Cooling Cardiac Arrest Victims' Brains Before Admission Appears Beneficial

[Sasha]

Cooling Cardiac Arrest Victims' Brains Before Admission Appears Beneficial
Full Article: http://www.medpagetoday.com/EmergencyMedicine/EmergencyMedicine/17023

Cooling the brain of a person shortly after an out-of-hospital cardiac arrest may improve the chances of survival without brain damage, researchers reported here.

Across 15 EMS systems in Europe, patients who had intranasal brain cooling within 10 minutes of CPR initiation were more likely to have good neurological function at discharge than those who received standard treatment (45.5% versus 17.6%, P=0.01), according to Maaret Castren, MD, of the Karolinska Institute in Stockholm.

Brain-cooled patients also demonstrated significantly better survival to discharge (59.1% versus 29.4%, P<0.05).

The PRINCE (Pre-resuscitation Intranasal Cooling Effectiveness) study set out to assess the safety and feasibility of using an intranasal cooling device during CPR in the prehospital setting.

The device, called RhinoChill, is noninvasive and introduces a volatile coolant that evaporates and removes heat through nasal prongs. It is battery powered and does not require refrigeration.

I've read about therapuetic hypothermia before, but never through the nose.. interesting!!

 

[TheMowingMonk]

In the Bay Area I know of at least two counties that now have Theraputic Hypothemia in their porotocals for head injuries and Ive heard they are looking to add it for cardiac arrest as well.

 

[guardian528]

we don't have any brain chillers, but we have iced saline for post conversion in our protocols

 

[DV_EMT]

It actually was in an episode of trauma if you can believe that...

I've heard it can be beneficial used under the proper circumstances. I'd be interested to talk with some of the trauma surgeons shere about it and they're research.

 

[TheMowingMonk]

It actually was in an episode of trauma if you can believe that...

I've heard it can be beneficial used under the proper circumstances. I'd be interested to talk with some of the trauma surgeons shere about it and they're research.

Its only beneficial if the hospitals in your system use therapeutic hypothermia so that it is continued after you transfer care, if your hospitals don't continue it there is no point doing it in the field because they have to remain hypothermic for the next 24 hours after it has been initiated. Right now my system does it with 6 ice packs, but soon they are looking into chilled IVs

 

[kai.kasin]

Its only beneficial if the hospitals in your system use therapeutic hypothermia so that it is continued after you transfer care, if your hospitals don't continue it there is no point doing it in the field because they have to remain hypothermic for the next 24 hours after it has been initiated. Right now my system does it with 6 ice packs, but soon they are looking into chilled IVs

if the pt have GCS under 8 and they have too keep the temperature over 33 degrees celsius (internal temp) (under is dangerous because of arytmias)

 

[firetender]

...and commandeering an ice cream truck has not been accepted as viable protocol...

YET!

 

[VentMedic]

In the Bay Area I know of at least two counties that now have Theraputic Hypothemia in their porotocals for head injuries and Ive heard they are looking to add it for cardiac arrest as well.

Which counties? California can not do a full protocol since they are limited to what meds for sedation and paralytics they can give to prevent shivering.

 

[reaper]

I have seen to many services that are attempting this without paralytics. When you question them on the controlling of the bodies response, they are dumbfounded.

Some places are jumping into this, just to say they are doing it. They are not going off the science of it or care about doing it correctly!

 

[kai.kasin]

the sience for cooling is easy, less need for oxygen and less damage because hypoxia and for headinjuries i think they want too keep the swalling minimal until they get too the hospital?