Mercy Heart and Vascular Hospital is the first hospital in the St. Louis region to implement pre-hospital therapeutic hypothermia treatment. An integrated care delivery team including area emergency responders, cardiologists, intensivists, emergency room physicians and nurses recently trained on therapeutic hypothermia for cardiac arrest patients. The training finished on Dec. 31, 2009, with eight area EMS crews (Creve Coeur EMS, Eureka EMS, Frontenac EMS, Maryland Heights EMS, Metro West EMS, Monarch EMS, Olivette Fire Department and West County EMS & Fire) now trained to offer pre-hospital therapeutic hypothermia treatment.
Mercy has performed therapeutic hypothermia on cardiac arrest patients for three years in the intensive care and cardiac care units and believes patient recovery could improve further if the treatment was started earlier. Doctors and nurses from Mercy’s emergency department, rapid response team and cardiac catheterization labs also were trained on therapeutic hypothermia.
“We want all of our patients to have the best chance at a full recovery,” said Dr. George Kichura, medical director of the cardiac catheterization lab at Mercy. “For some patients, even though we save the heart after a cardiac arrest, they may not fully recover due to damage to the brain. By offering therapeutic hypothermia before a patient arrives at the hospital, it may lessen the damage to the brain tissue.”
During cardiac arrest, the heart stops pumping blood and oxygen to the brain. If the heart is successfully restarted through CPR, there still can be ongoing damage to the brain preventing a full recovery. Therapeutic hypothermia is the only treatment that has been recognized by the American Heart Association to improve survival with good neurological outcomes of patients who remain comatose after an out-of-hospital cardiac arrest.
Therapeutic hypothermia used by the area EMS crews lowers patient body temperatures using chilled intravenous saline. When the patient is transferred to Mercy Heart and Vascular Hospital, cooling pads are used to maintain the body’s temperature at 92 degrees Fahrenheit for 24 hours. After 24 hours, the body temperature is gradually raised at a rate of less than 1 degree an hour.
Funding for cooling units needed to chill the intravenous saline was provided to the EMS crews by the Mercy Foundation.