Therapeutic hypothermia decreases risk of brain damage, increases survival chances, officials say
By Matt Presser
American-Statesman
Copyright 2008 American-Statesman
AUSTIN, Texas — When Connie Snell’s husband found her in bed one Sunday morning five years ago, her tongue was hanging out of her mouth, her eyes were rolled back and she “was already basically dead,” she said.
Paramedics took her to Seton Medical Center, where she had been treated for breast cancer years before. After she arrived there, doctors thought the only way to prevent severe brain damage would be to try an experimental technique called therapeutic hypothermia, or cooling therapy. The technique involves lowering the body temperature of someone suffering from cardiac arrest to protect the brain from injury.
Doing so saved Snell’s life. “It was like a miracle,” said Snell, now 61. “I’m not a vegetable. I’m not in a nursing home right now. I’m not dead.”
Because of cases like Snell’s, officials plan to make Travis County one of the first areas in the U.S. to use hypothermia to reduce brain damage in cardiac arrest victims. The plan calls for placing cooling systems in all hospitals and Emergency Medical Services vehicles by March or April and training the system’s approximately 300 paramedics by June.
“Only a couple of cities in the country are doing this (therapy) on a regular basis,” said Dr. Paul Hinchey, assistant medical director for Wake County EMS in Raleigh, N.C., which uses the treatment. “Austin is going to be one of the early adopters, and we’re thinking it’ll really be a model for others.”
About 100 emergency responders, hospital executives and physicians from across Central Texas met Wednesday to examine data and discuss how to standardize the use of therapeutic hypothermia.
“Cooling is the hottest topic in resuscitative medicine right now,” said Dr. Edward Racht, medical director for Austin-Travis County EMS. “The evidence continues to evolve, and we feel like this community is in a perfect position to move that science into practice.”
Cooling therapy, which tends to last hours or even days, can be carried out by multiple means, including an infusion of intravenous fluids and the application of ice packs or blankets.
Therapeutic hypothermia gained national attention when it was used to treat professional football player Kevin Everett of the Buffalo Bills, who suffered a life-threatening spinal cord injury during a game in September. After cooling therapy, Everett can walk again.
An estimated 310,000 people die from sudden cardiac arrest each year, and only about 6 percent of cardiac arrest sufferers survive, according to the American Heart Association.
The Austin area is in a unique position to use hypothermia because of the cooperative nature of its hospitals and emergency response agencies, Racht said. “We joke that Austin, Texas, is the best place in the world to have a cardiac arrest. We’re fortunate in this community.”