New York City paramedics are initiating a policy of delivering many of their cardiac arrest patients only to hospitals equipped with therapeutic hypothermia capabilities. As many of our readers know, there is a growing evidence of data that shows that patients with neurological sequelae after a cardiac arrest retain more neuro function if treated with mild hypothermia, even if it was initiated as long as 6 hours after arrest.
From the New York Times:
Dr. Prezant [Dr. David J. Prezant, chief medical officer of the New York Fire Department, and who coincidentally served as a consultant for Medivance, and holds stock options in the company –ed.] said that in deference to hospital finances, the city has set no requirements for the kind of cooling techniques hospitals must use — some may start with inexpensive saline solutions and plastic bags filled with ice, while others employ sophisticated equipment manufactured and aggressively promoted by companies like Alsius, Innercool Therapies and Medivance.
Under the New York protocol, patients would be eligible for cooling if they suffered cardiac arrest and regained a pulse within 30 minutes of the start of resuscitation but remained neurologically compromised. Hospitals without the ability to cool patients would be bypassed if one that did was within a 20-minute drive. Dr. Prezant said his goal is, within six months, to begin the cooling process in the ambulance, accelerating treatment.
More in the New York Times…
ILCOR Advisory Statement: Therapeutic Hypothermia After Cardiac Arrest… Circulation. 2003;108:118.
Abstract: Mild Therapeutic Hypothermia to Improve the Neurologic Outcome after Cardiac Arrest N Engl J Med 346(8):549-556 February 21, 2002.
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