Scribd Logo
Upload

Welcome to Scribd!

  • 21 views

    Hypothermia in Patients Resuscit A Nontraumatic Cardiac Arrest

    Uploaded by

    alex
    This document provides guidelines for inducing mild hypothermia in comatose patients after non-traumatic cardiac arrest to minimize hypoxic brain injury. It recommends maintaining patients' core body temperatures at 33°C for the first 24 hours post-resuscitation to protect the brain during global ischemia. The guidelines specify methods for cooling patients with temperatures over 34°C or warming those below 32°C. They also address treating shivering and rewarming patients after 24 hours or upon awakening.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Hypothermia in Patients Resuscit A Nontraumatic Cardiac Arrest

    Uploaded by

    alex
    21 views3 pages
    This document provides guidelines for inducing mild hypothermia in comatose patients after non-traumatic cardiac arrest to minimize hypoxic brain injury. It recommends maintaining patients' core body temperatures at 33°C for the first 24 hours post-resuscitation to protect the brain during global ischemia. The guidelines specify methods for cooling patients with temperatures over 34°C or warming those below 32°C. They also address treating shivering and rewarming patients after 24 hours or upon awakening.

    Original Title

    PassiveHypothermiaProtocol1202

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document provides guidelines for inducing mild hypothermia in comatose patients after non-traumatic cardiac arrest to minimize hypoxic brain injury. It recommends maintaining patients' core body temperatures at 33°C for the first 24 hours post-resuscitation to protect the brain during global ischemia. The guidelines specify methods for cooling patients with temperatures over 34°C or warming those below 32°C. They also address treating shivering and rewarming patients after 24 hours or upon awakening.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    21 views3 pages

    Hypothermia in Patients Resuscit A Nontraumatic Cardiac Arrest

    Uploaded by

    alex
    This document provides guidelines for inducing mild hypothermia in comatose patients after non-traumatic cardiac arrest to minimize hypoxic brain injury. It recommends maintaining patients' core body temperatures at 33°C for the first 24 hours post-resuscitation to protect the brain during global ischemia. The guidelines specify methods for cooling patients with temperatures over 34°C or warming those below 32°C. They also address treating shivering and rewarming patients after 24 hours or upon awakening.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    HARBORVIEW MEDICAL CENTER Patient Care Services

    CRITICAL CARE GUIDELINES

    SUBJECT: HYPOTHERMIA IN PATIENTS RESUSCIT A NONTRAUMATIC


    CARDIAC ARREST

    APPROV AL: Chair, Critical Care Advisory Committee Assistant Administrator, Patient
    Care Services

    OBJECTIVE: To minimize hypoxic brain injury in patients recovering from in- or out-of-
    hospital non-traumatic cardiac arrest

    INCLUSION: Emergency Department; all Critical Care Units

    EFFECTIVE DATE: December 5, 2002

    Background: Anoxic brain injury is a major source of morbidity and mortality after cardiac
    arrest. However, there is a large body of experimental evidence and two
    prospective, randomized clinical trials that suggest that mild-moderate
    hypothermia protects the brain during global ischemia after primary non-
    traumatic cardiac arrest (ventricular fibrillation), and leads to improved
    neurologic outcome. (N Engl J Med 2002; 346:549-56, 557-63, 612-3). In
    addition, the ACLS Guidelines (October, 2000) recommend the maintenance
    of mild hypothermia (temperature >33°C) after cardiac arrest (level of
    evidence Class lIb).

    Indications: All comatose patients after VF jVT, PEA, or asystolic non-traumatic cardiac
    arrests with no contraindications to mild hypothermia.

    Contraindications: Recent trauma, burns, or surgery, hemodynamically significant bleeding or


    bleeding diathesis, refractory arrhythmias.

    Specifics: The goal temperature for the first 24 hours post-resuscitation is a core body
    temperature (esophageal) of 33°C. Specific recommendations for temperature
    management are as follows:

    If temperature is > 34°C


    • Place Cooling Blanket under patient. Set blanket temperature to lO°C.
    • Place Polar Bair Blanket over patient. Set blanket temperature to lowest setting of 1O°C.
    • Place 6 ice packs on patient - 1 under neck, 1 on top of neck, 1 in each axilla, 1 in each groin.

    • If no Polar Bair available use another Cooling Blanket (plugged into same machine) placed over
    patient.

    If temperature is between 32°C and 34°C


    • Leave patient uncovered as modesty allows.
    • DO NOT USE ANY METHODS OF COOLING OR WARMING.

    If temperature is < 32°C


    • Apply warm blankets.
    • If temperature does not move _32°C after 30 minutes, use warming methods such as the Bair Hugger
    or warm fluids ONLY until temperature reaches 32°C, then STOP warming methods.

    For patients with shivering and or agitation, meperidine and diazepam should be administered, with
    consideration of neuromuscular blockade in refractory cases.

    Rewarming after 24 hours, or sooner if the patient awakens, should be passive.

    These guidelines can be applied by initiating the complementary order form entitled "Hypothermia
    Protocol For Comatose Patients Resuscitated From Nontraumatic Cardiac Arrest", which includes
    specific interventions and drug doses.

    Version 5, 12/11/02

    You might also like