Essay On Therapeutic Hypothermia

For more than a decade, Targeted Temperature Management (TTM) has been the recommended treatment modality in adult comatose patients following out-of-hospital cardiac arrest (OHCA)[1] in order to improve survival and neurological outcome by minimizing brain injuries due to anoxia and reperfusion injury.

Purpose: The purpose of this speech is to educate and inform my audience of the risks inherent from unintended hypothermia. I’m eager to alert perioperative staff of the potential dangers as well as the preventative measures that can be taken in order to avoid complications associated with unintended hypothermia. My central idea is hypothermia management saves lives.

Cryotherapy involves the use of low temperatures to remove heat form a body part. It decreases pain and inflammation, promote vasoconstriction (narrowing of blood vessel) and prevent the development of waste products.

He then took samples of urine, blood, and mucous as body temperatures lowered. Through this tortured, Rascher used the data to create the hypothermia treatment called "active rapid rewarming." More than 90 people lost their lives for this medical advancement (Adams).

It is a beneficial treatment that should be implemented as early in patient care as possible, such as, within the EMS system. Through the last century this therapy has been accepted and rejected by many medical professionals. Since medicine is an ever-changing field, future research and practice of hypothermia will dictate if this therapy is more beneficial than harmful, and maybe one day could be a permanent major role, or it may never be used again. Hypothermia has been proved to decrease neurological impairment after cardiac arrest, but also has many limitations that can occur. A major limitation of this therapy is, if continued care cannot be guaranteed by receiving hospitals, therapeutic hypothermia is irrelevant for EMS to initiate. Likewise, if hypothermia is not begun in the field by EMS, then the receiving facilities now will have a delayed time in starting the therapy and anoxic brain injury could have already occurred. EMS agencies can drive the implementation of therapeutic hypothermia in the medical field. This therapy allows EMS providers to have a major role in the outcome of a cardiac arrest patient’s recovery and neurological outcome. With the progression of research and practice, medicine is evolving day after day, and patient mortality and morbidity have decreased over the years. Although, cardiac arrest patients have a poor

Malignant Hyperthermia is primarily thought to be an autosomal dominant genetic disorder that causes a hypermetabolic state after administration of volatile anesthetics. When a patient is under anesthesia, the muscles are usually relaxed, but when a patient is experiencing Malignant Hyperthermia crisis, certain IV anesthesia causes the opposite effect. Most inhaled anesthetics other than nitrous oxide, cause or trigger Malignant Hyperthermia. More specifically, the anesthetic agents: Halothane, Chloroform, and Succinylcholine. The genic condition of Malignant Hyperthermia only becomes apparent when a patient is exposed to certain anesthetics such as halothane, which causes muscle rigidity.

The victim would be placed beneath sun lamps, which were so hot, the skin would burn. They would then freeze and reheat the victim, repeatedly. Another revival technique was irrigation; the victim would have boiling hot water irrigated throughout their bladder, intestines and stomach. All patients died from this technique. They would also submit to high altitude changes. They would be locked in a low-pressure chamber until their lungs would explode. These experiments would help the doctor to determine the limits of the human body.

Malignant Hyperthermia (MH) is a genetically inherited, pharmacogenic disorder involving a severe malfunction within the skeletal muscles, causing them to be stuck in a contracted state. It is found to be triggered in susceptible patients by the administration of certain anesthetic agents during and after surgical procedures. It may also be activated by the use of other drugs, such as muscle relaxants and triggered by other circumstances such as stress, trauma, and even exercising. Not only are the muscles normal physiology affected, but abnormalities of the whole body occur disrupting its natural homeostasis. If it is not treated immediately, it can be fatal. Susceptibility is found in patients who have had a known family history of MH. In order for a medical professional or a patient to be prepared to handle MH one must understand how it affects the normal physiology of the body, what signs to look for, and how it can be diagnosed, treated, and prevented. There is no cure for MH, but there are specific drugs and precautionary measures that are used to prevent and treat it when a patient is susceptible.

