You At Your Best

As Division Chief for the City of Bella Vista Fire Department, Scott Cranford plays a vital role in training and supervising first responders whose job it is to save lives. But it was he himself in need of rescue on October 21 when he had a major heart attack at work. Husband to Jessica and father of eight children ages 4 to 21, Cranford, 45, had never had any heart problems. He works out, officiates sports, and doesn't drink or smoke. In fact, he'd even lost about 50 pounds in the past two years. He describes himself as "always working… that's my lifestyle." Cranford's day had begun with a large, mass-casualty training exercise which was quickly followed by a real emergency. A bus wreck on Highway 49 caused a fire which threatened to ignite two large propane tanks. Cranford and his team from the Bella Vista Fire Department were called in as mutual aid to provide immediate assistance to the White Rock Fire Protection District. People were being evacuated within a mile of the incident in all directions. "There was a lot of strain and stress as well as physical exertion," he recalls. In hindsight, he noticed his first symptoms at the scene. "I started feeling nauseous at the scene, but it went away. Then when we got back to the station, I felt general malaise (discomfort or uneasiness). Then I got pale and diaphoretic (sweaty)… I was cold and couldn't seem to get warm. It felt like I'd sucked in 15 minutes of cold air. I sat in a chair inside the fire station to recover and – even though I knew the symptoms of a heart attack – I was experiencing every bit of denial." That's when his co-workers – fellow Firefighter/Paramedics – noticed. "They said: Scott, you don't look so good… let us hook you up to the EKG monitor." When the EKG monitor was first applied to Cranford, no symptoms of heart attack was detected. But because medics use a concept called "Treat the patient; not the monitor," they kept watching the Chief because of his symptoms. A few minutes later, Paramedic Leon Lieutard performed another EKG which showed an anterior wall left myocardial infarction involving a left anterior descending (LAD) artery blockage. That type of blockage is called a "widow maker" because it kills so many people before they can even seek care. While some of the next steps are fuzzy, Cranford recalls being loaded into an ambulance even as his co- worker, Paramedic Lieutard, was calling Northwest Medical Center-Bentonville. Thanks to the newest protocols, first responders now identify heart attacks in the field and alert the hospital staff en route to activate the Cardiac Catheterization Lab in order to have the staff ready as soon as the ambulance pulls in. This enables the patient to skip the Emergency Department altogether and get straight to cardiac catheterization laboratory for life-saving treatment faster. Every minute counts in a heart attack. The longer the artery is blocked, the greater the potential for death or permanent injury or disability. In Cranford's case, the steps his co- workers took likely saved his life. He remembers the phone call by Paramedic Lieutard, ("we're coming in with one of our own"), many nurses, doctors and "Big Wigs" being there, and other hospital staff "lined up left and right" as he was wheeled through the doors of the ER. He even remembers being rolled straight into the Cath Lab from ambulance and commenting on the monitors. But then his heart stopped. CPR was performed and a defibrillator was used to shock his heart twice. "I woke up to a nice-smelling nurse with beautiful brown eyes who was saying 'honey, just stay with me.' I felt good, and had no soreness." Interventional Cardiologist Dr. Pahul Singh performed cardiac catheterization emergently which showed proximal LAD occlusion (blockage) and implanted a 3.5mm stent to open the artery. Cranford's "door-to-balloon time" – even with CPR and defibrillation – was an amazing 25 minutes. "If this had happened after work – or if I had gone anywhere else - who knows what my prognosis would have been?" What did Cranford take away from this that's going to help others? "I did not have any chest pain. The reality is that no one knows what a first- time heart attack or stroke is going to feel like to them. For me, it kind of felt like the flu was coming on, but I didn't buy into that because no one had the flu in the fire department. As a paramedic by trade, I know we try to diagnose ourselves. But what I would tell the average person is that there's no way to know what signs and symptoms of a first-time event are going to feel like, to you specifically. We are each different, and we can be our own worst enemy (by denying that our symptoms could be serious)." "As soon as you put together any of the signs and symptoms, you need to recognize what could be happening and call for help immediately. The speed with which you get to definitive care can be a matter of life or death," Cranford said. "In the case of a heart attack, for me, getting definitive care was not seeing a paramedic or going to an urgent care center or even an ER but going straight from the ambulance into a Cath Lab where they could open the blocked vessel." "People have to recognize when something's not right; something could mean everything." Dr. Singh adds: "Stay calm and call for help right away if you experience any signs of symptoms of heart attack including chest pain, shortness of breath, jaw pain, profuse sweating since EVERY MINUTE COUNTS". every minute matters in a heart attack Chief Scott Cranford survives widow-maker heart attack; uses experience to help others sponsor content cranford had a widow-maker, one of the deadliest kinds of heart attacks, responsible for as many as one-third of sudden cardiac deaths in the U.s. it happens when a blockage occurs in the left anterior descending (lad) artery. this vessel provides blood and oxygen to the entire front of the heart (about 40 percent of the heart's blood supply and a significantly larger area than other coronary arteries supply. DTB time is key Door-to-balloon (DTB) time – or definitive treatment to unblock an artery – has been set as a core quality measure for hospitals who are accredited by The Joint Commission. Thanks to the work of hospitals and care providers nationwide, a patient experiencing an ST-segment elevation myocardial infarction (STEMI) anywhere in the U.S. can now expect to receive lifesaving reperfusion (restoration of blood flow) in less than 90 minutes. At Northwest Medical Center- Bentonville and Northwest Medical Center-Springdale, the staff routinely outperforms national average door-to- balloon times. Critical to this success is the interdisciplinary team which extends beyond the walls of the hospital to include emergency medical services (EMS) and all first responders. In fact, the pre-hospital electrocardiogram (ECG) by EMS for faster identification of a suspected STEMI and direct transfer of the patient to the Cardiac Cath Lab immediately upon arrival at the hospital is critical. 4 | yoU at yoUr Best | nWadg.coM/yoUatyoUrBest March - natUral health & Wellness | satUrday, feBrUary 29, 2020

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