Get Cool to Survive Cardiac Arrest

If you should suffer from cardiac arrest you will benefit from living in cities like New York, Seattle, Boston, Miami, Vienna or London. In fact, you might keep living in these places because hospital emergency rooms have equipment to give patients cooling with therapeutic hyperthermia and emergency personnel know how important it is to get patients to these hospitals. This treatment has been endorsed by the American Heart Association.

Death from cardiac arrest, resulting from ventricular fibrillation or clogged arteries, usually happens because the person's brain becomes oxygen starved. Consider this awful statistic: only 6 percent of the 220,000 Americans who suffer cardiac arrest each year survive it. The goal of the cooling treatment is to get the body temperature about 8 degrees Fahrenheit below normal. The person's pulse must be restarted with defibrillation if the treatment is to work, even though they may be comatose.

Hospitals use different kinds of cooling techniques, from relatively simple to high tech. On the simple, inexpensive side is saline solutions and plastic bags filled with ice, or cooling blankets and alcohol washes. On the sophisticated side is equipment manufactured and aggressively promoted by a number of companies. Research found that cooling is needed within six hours of an attack and should be maintained for 24 hours and then followed by gradual warming of the patient. The patient is also given sedating and paralyzing drugs to prevent shivering and put on a ventilator.

In 2002 two studies were published in the New England Journal of Medicine that made the case for using cooling to save lives. For example, in one study, 55 percent of the patients who received the cooling treatment experienced moderate or no brain damage, compared with 39 percent who received standard treatment. For cooled patients, about 41 percent died within six months, compared with 55 percent of the others.

Yet hospitals have been slow to adopt the cooling treatment, with probably fewer than 500 of the nation's 4,000 hospitals using it. Why? The treatment requires more care and coordination among emergency responders and medical personnel. But from the patient's perspective getting to an emergency room that offers cooling is critically important, even if it means bypassing a closer hospital.

Despite all the positive results with cooling that is saving lives relatively few Americans are aware of this treatment. Most are uninformed about whether their community's ambulance or fire department response personnel know about it and has a protocol to get the patient to a hospital that has the cooling equipment. This must change.