Holy Name Establishes Hypothermic Therapy Program
For certain cardiac arrest patients, lowering body temperature to 93°F halts brain damage
Teaneck, NJ - Critical care and emergency medicine professionals have always celebrated "getting a patient back" from cardiac arrest. Unfortunately, that success sometimes brings with it lifelong deficits, as people deprived of oxygen can suffer brain damage with catastrophic results. But a technique that involves cooling the body temperature to the point of hypothermia can reduce the incidence of brain damage, increasing the chance for a normal quality of life for cardiac arrest patients whose lives would otherwise have been forever altered.
This month, Holy Name Medical Center (HNMC) established its new Hypothermic Therapy Program, which will be administered exclusively to eligible patients admitted through its Emergency Care Center. According to Holy Name's Joe Giles, RN, MSN, CNE-BC, Administrative Director of Critical Care and Emergency Services, there are a variety of therapeutic hypothermia methods, but Holy Name will use the ThermoSuit® System, which involves placing the patient in an inflatable tub-like vessel (the ThermoSuit®), into which cold water and cubed ice are introduced. An esophageal probe monitors the patient's core temperature, which is lowered to 93°F for 30 minutes.
After the target temperature is reached, the healthcare team has a six-hour window during which patients can undergo diagnostic testing, such as catheterizations and CT scans. The patient is then transferred to the ICU where, for between 16 and 24 hours, s/he remains hypothermic via cooling blanket. Thereafter, the patient is slowly warmed over the course of 24 hours.
"Therapeutic hypothermia gives us the opportunity to not only celebrate survival, but to offer a greater likelihood of returning the patient to a productive life," says Sheryl Slonim, DNP, RN-BC, NEA-BC, Executive Vice President, Patient Care Services and Chief Nursing Officer. "Preserving quality of life takes our role of caregiver to the next level; it's what we're all about at Holy Name."
A years-old concept, revisited in recent decades
Not a new concept historically, but revisited and refined over the last several decades, therapeutic hypothermia works by reducing the cerebral metabolic rate and suppressing the chemical reactions that can lead to cell death. Eligible patients are 18 years or older, and are comatose following a non-traumatic cardiac arrest with return of spontaneous circulation (ROSC) within five minutes.
Last year, New York State enacted legislation that made therapeutic hypothermia the standard of care for patients who were comatose after cardiac arrest with ROSC. There, paramedics delivering such patients to the hospital must bypass emergency rooms that don't offer the therapy. Like New York, not all hospitals in New Jersey have hypothermic therapy. Caregivers at Holy Name are pleased to afford this quality-of-life-saving intervention to its patients and to be ahead of the curve before therapeutic hypothermia becomes law in our state, as well.