Wake Government Information on Hypothermia

Official Wake County Government Site – Hypothermia Information

Induced Hypothermia

Every 18 hours, the Wake County EMS System responds to a patient in cardiac arrest.  These individuals have no pulse and no respiratory effort and will certainly not survive in the absence of intervention from the EMS providers.

The citizens of Wake County benefit from a well coordinated, evidence-based EMS response.  Victims of cardiac arrest in our community are among those with the greatest chance of survival.  In April of 2005, we modified our method of CPR delivery, eliminating the pauses in compressions associated with counting 15:2 or 5:1.  Since that time, we have noticed a 10% increase in the return of spontaneous circulation for victims of cardiac arrest in our community.

Despite this excellent level of care, over 75% of our cardiac arrest victims do not survive from the hospital neurologically intact.  In a large portion of these cases, we are resuscitating the heart but not the brain, leaving our patients in persistent vegetative states.

Beginning in May of this year, we evaluated data regarding controlled cooling, or induced hypothermia, for victims of cardiac arrest.  Representatives from Duke Health Raleigh Hospital, Rex Healthcare, and WakeMed Health and Hospitals joined the Wake EMS System in this evaluation process.  Over several months, we reviewed the American Heart Association guidelines, the studies from the literature, and practices from other communities.  As a result, we have developed a comprehensive, community-wide plan for care of victims of cardiac arrest.

The therapy is focused upon controlled cooling for patients who have return of pulse but are not neurologically intact — aka, remain in a coma.  While this is a new indication for induced hypothermia, it is important to note that induced hypothermia has been utilized for years.  Since the 1960s, this has been utilized in the operating room for patients undergoing open heart surgery.  More recently, it has been used for victims of heart attack and continues to be evaluated for future use in traumatic brain injury and stroke.
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