Brian Duffield

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When 41-year-old Brian Duffield suffered a heart attack last May, it was a big surprise not only to him, but to his family and friends who describe the Tucsonan as an elite swimmer and athlete.

Even more surprising, Duffield beat the odds; his doctors say the chance of surviving a heart attack of that nature outside of a hospital is only 3 percent to 5 percent.

Duffield and doctors at University Medical Center say they believe the reason he survived and is back to swimming three to four days a week is a treatment protocol put in place about 18 months ago by UA doctors in collaboration with the Tucson Fire Department and Sarver Heart Center.

The "pioneering" protocol consists of three phases:

● Cardiocerebral resuscitation, a method of CPR pioneered at UMC's Sarver Heart Center that emphasizes continuous chest compressions and does not involve mouth-to-mouth breathing.

● Prompt emergency medical services response.

● Aggressive post-resuscitation treatment, including inducing a state of hypothermia for 24 hours and doing early analysis of the heart arteries to detect any blockages.

UMC is one of the few hospitals in the state using hypothermia treatment on comatose heart attack patients, and its doctors are talking about Duffield's case now to encourage other hospitals to consider adopting it.

The process involves wrapping the body in cooling pads to lower the core body temperature to 93 degrees, according to Daniel Stolte, a spokesman for the Sarver Heart Center.

This cooling treatment has been used on about half a dozen patients at UMC since it was implemented. Of those patients, two did not survive.

"The precise mechanisms are still unclear, but it appears that hypothermia lessens the detrimental effects the lack of blood supply has on the body, especially the brain," said Dr. Arthur B. Sanders, a resuscitation expert at the Sarver Heart Center and a professor of emergency medicine at the UA.

That morning in May, the planets aligned for Duffield, and all three phases of the protocol came into play.

"I was in my normal early morning routine of my swim workout at the University of Arizona Hillenbrand pool when I began feeling sluggish, so I got out of the water," Duffield said. "I went and got into the shower, where I had a life-altering heart attack."

Duffield collapsed and only remembers waking up in the intensive care unit at UMC three days later, he said. But much happened in the time he was unconscious.

Someone nearby saw Duffield fall and ran to get help from Dianne Wygal-Springer, a captain and paramedic with the Tucson Fire Department, who also swims on the Ford Aquatics Masters team.

"I was getting ready to leave, and someone came to me and said that someone was down in the men's bathroom," said Wygal-Springer, who has been with the Fire Department for 16 years. "I ran in and I saw Brian on the shower floor having a seizure."

First, Wygal-Springer told the swim coach to call 911, she said. Duffield had a pulse and was breathing when she told another team member to grab the automated electronic defibrillator that was out near the pool.

During the time it took to get the defibrillator and dry off Duffield's chest — less than a minute —he lost his pulse, she said.

Wygal-Springer shocked Duffield once with the defibrillator before the Fire Department arrived. She shocked him once more but still could not regain a pulse.

Other paramedics began performing the continuous chest compressions, and after one round a heart rhythm was established, she said.

While en route to UMC, Duffield remained unconscious. After he arrived he was wrapped in the cooling pads, Stolte said.

He was later taken to UMC's cardiac catheterization lab where a blocked coronary artery, which had triggered his heart attack, was reopened.

"Mr. Duffield's case is a great testimony to the difference an optimized and gapless treatment protocol like ours can make," said Dr. Karl B. Kern, a member of the Sarver Heart Center and professor of medicine.

Duffield, a husband and a father of two, agrees that the treatment policies saved his life.

"This protocol is world-renowned, and we are fortunate to be here in Tucson and have such great pioneering in health care," he said.