The Effects Of Induced Therapeutic Hypothermia On Cardiac Arrest Survivors

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.

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

The lack or delay in appropriate treatment for individuals who experience a sudden cardiac arrest has created a major public health disparity. Research into pre-hospital treatment and subsequent implementation has historically seen neglect by the medical and scientific community creating vast differences in survivability of cardiac arrests between demographic groups. In 2010, the American Heart Association and Emergency Cardiovascular Care program developed the 2020 impact goal to reduce death from cardiovascular disease and stroke by 20% and double out-of-hospital cardiac arrest (OHCA) survival rates (http://circ.ahajournals.org/content/121/4/586#sec-1). This has prompted a massive influx of research into the disparities that exist and an

This paper will be going over a scenario involving a real patient and what things could have been different with EMS care. It will also be covering what exactly cardiac arrest is and what rhythms produce it. And for every cardiac rhythm in cardiac arrest, there is a specific treatment plan paramedics can follow.

The evidence surrounding the topic of therapeutic hypothermia post cardiac arrest is one lathered in potentially advantageous benefits, as well as harmful side effects. Although this procedure has potentially lifesaving and neurologically preserving implications, it does come with various side effects which can be dangerous in general or if left untreated. This paper will first address the many benefits, some of which include prolongation of life, retention of neurological function. It will then shed light upon some of the subsequent risks and harmful effects that are associated with therapeutic hypothermia. Lastly the paper will discuss why or why not the overall benefits outweigh the aggravating factors. Thus, being a topic of much controversy

Six... seven... eight. “You’re going to have to push harder than that! What’s her oxygen reading? Alright, let’s give her another dose of Epi.” Sweat was dripping down my face and adrenaline was rushing through my system. I was out of breath, but I pressed harder like the doctor asked. Twenty-eight... twenty-nine... thirty. “Okay, she’s tired, have someone switch off with her. Let’s keep going. I’ll go update the husband.” It had been forty minutes since the patient coded. Everyone had been exhausted from taking turns doing CPR. The patient’s face was pale and hands were ice cold. I wiped my sweat off and took a quick look at the patient’s face as I stepped down for the next person to do CPR. She looked like every other person that I probably could have met on the street, at the mall, or at a random restaurant. She was young. I watched silently as the EMT performed the compressions. The patient’s arms were hanging off the gurney, bobbing up and down

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.

5:13 p.m.: heart rhythm is normal sinus, B/P is 110/70, and pulse is palpable. Patient not breathing on his own and is fully dependent on the ventilator. Pupils are fixed and dilated. No spontaneous movements and not responding to noxious stimuli. Air transport is called. Patient is transferred to a tertiary facility for advanced care.

In this article published in the journal Dyanmics, also known as the journal for the Canadian Association of Critical Care Nurses, the authors review a retrospective cohort regarding the barriers for time to target temperature management in cardiac arrest patients who are treated with therapeutic hypothermia. The article authored by a both registerd nurses and medical doctors open by reviewing the benefits of therapeutic hypothermia. The article reviews two randomized controlled trials that showed that therapeutic hypothermia when compared to no intervention correlated with improved neurological survival in patients after cardiac arrest. Therapeutic hypothermia has a direct relation to patient survival with intact neurologic function; however

The three major life-breathing concerns for a patient is a disruption of the airway, breathing, and circulation. When a patient goes into cardiac arrest due to pre-existing conditions or trauma, an EMT will initiate the steps of cardiopulmonary resuscitation (CPR) and hopefully using an available automated external defibrillator (AED). However, some patients due to having a terminal illness, age, or personal choice does not want to be resuscitated or have

The determination of the potential for cardiac arrest is readily apparent in some patients. Patients with the greatest potential for cardiac arrest require close scrutiny for the signs and symptoms of respiratory and hemodynamic instability. This investigation will attempt to determine the best methods of administering high quality chest compressions in CPR. The PICO(T) acronym represents a format that can be used to create an answerable research question. The PICO(T) formulated question for this investigation is: In adult cardiac arrest, will the utilization of automated chest compressions compared to physical chest compressions during cardiopulmonary resuscitation improve survival outcomes? PICO(T) components consist of patient population (P), intervention (I), comparison (C), outcome (O) and time (T). The PICO(T) components used to formulate the answerable research question are: Patient population: adults in cardiac

Yearly, the adult population suffers over 350,000 out-of-hospital cardiac arrests (OHCA) in the United States (Go et al., 2012). Prehospital emergency medical services (EMS) is involved with about 60% of these cardiac arrests (CA) (Go et al., 2012). EMS frequently transports these patients to the emergency department (ED) without return of spontaneous circulation (ROSC). Of those transported without ROSC it is not unusual to pronounce the time of death shortly after arrival in the ED. The ED then must allot resources to complete the protocols after a death. Additionally, the patient’s family now has a bill for ED services, even if the patient arrived dead.

Without early intervention on average 360,000 people out of the hospital succumb to cardiac arrest. “ Cardiac arrest and sudden death account for 60 percent of all deaths from coronary artery disease”,(Bledsoe, Porter, & Cherry, 2011,2007,2004, p. 1229)There are several causes of sudden cardiac arrest. Most are caused by ventricular fibrillation. “During ventricular fibrillation, the ventricles do not beat normally. Instead they quiver rapidly and irregularly.” When this occurs, the heart pumps very little and blood does not get circulated throughout the body. “ Most of the cases found with sudden cardiac death are related to undetected cardiovascular disease.("Sudden Cardiac Death," 2015, para. 2)Sudden cardiac arrest are immediate and drastic that includes sudden collapse, no pulse, not breathing, and loss of consciousness. “Four rhythms produce pulseless cardiac arrest: ventricular fibrillation, rapid ventricular tachycardia, pulseless electrical activity and asystole.”("Circulation ," 2005, p. IV-58)Other signs and symptoms that could occur prior to sudden cardiac arrest, include fatigue,

The results suggest that preoperative warming with forced-air warmers offers no benefit over traditional therapy in maintaining normothermia during the patient’s perioperative process.