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Hey, good research topic. our service does not do hypothermia because we are so far away from a STEMI/Cardiac center that there is a real possibility that the patient will begin the re-warming process before they get there. The only thing we even remotely do is cold packs to the axilla, groin, small of the back and behind the neck. Any further and we feel that we run the risk of doing more harm than good. Now if we have ROSC and put them in a helicopter from the scene, then we very often put cold packs in those places but thats only if the paramedic thinks of it. So to make a long story short - we do not have a permissive hypothermia protocol/guideline - it's more of a paramedic remember guideline. Does that make sense? By the way, you probably won't get much more of a response out of here, we have a very limited number of people who still post, heck I might be one of the single handful of people who come here and actively review the forum. YOu might have better luck on the facebook sites.