Induced Hypothermic CPR

[Medic One]

We recently starting to use Induced Hypothermic CPR at our service and was wondering if anyone else has used this technique?

[boeingb13]

Here in North East Florida, we are doing the F.I.T.H. Filed Induced Therapeutic Hypothermia. Which includes Vecuronium at 0.1 mg/kg, 2 1000cc bags of chilled saline which we keep in the rescues fridge, dopamine to raise the mean arterial pressure to or above 90, as well as ice packs. We only start after we get a return of spontaneous circulation ROSC. The we take our rescue pod ( ETD device ) off the bvm and just bag them regularly. We have 5 major hospitals in the area that are now on board to comtinue the care. With all this you have 2 large bore lines in the ac's and a IO. 1 saline 2 dopamine 3 in case you converted on lido and need to hang a drip.

[EMT155]

Not in our protocols at this time in Central NY, but thanks for the topic. I'm reading up on it now and will be asking questions about it considering our weather patterns up here.

Jim

[Doczilla]

Region wide protocol this year. One service is using it (kind of the spearhead), with several others planning to implement it soon.

'zilla

[Paramagic]

Been using post-ROSC hypothermia for some years now and are currently awaiting the green light to trial during arrest hypothermia.

[medicgirl05]

Our service is in the procces of putting fridges on the trucks for this purpose. Those of you who do use it, what are your thoughts? Do you find it beneficial?

[Paramagic]

Our service is in the procces of putting fridges on the trucks for this purpose. Those of you who do use it, what are your thoughts? Do you find it beneficial?

Actually, it hasn't been proven to be beneficial. Hypothermia post arrest is definitely a good thing, definitely improves neurological outcome. However there is no evidence that starting cooling in the field improves outcomes over starting cooling in the hospital. There needs to be more work done on the exact timing of the cooling. Currently the standard is to cool post-ROSC. However, because we are essentially trying to mitigate reperfusion injury, it may be that we need to start cooling during the arrest to ensure that the first stages of reperfusion injury are blunted before they start.

It also needs to be done as part of a high quality post arrest care bundle, maintaining good blood pressures, ventilating appropriately and so on.

[Richard B the EMT]

FDNY EMS is part of a Pilot Program for it. Back soon with more details.

[CBEMT]

If it means buying anything, I don't anticipate seeing widespread pre-hospital use in my area anytime soon, at least amongst the agencies that actually get a decent number of arrests.

There are one or two hospitals that I know are doing it so far, there may be others that I don't know of.

[celticcare]

Hospital policy to cool on ROSC and transfer to ICU and its national ambulance policy in the procedures to cool post ROSC as well. I know people that cool during resuscitation period just to facilitate the decrease of neuronic damage. I look forward to more of the research from this

Scotty