THT is the only therapy that has appeared to positively affect the neurological outcome of patients after cardiac arrest. THT has been around for more than fifty years. The history of the scope of THT is limited and the only consistent application of this therapy invasive surgery. Within the last 10 years, the benefits of induced therapeutic hypothermia have been rediscovered, mainly with the improvement in neurological outcomes in out-of-hospital cardiac arrest (OOHCA) victims. In addition, therapeutic hypothermia has been suggested to improve outcome in other neurological conditions such as traumatic brain injury, neonatal asphyxia, cerebrovascular accidents and intracranial

Markus Thalmann, the cardiac surgeon who saved the little girl from death by drowning in icy water, said that she was not the first hypothermia and suffocation case. However, she was the first one to survive. In her complicated rescue they tried to follow a checklist that stats that in such a case, a rescue team was required to tell the hospital to prepare for possible cardiac bypass and rewarming. So, what was so effective about this approach is that by the time the patient gets to the hospital, everything is ready and standing by. These kinds of cases are time sensitive. In such complicated cases, success requires having a huge number of equipment and people at the ready. So, even small simple checklist could help in complicated rescues and even bring people to life

In the article written by Marien Ko “Life Lessons in the Snow”, the discovery of how to treat hypothermic bodies , led to a process of several methods for example using sun lamps , and the usage of heated water . The doctors came to a conclusion through their on going research that the most effective method was immersing the victims in hot temperature liquids. Today doctors are able to use scientific references ,in order not create the same mistakes performed during the Nazi experimentation trial . Erick Norby a twelve month child went outdoors into a temperature of -24 degrees. Erick was later found with no sign of heart beat. She was treated from hypothermia through being placed in warm temperature. In other cases different measure were taken to reheat the bodies of the victims that have suffered through

Malignant hyperthermia may not show itself during the first surgery. Yet, during future surgeries the risk remains. In some rare occurrences, people with the condition have shown signs of a reaction after intense exercise. The surgeon and anesthesiologist should be notified prior to surgery if the patient has been diagnosed with malignant hyperthermia so that they can be prepared to treat the reaction if it should occur. Treatment consists of a drug called dantrolene (Dantrium). Dantrolene is a skeletal muscle relaxant. It is indicated for the prophylaxis treatment of malignant hyperthermia. It acts directly on skeletal muscle, causing relaxation by decreasing calcium release from sarcoplasmic reticulum in muscle cells. It also prevents the intense catabolic process associated with the condition. The dosage indicated for adults by PO is 4-8 mg/kg/day in 3-4 divided doses for 1-2 days before the procedure, the last dose is to be given 3-4 hours preoperative. The dosage for adults during a post-hyperthermic crisis follow-up is 4-8 mg/kg/day PO in 3-4 divided doses for

The nursing topic that I am going to base my final paper on is the use of hypothermia therapy following the successful resuscitation of adult patients. I want to further understand the positive or the negative outcomes for patients after we have using the hypothermia therapy protocol. hypothermia _1_.pdf This is one of the research studies that I plan on using in the research for my finial paper. The PICO question that I will be trying to answer in my research paper will be " In the resuscitated adult patient does the use of hypothermia therapy have a reduced mortality rate for adult patients after they have been discharged from the hospital?" By using the definition of PICOT from our book, the P in my research is resuscitated adult patients,

Therapeutic hypothermia, also called targeted temperature management, is a procedure that lowers the body's temperature in order to treat a heart that has suddenly stopped working (cardiac arrest). This procedure is used in emergency situations. During cardiac arrest, the brain cannot get enough oxygen. The brain also starts to swell, which can damage or kill brain cells. Therapeutic hypothermia helps reduce swelling in the brain. It also slows down the body's metabolism and allows the heart and brain to recover.

Aside from these benefits, cryotherapy is also known to carry a few side effects that are not so dangerous such as scarring and mild skin irritation. The only major concern is that the nearby areas of the skin that are healthy may become