, an A-level student at Dulwich College, suggested that the surgeon could leave a “message” inside the patient’s chest to indicate the number of heart grafts and their location.
He and his father devised a coding system, which involves tying the wires that close the sternum, or breastbone, in a certain way.
Ben said: “I noticed how in one case where the medical records were not available, there was confusion and a bit of uncertainty.
“I could see that perhaps you could use these wires and sculpt them into something that could tell the cardiologist 10 years down the line what had happened at the original operation.
“I asked a question about whether the wires could be sculpted into letters and was mocked a bit. It was slightly implausible. But my father realised it could be developed into a code.”
The code last month won a prize for innovation at the Society for Cardio-thoracic Surgery. The concept will be presented at the British Cardiovascular Society annual conference in June.
Each year, Barts Heart Centre performs about 6,500 angiograms — X-rays checking for blood flow — including about 600 on patients who have previously undergone cardiac grafts.
In about 100 of these the records are missing or incomplete, often because the patient was treated in another hospital, in another country or many years ago.
Patients who undergo a coronary artery bypass have their heart “re-plumbed” with veins or arteries taken from elsewhere in their body, creating a new pathway for oxygenated blood.
These grafts only show up if the cardiologist manages to identify their origins during the angiogram and inject a dye which lights up under the X-ray.
“This is an all too common problem that is frustrating for doctors and increasing risk to patients,” Professor Wald said. “Cardiologists need to know if the patient has been operated on before and how the previous surgeon has re-plumbed the arteries.”
A key part of the code is that the top wire points upwards — an unusual technique, indicating that the code is in use.
All the other wires point downwards and to the left or right, giving information on how many grafts there are and where they are located.
Alex Shipolini, a cardiac surgeon at Barts, said: “This is unique idea that solves a common problem. I have used the code and it’s easy to apply. The challenge is now making this code routine and we are talking to surgeons across the country to do so.”