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DCMH Emergency Medical Services Professionals Provide Hypothermia Therapy at the Scene

In Brief

  • Hypothermia therapy is a treatment used to prevent brain damage and preserve brain cells after a person suffers a heart attack.
  • During hypothermia therapy, a person’s body temperature is taken down to a range of 91 degrees to 94 degrees. This is accomplished by injecting the patient with a cold saline solution and placing ice packs around the body. Some hospitals, including Crozer-Chester Medical Center and Delaware County Memorial Hospital, have cooling beds.
  • Paramedics at Delaware County Memorial Hospital have worked with the Hypothermia Therapy Task Force to start the treatment on the scene.

Delaware County Memorial Hospital Emergency Medical Services (EMS) professionals recently began providing hypothermia therapy to patients on the scene, potentially preventing brain damage after a patient suffers a cardiac arrest (heart attack). Hypothermia therapy, in which the temperature of a heart attack patient is cooled to as low as 91 degrees, has been offered at DCMH and Crozer-Chester Medical Center since last year.

When a body is revived after cardiac arrest, the restored blood supply causes damaging chemicals to enter the brain. This often leads to a vegetative state, recovery with severe disabilities, or even death. Hypothermia therapy slows down metabolism in the brain and calms the onslaught of these chemicals. During hypothermia therapy, a patient’s body temperature, normally around 98.6 degrees Fahrenheit, is taken down to a range of 91 degrees to 94 degrees. The body remains in this state for at least 24 hours and is then slowly warmed up.

To perform this therapy, the patient must be unconscious and then given medications to keep them from shivering. A cold saline is then injected into the patient’s veins and ice packs or cooling pads are placed on the body. Both DCMH and Crozer havecooling beds that make this process easier. The beds have a machine that pumps cold water into pads that are wrapped around the patient’s body. 

Until recently, hypothermia therapy was only started upon the patient’s arrival at the hospital. However, it has been found that the sooner the therapy begins, the greater the chances of a positive outcome. That prompted DCMH to create a Hypothermia Task Force to start the process on the scene.

The task force consists of EMS personnel as well as staff in the Emergency Department and the Critical Intensive Care Unit. The task force consists of physicians, nurses, educators, administrators, paramedics, neurologists, respiratory therapists and pharmacists.

DCMH is one of the first hospitals in the Philadelphia region to have paramedics begin hypothermia therapy at the scene. Tim Mengel, director of Emergency Medical Services at DCMH, explains, “We try to watch national trends and study the evidence of what is successful. We decided to do this due to the stunning evidence of improved outcomes and a large success rate at other hospitals like those in Wake County, North Carolina and the University of Pittsburgh.”

Doctors say that hypothermia therapy is cost-effective, relatively easy to perform and has only a small risk of causing serious complications. However, hypothermia is not without risk. Potential side effects include infections, such as pneumonia, increased risk of blood clots and the possibility of developing an arrhythmia.

A 2002 study published in the New England Journal of Medicine found that patients who did not receive cooling therapy after cardiac arrest had a 57 percent chance of dying or having significant brain damage. In the patients who did receive the hypothermia therapy, that rate of death or brain injury dropped to 38 percent.

Mengel says, “These statistics prove to me, from an EMS standpoint, that implementing hypothermia therapy is a major plus and very reasonable. If you have a facility that can do this, there is no reason why you shouldn’t be.”

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