Code Cool: very cool

[Tapout 42]

I know this is not new, but the article is interesting nonetheless. For those who have used it, like it? Love it? Hate it? Why?

I know most of you reading this are pre-hospital, but I still want to hear your thoughts. We used it recently in my ER, but the outcome wasn't a happy one.

I welcome any input. Thanks...

http://www.usatoday....ling29_ST_N.htm

Edited March 29, 2010 by Tapout

[JJB531 652]

In other parts of the country, prehospital use of induced hypothermia is routinely used by paramedics working in progressive systems. White Plains ER successfully used it in the recent past to resuscitate a cardiac arrest with very positive results.

[WAS967 97]

Hypothermia treatment in cardiac arrest is the way of the future. Knowing Westchester, we'll see it sometime after 2020 because they will have to do "studies". :angry:

[PFDRes47cue 653]

Does anyone know if this is this paramedic protocol anywhere in the country? I am not a huge fan of the show Truama but i recently watched an episode and the flight medic did this with great success. It was for a pt with a severe spinal injury.

[JJB531 652]

Does anyone know if this is this paramedic protocol anywhere in the country? I am not a huge fan of the show Truama but i recently watched an episode and the flight medic did this with great success. It was for a pt with a severe spinal injury.

It is protocol in a number of systems across the U.S., especially proactive systems down south and out west.

[ny10570 745]

A system in North Carolina, Wake County was an early adapter and has published a lot research. It has since spread to agencies across the country. There are a variety of methods of induction used including cooling blankets, ice packs, and cold saline infusions. FDNY is awaiting the next round of ambulances before they begin cooling patients in the field.

Benefits of hypothermia for spinal injuries is still hypothetical and not well researched. In post arrest patients cooling has shown a small increase in survival rates, but a substantial bump in survival to discharge and patients remaining neurologically intact.

With cooling, you're not necessarily going to save more lives, but you're going to give people a chance at going back to a normal life.

Thanks Goose for the correction

Edited March 30, 2010 by ny10570

[Goose 188]

A system in South Carolina was an early adapter and has published a lot research. It has since spread to agencies across the country. There are a variety of methods of induction used including cooling blankets, ice packs, and cold saline infusions. FDNY is awaiting the next round of ambulances before they begin cooling patients in the field.

Benefits of hypothermia for spinal injuries is still hypothetical and not well researched. In post arrest patients cooling has shown a small increase in survival rates, but a substantial bump in survival to discharge and patients remaining neurologically intact.

With cooling, you're not necessarily going to save more lives, but you're going to give people a chance at going back to a normal life.

I think you mean North Carolina, and that would be Wake County EMS.

Also, good point that this wont save more lives...but for those we get back we may not be looking at survival only to be a veggie at the local nursing home but survival to the point where one can lead a relatively normal life.

[16fire5 693]

The Commisioner's opening comments in WNYF(the official publication of the FDNY) Issue 1/2010 states that the FDNY will begin implementing this in the spring.

[Guest partyrock]

The Commisioner's opening comments in WNYF(the official publication of the FDNY) Issue 1/2010 states that the FDNY will begin implementing this in the spring.

Maybe an EMS member has heard otherwise, but that had been delayed pending REMAC approval.

[WAS967 97]

It was actually pending SEMAC approval (which it got). Now I believe it just needs to be rolled out.

From http://www.saratogaems.org/SEMSCO%20News/2010_SEMSCO1_Feb.doc

1.In other business, both Medical Standards and SEMAC approved a prehospital hypothermia study proposed by NYC. [snip] Under the proposed (and approved) protocol, medics will begin an infusion of 30 cc’s per kilogram of 4°C saline (up to 2 liters total) at the start of each out of hospital resuscitation. It is hoped that the results will boost the present 1:4 survival to discharge rate.

Note that it's considered a study (for now). IF the results are positive, expect it to be adopted for the long term.

[ny10570 745]

It was supposedly going to be part of the changes this April, but was dropped from the final version. I've heard 2 stories. First, Remac has questions about when the cooling will begin, before or after rosc. The second is FDNY stalled it awaiting the delivery of the next round of vehicles which will have the saline coolers.

[nwpfdjr27 39]

The ambulance company that I work for here in the Albany/Schenectady area has just implemented the therapeutic hypothermia protocol under REMO. We are able to transport ROSC patients receiving the treatment to Albany Medical Center or St. Peters Hopsital in the City of Albany, or Ellis Hospital in the City of Schenectady. Hopefully, we will start to see some real success with the new protocol even at the pre-hospital level.

[Tapout 42]

Thanks for all of the useful and interesting replies. I hope the use of the code cool protocol PRE-hospital will improve the outcomes we end up with IN-hospital.

Stay well, be safe and don't come to me in any way but to DROP OFF a patient. In other words, don't get yourself hurt on-scene and end up AS my pt. because I reeeeeally like my 16's and 18's in AC's and I can get them there overhand from across the room....

[WAS967 97]

Talk to us when you can get 14s in the hand blindfolded.

To quote a medic I once worked with - "orange is my favorite color"

[Tapout 42]

Talk to us when you can get 14s in the hand blindfolded.

To quote a medic I once worked with - "orange is my favorite color"

Ok, I can put in a 14g in a hand either blind-folded OR in the dark and with or without a tournequit... but why on earth would I WANT to???!!! Yikes! Isn't that just cruel and unusual?

T.O.