 |
 |
In message <[log in to unmask]> "Black, John" <[log in to unmask]> writes: > Ayan, > > I have had experience of thromobolysis in young PEA patients with confirmed > pulmonary embolism on echo or confirmed DVT. Although the patients were > quickly resuscitated (5-10 mins of ALS) the neurological outcome was poor as > a consequence of a completely obstructed circulation at normothermia - this > was before systemic cooling protocols as recently advocated by IlCOR > (Circulation 108:118-121). > > How many of you are implementing cooling strategies in unconscious patients > following out of hospital cardiac arrest? Are you being selective? > <SNIP> Yes, though our cardiologists balked at the 2 litres of cold normal saline and we have elected to go for 2 x 500mL cold normal saline instead. Ice packs also applied and directions to crews to open windows, undress patient and put extractor fan on to cold blow. Our digital thermometers needed to be replaced as could not read that low. Have written to our local ITUs and EDs and know that one ITU has equipped with cold equivalent of Bair Hugger for the advocated period of hypothermia in ITU. Our paramedics also routinely thrombolyse post-cardiac arrest as well if the 12 lead ECG shows an acute MI, even if the patient is still unconscious. Anton Staffs