Therapeutic hypothermia protocol saves the brain after a cardiac arrest or heart attack. Decreasing the temperature helps brain injuries after a cardiac arrest. There are a plethora of reasons for someone to sustain a brain injury. In this article, we will discuss brain injuries that result from a person‘s cardiac arrest. When people have a sudden cardiac arrest, or when a person has a witnessed cardiac arrest, they are a candidate for a protocol that is called the Hypothermia Protocol.
What is the Hypothermia Protocol That Saves the Brain
Decreasing core temperature has been shown to improve survival rates and neurological status in people that have had an arrest from ventricular fibrillation or ventricular tachycardia. Usually, the protocol is started in the emergency department because that’s where the majority of the cardiac arrest patients come in.
They usually come in via 911. Once the emergency personnel is able to restart their heart, they will usually implement hypothermia protocol or decreased the core temperature. When the temperature is decreased, the brain does not need as many metabolic demands. This allows for the brain to heal.
There are some contraindications for this protocol. Such as :
- A pre-existing coma
- Major surgery
- Active bleeding
- Traumatic head injuries
- Respiratory failure
Experts are not sure why cooling the body, reduces brain damage. Perhaps the chemical reactions of the body slow down and the Lord temperature may also lessen inflammation in the brain.
Immediate Post Arrest
1. Patients who meet inclusion criteria post-cardiac arrest should have their core body temperature reduced to 32° –
34°C as soon as possible, ideally within 4 hours of return of spontaneous circulation (ROSC).
2. If the patient is not already in an Intensive Care Unit (ICU) arrangements must be made to a transfer to the first
available ICU bed.
3. One to one nursing care is required for any patient receiving therapeutic hypothermia.
4. The patient’s circulation must be maintained with a Systolic B/P > 90mm/HG and airway with 02 saturation of
5. The goal is to continue the therapeutic hypothermia for a period of 24 hours from initiation of cooling.
6. Once 24 hours of cooling has occurred, a slow (passive) rewarming phase will be initiated to reach the goal
temperature of 36.5° Celsius. It should happen no faster than an increase of 0.25°C per hour.
How Does the Hypothermia Protocol Work? How Long is the Protocol?
Once the patient has been resuscitated, the physicians will order a Hypothermia Protocol. The patient is actually cold for 24 hours to a goal temperature of 32- 34°C ) 89-93F). Back in the day, we used to just use cold saline and cooling blankets. However, we now have a machine made by Zoll that will automate the entire process.
This process should be started as soon as possible but no later than six hours after the patient has been resuscitated. Hypothermia temperature is maintained for 24 hours starting from the time of the initial therapy.
The rewarming phase begins at our 24. Protocol says that the body should not be reheated any faster than 0.5°C per hour until the normal temperature is reached. At this point, a normal temperature should also be maintained for another 24 hours.
Unlike the rewarming bees, the cooling phase must be done as rapidly as possible to achieve maximum effectiveness.
The effectiveness of the Hypothermia Protocol
Only one-third of patients admitted to the hospital survive to hospital discharge. Approximately one out of ten people who experience an out of hospital cardiac arrest survive to be discharged from the hospital. Only 2 out of 3 of them have a good neurologic recovery.
Every household who has a person with heart disease need to have an automatic defibrillator.
This is the training unit for the defibrillator.
This is an oxygen bag that is used for CPR.
These are the disposable masks to be used.
The earlier someone starts CPR after an arrest, the greater the chances that the person will survive. We now have portable defibrillators that are saving thousands of lives. CPR supplies are also available.