CTMC/St. David’s HealthCare Affiliation Leads to New Therapeutic Hypothermia Protocols for Cardiac Arrest Patients
Central Texas Medical Center (CTMC), working with St. David’s HealthCare, today will begin implementing therapeutic hypothermia protocols in the emergency room to lessen or prevent neurological damage due to cardiac arrest.
CTMC and St. David’s HealthCare announced a formal affiliation agreement in December 2008 in which the Austin-based hospital system would provide clinical and other support services to CTMC, including emergency department and neonatology physician staffing.
The American Heart Association has recommended induced therapeutic hypothermia following cardiac arrest and after a patient’s pulse has returned because the treatment has been shown to decrease a patient’s chances of brain damage.
When the heart stops beating during cardiac arrest, the brain’s supply of oxygen is cut off. Doctors used to believe it was because of the oxygen loss alone that many patients who lost consciousness would die or suffer severe brain damage. Now, doctors believe that the oxygen loss sets off a series of other harmful processes. For hours and possibly days after the heart starts beating again, the body’s reaction to the trauma can make neurological damage worse. Induced therapeutic hypothermia treatment slows that process down.
“This new service represents another good example of how collaboration between two cutting-edge healthcare providers can save lives,” said Gary L. Jepson, chief executive officer, Central Texas Medical Center.
As a first step in launching hypothermia, or “cooling,” treatments at CTMC, St. David’s HealthCare clinicians helped CTMC to develop formal protocols for treating post-cardiac arrest patients who have had a return of their heart beat and who would be appropriate for therapeutic hypothermia treatment.
After the therapeutic hypothermia treatment protocols were developed, St. David’s HealthCare clinicians provided onsite training to CTMC emergency room staff.
An appropriate candidate for induced hypothermia treatment is a patient whose pulse has returned following a cardiac arrest. Once CTMC emergency room staff members determine that a patient is appropriate for induced hypothermia treatment, Travis County’s STAR Flight will be contacted to transfer the patient to a St. David’s HealthCare hospital that has been designated a Resuscitation Center of Excellence by Austin Travis County Emergency Medical Services. (STAR Flight is the chosen air medical service because it has controlled cabin temperatures and necessary refrigeration equipment.)
As soon as STAR Flight arrives, CTMC staff members will initiate “cooling” with an intravenous infusion of saline chilled to four degrees Celsius. Additionally, CTMC staff members will initiate the diagnostic process to identify the cause of the patient’s cardiac arrest as well as his or her risk factors in order to expedite the course of treatment upon arrival at a designated St. David’s HealthCare facility.