Friday, January 04, 2008

Therapeutic hypothermia after cardiac arrest: it’s not getting done

An article in Emergency Medicine News asks why. For one thing, simple though it seems, it’s hard to implement and requires an institutional commitment. Another reason is no one is promoting it despite the fact that we’re five years out from published studies now. Where’s Joint Commission?

2 comments:

MaryClareHill said...

Hello Dr. RW -
I understand your frustration. It has been difficult for us to UTILIZE our therapeutic hypothermia protocols even though the protocols have existed for a while. Here is what has helped us: Take a look at www.takeheartamerica.com. This is a campaign which is working to implement TH, ITD, good CPR, and early PCI in entire communities - I recently became aware of this campaign. Our hospital is currently using all these interventions and awaiting outcomes. I am hoping to bring Take Heart America to Cincinnati, because it provides a framework for implementation of these interventions throughout the entire community. So, Take Heart, Dr. RW, don't give up. Please communicate with me if you wish to discuss our plans / your plans further. Mary Clare Hill MD, Associate Professor of Clinical Anesthesiology, University of Cincinnati; Chair of CPR and Rapid Response Team Committees, University Hospital, Cincinnati, OH. (hillmc@ucmail.uc.edu)

Mary Clare Hill MD said...

Hello RW,
It's Mary Clare Hill again. I wonder why there have not been followup comments. Could it be that there is little interest? Or is it a matter of awareness? I am anxiously awaiting the 2010 AHA Guidelines - hoping there will be more emphasis on Therapeutic Hypothermia this time 'round. (Now that everyone has the idea of "good CPR", maybe we can move on to focus on other adjuncts such as TH and ITD's.) In our hospital, we finally have a "champion" for TH - a neuro-critical care Fellow who is dedicated to changing our hospital's culture of post-resuscitation care.
With respect to the larger community - in my previous post, I talked about Take Heart America. I still think that is a great organization (www.takeheartamerica.com). However, as a result of discussions with some key persons in my community, I have decided instead to work within the system set up by the AHA - we have formed a community coalition made up of community educators, pre-hospital emergency caregivers, and hospital caregivers(American Red Cross/individual community groups, paramedics/fire, emergency medicine/cardiology/intensivists). We will be working together to follow the recommendations made by the AHA and expect to improve the survival rates (including functional survival) from cardiac arrest in our community. Wish us luck.
Mary Clare