Wednesday, July 13, 2011

Therapeutic Hypothermia now offered in Hinds County

The Hinds County Board of Supervisors approved a few weeks ago new fees charged by AMR to cover a new service provided by its EMT's. The Wall Street Journal published a story and this video on its website yesterday. Very interesting stuff and shows how much difference the new cooling technique makes in helping victims recover from cardiac arrest.



Here are some excerpts from the article:

"A new study could bolster growing interest in a technique to chill the bodies of sudden cardiac-arrest patients that has been shown to help keep victims alive.

Researchers found that of 140 patients who got the treatment, in which the body is quickly cooled after the heartbeat is restored, 56% survived to be discharged from the hospital—92% of them with most or all of their cognitive function intact.

Across the U.S., fewer than 10% of victims survive sudden cardiac arrest when it occurs outside the hospital and among those who do, only a minority recover sufficient brain function to return to a normal life....

About 300,000 people in the U.S. suffer cardiac arrest each year as a result of either a heart attack or an electrical malfunction that throws the heart wildly out of rhythm. About 125,000 are discovered too late for help. Of those whose pulses are restored, only about 1 in 5 gets treated with therapeutic hypothermia...

Therapeutic hypothermia is applied after a patient's heartbeat has been restored through cardiopulmonary resuscitation and shocking with a defibrillator. Increasingly, rescue squads are initiating cooling by placing ice packs on patients as they are being transported to the hospital. The city of New York and top medical centers in New Orleans, Tucson, Ariz., and Nashville are among places that have embraced the technique.

In the study, every hour of delay in initiating cooling was associated with a 20% increased risk of death, the researchers found.

More sophisticated cooling blankets that regulate both the temperature drop and a rewarming of the patient are used after admission.

Generally, patients are cooled to about 90 to 92 degrees Fahrenheit, or about six to eight degrees below normal temperature. They are put in a medically induced coma for 24 hours before their temperature is gradually brought back to normal. Patients may remain in a coma for a few days before being brought back to consciousness.

"It's a very robust therapy and it's simple," says Dr. Mooney. "It doesn't necessarily rely on fancy equipment. Simple measures make a huge difference."

One reason for its slow adoption, Dr. Mooney said, is that cardiologists have been skeptical that new approaches can make headway against the historically poor outcomes for victims of sudden cardiac arrest. Another concern is that a new strategy may improve survival, but not quality of life.

"Our biggest worry would be that we'd bring back folks that didn't function as Mom in the family or Dad in the family," Dr. Mooney said. But, as reflected in the 92% who were revived and able to return to normal or near-normal life, "that hasn't happened
."

Here is the abstract of the study in the journal of the American Heart Association.












9 comments:

Anonymous said...

That must be what the commercial is about which has the guy called "ice man".

Anonymous said...

You think so einstien?

Anonymous said...

This is so cool.

Anonymous said...

11:08, the correct spelling is Einstein.

Anonymous said...

As a paramedic, I would like to say this is a great advancement and is just another tool for us to help. However, THE MOST IMPORTANT tool is chest compressions immediately!
If someone collapses in front of you and you see they are not breathing and you can't feel a pulse then just start pushing hard and fast on the center of their chest. Don't worry about mouth-to-mouth; there's still enough oxygen in their blood. Just push hard and fast to the beat of "Stayin' Alive". Corny, but it works.

Depending on where you live it and how taxed your ambulance provider is, it could be 10-20 minutes (or more) for an ambulance to get there. Chest compressions keep blood flowing and keep the brain alive.

It doesn't matter how many cool toys a medic may have or many vials of drugs. If the brain and other tissues are not perfused while we are on the way, our hands are pretty much tied.

I've never seen a cardiac arrest patient that didn't have chest compressions done before the ambulance or fire dept got there that walked out of the hospital.

Anonymous said...

the correct spelling is "only douche-bags correct other peoples grammer on a blog". unless you are an English teacher piss off

Anonymous said...

No, commenter was told how to spell Einstein, because he/she ridiculed the first commenter.

Anonymous said...

Wow a blog that has referees too...

Anonymous said...

"Wow a blog that has referees too..."

You don't even know how truly funny that really is.


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