November 17, 2006
On Oct. 5, the Wake County EMS System in Raleigh, N.C., began prehospital induction of hypothermia for victims of cardiac arrest who are non-neurologically intact after return of spontaneous circulation (ROSC).
During the preceding six months, representatives from EMS joined with partners from receiving hospitals to form an induced hypothermia task force. Participants included paramedics, emergency department and critical care nurses, and physicians representing EMS, emergency medicine, cardiology and intensive care. This group developed protocols promoting coordinated care that begins in the field, continues in the emergency department and is completed in the ICU.
The task force concluded that commercially available cooling products could not be placed aboard the nearly 50 ambulances in our EMS system due to fiscal constraints and lack of sufficient space on the ambulances. After reviewing previously published protocols, the group chose to use ice packs and the infusion of chilled saline as the prehospital tools for induction [click to follow the link]