Covering the Goulburn and Murray valleys

Clot-busting 'angels in disguise' save Avenel man

Mark Grainger cannot believe his luck after suffering a heart attack on the day a new drug was approved to be administered by paramedics.

CHALPAT SONTI July 30, 2014 3:57am

Mark Grainger is flanked by stepson James Bell and partner Raelene Sidebottom in their Avenel home, watched on by the Seymour paramedics who were there to save him recently - Regan Black, Michelle Naylor and Guy Zuccala.

Mark Grainger was out concreting the dog run at the back of his Avenel property in the early evening when the first signs appeared.

‘‘I had pains in both arms and I came in and spoke to (partner) Raelene,’’ he said.

‘‘I thought I’d strained something from concreting so I went back out and continued concreting but the pain went to my chest. I jumped in the bath and thought it would go away but it came up to my jaw.’’

His partner, Raelene Sidebottom, takes up the story.

‘‘My son (James Bell, 20) and I could visibly see he was grey when he came inside,’’ she said.

‘‘James said ‘Mum, this is not good’ and we rang the ambulance. We started looking for aspirin but couldn’t find any, James went out and no-one had any so he went to the shop. I finally found some and gave it to Mark to chew.

‘‘All this time I was on the phone to Triple Zero. They asked a lot of questions but Mark was in so much pain he couldn’t really answer. James kept lying with him, kept talking to him and made sure he was conscious.’’

The nearest available ambulance at the time was in Euroa, and it was dispatched and arrived, but Seymour MICA paramedic Regan Black and paramedic Michelle Naylor were there not long after to take over.

‘‘When we arrived Mark was sweaty grey in colour,’’ Mr Black said.

The 45-year-old was also suffering the pains that pointed to him having a heart attack. Mr Grainger was promptly loaded into the ambulance, was managed as any patient having an acute coronary would be, then was assessed in a new way.

‘‘It was basically to see if he met the criteria to give him the ‘clot-busting’ drug,’’ Mr Black said.

That including not being on blood-thinning medication, that he was a certain age and several other factors. The drug, or more accurately drugs, were Tenexteplase and Clexane, which have been used in hospitals for years to break up blood clots. But they had only been signed off for use by MICA paramedics about 4pm the previous day.

Mr Grainger was in luck — Mr Black was one of the selected paramedics who had undergone the training. Mr Grainger was about to become the second person in Victoria administered the drugs by paramedics, but there was a delay.

The only local ambulance officer who had the drug was Mr Black’s fellow Seymour MICA paramedic Guy Zuccala, another of the three in the Hume region who at that stage had been trained to administer it. He was off duty, but as so many locals no doubt gratefully recognise, that doesn’t stop Mr Zuccala.

‘‘There’s never an ambo who’s worried about being dragged out of bed, away from the family or whatever to fix someone who’s crook,’’ he said.

Mr Zuccala met up with the ambulance, being driven by Ms Naylor, on the Hume Fwy just north of Seymour, and the MICA pair got to work. About 45 minutes after the ambulance first arrived, Mr Grainger, with his consent, had been given the drugs.

‘‘Thirty minutes after we gave him the drug, Mark’s heart started to have some irregular beats (arrhythmias),’’ Mr Zuccala said.

‘‘It’s a common side effect called a reperfusion arrhythmia. But the extent he was having this (Mr Grainger’s heart rate went down to 10 beats a minute) isn’t very common. Usually there’s a couple of irregular beats and that’s it.

‘‘He then said his pain had gone away, and that was the drug doing its job (breaking up the clot).’’

Mr Grainger was handed over to the team at the Northern Hospital in a state they had never seen in a coronary patient before, and it almost left them nothing extra to do.

‘‘Overall the reception was of amazement from the hospital and it was well received,’’ Mr Black said.

‘‘We basically took the coronary ward out to Mark.’’

So what would have happened had Mr Grainger not been administered the drugs?

‘‘The artery supplying blood to a particular part of the heart was blocked,’’ Mr Zuccala said.

‘‘If we were unable to give this drug, it would have been a one hour 20 minute drive to the hospital and for that time Mark’s heart would have been deprived of oxygen. Irreparable damage could have been done to his heart, given the amount of pain he had.’’

Mr Grainger’s family are grateful for the outcome.

‘‘It’s quite overwhelming, it makes you want to cry,’’ Ms Sidebottom said.

‘‘They’re just so caring, not just about the patient but everybody else too. To be in the ambulance on the way down and watch these guys do their stuff, people just don’t realise what they do. They really are angels in disguise and we’ll just be forever grateful.’’

Mr Grainger is now recovering at home and will be off work (he is the maintenance manager at Swettenham Stud) for a few weeks yet. To look at him, it is hard to guess what he has just been through.

And the experts also praise the family for their quick response.

‘‘Early recognition, early intervention and early management are all stages of advanced life support,’’ Mr Black said.

‘‘It was important they recognised what Mark was having was a (heart attack) and they acted on it.’’

As for Mr Grainger, he has given up smoking, but he didn’t have many other risk factors, with a normal cholesterol level and being otherwise healthy. It was a reminder that anyone could be at risk of being in a similar situation.

And what about the drugs (affectionately referred to by the ambos as ‘‘Drain-O’’ because it cleans the ‘‘pipes and drains’’)? The intention is they are administered by MICA paramedics in regions at least 60 minutes away from a cardiac facility and Mr Grainger’s case has already been useful in further training of intensive care paramedics.

‘‘How good is this for people out in rural Victoria?’’ Mr Grainger said. And he, more than anyone, should know.

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