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Lessons in Transport - Therapeutic Hypothermia Part 3
Prehospital Medicine, Lessons in Transport Medicine Ryan Gerecht, MD Prehospital Medicine, Lessons in Transport Medicine Ryan Gerecht, MD

Lessons in Transport - Therapeutic Hypothermia Part 3

Common Issues in Therapeutic Hypothermia

1) Bradycardia: may occur during induced hypothermia (even to as low as 35 bpm) and except in rare cases, is NOT a reason to discontinue hypothermia.

  • If bradycardia is severe, associated with persistent hypotension, and is not responsive to fluid and vasopressor therapy, a decision in conjunction with medical control to discontinue hypothermia may be made.

2) Dysrhythmias: generally does not occur unless temperatures fall < 30*C and hypothermia related ventricular fibrillation is rare unless temperature is < 28*C.

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Lessons in Transport - To Cool or Not to Cool?
Prehospital Medicine, Lessons in Transport Medicine Ryan Gerecht, MD Prehospital Medicine, Lessons in Transport Medicine Ryan Gerecht, MD

Lessons in Transport - To Cool or Not to Cool?

To COOL or NOT To COOL that is the question...

(Read each of the following scenarios & honestly ask yourself if this is a patient suitable for therapeutic hypothermia)

Scenario 1: 67 yo male scene STEMI, witnessed Vfib arrest with ROSC, GCS 3T, stable vitals

Scenario 2: 24 yo female MVC, ejected, hypotensive for EMS, 10 minute cardiac arrest with ROSC, GCS 3T

Scenario 3: 2 yo female cardiac arrest suspected choking, ROSC after removing food from her airway. GCS 4T (1T2)

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