By Teri deMatis, Rex Healthcare
Sudden cardiac arrest results in more than 400,000 deaths in the United States each year. Of those patients who survive, many receive only supportive care, with only five to 30 percent of patients being discharged from the hospital.
Many of the survivors suffer from brain injury. Until recently, most interventions had little effect on preventing further brain injury. Rex Hospital is one of several hospitals throughout the country that uses therapeutic hypothermia as an intervention to protect brain function.
The idea of “chilling” a patient suffering from cardiac arrest may be surprising, but it is proven to save lives. Hypothermia—the exposure of the body to an abnormally low temperature—allows the brain to rest while other organs compete for oxygen during the health crisis.
Typically the hypothermia treatment known as Therapeutic Temperature Management begins in the ambulance when EMS responders instills cold saline and/or applies ice to the patient while in transit to the hospital. The goal is to reduce the core body temperature to the 32-34°C as quickly as possible. Once in the Emergency Department, Therapeutic Temperature Management begins under the supervision of specially trained medical staff in a controlled setting.
At Rex Healthcare, the critical care team monitors the patient’s condition for 24 hours while they are “cooling.” When treatment is completed, the patient is then re-warmed for an eight hour period to a temperature of 36 degrees Celsius. For the next 24 hours, the patient is kept at this temperature to finalize the therapy.
Rex treats on average two patients a month with Theraputic Temperature Management.
“The good news is if the patients survives, most of them are coming out of the treatment completely neurologically intact, or with only some short-term memory loss,” said Sonya Mangum, RN, BSN, Team Coordinator, Critical Intensive Care Unit Rex Healthcare.
In 2010, among patients treated at Rex that survived the cardiac arrest, 77 percent were completely neurologically intact or only had some short-term memory loss. Data for 2011 is still being compiled, but early results indicate that additional improvements were made in patient outcomes.
Why does hypothermia work? Induced hypothermia works to reduce the body’s demand for oxygen, giving brain cells extended life resulting in less damage to the brain.
In October, 2011, the Wake County EMS system celebrated the five year anniversary of implementing its Induced Hypothermia Protocol. The County’s data was published in the Annals of Emergency Medicine, a work recognized as one of the ten most influential publications in EMS in 2010 by the National Association of EMS Physicians.
The statistical analysis confirmed that the hypothemia approach saved three additional lives per 100,000 population per year as compared with the “old” way of cardiac arrest management. EMS’s efforts combined with those of local hospitals have saved approximately 25 additional lives per year, or 125 lives since the program began. Also noteworthy is knowing that 75 percent of survivors leave the hospital neurologically intact.
Teri deMatis is director of marketing and public relations at Rex Healthcare, rexhealth.com.