Aug 5, 2009 by KJ Mullins
In what could seem like a tale from of a science fiction book. the best way to protect a heart attack patient is by putting them on ice. Many hospitals have not begun to practice the procedure though.
When minutes can mean life or death going to the right hospital is just as important. The practice of cooling takes a recent heart attack patient’s body temperature down to 91 degrees for 24 hours. There is a good reason for this, the body doesn’t require the same amount of oxygen at this temperature. In the case of cardiac arrest almost 90 percent of patients die. When cooling is used those odds quickly change in favor of the patient, almost 37 percent of cooled patients survive.
With a technique that’s fairly simply you would think it is being used everywhere, but it’s not. Only 34 percent of critical care doctors and just 16 percent of ER doctors have the equipment that is needed to rapidly cool a body.
Hometown Station reports:
“We’ve done cooling measures for quite a long time, but there’s never been a concerted effort to go hospital-wide with the process, so that anyone who has a cardiac arrest in the local community or arrests in the hospital, has the ability to benefit from the protocol,” stated G. Scott Brewster, M.D., director of the Emergency Department at Providence Tarzana. “We’re creating a standardized approach that’s literature-based and coordinated between the Emergency Department and the ICU.”
In the United States that equipment is at less than 300 hospitals out of the more than 6,000 in the nation. The equipment is expensive, costing about $25,000 for a single cooling initially. After the equipment is in place though that cost goes down to about a thousand dollars per patient.
“It’s a paradigm shift. We’re using this for people whose eyes are yellow, they’re not moving, and you’re telling doctors to cool these people for 24 hours, warm them up for a day, then take them to the cath lab. You’re doing all these things for people who look dead, sound dead and act dead. It’s asking a lot,” Dr. Ben Abella says
Cooling saved Henry Postulart of Toronto. Within two hours of what could have been a fatal cardiac arrest Mr. Postulart’s body temperature was at 91. Although he spent weeks in a medically induced coma Mr. Postulart walked out of the hospital two months after his October 15, 2008 heart attack. Without the cooling the chances are high that he wouldn’t have left the hospital alive. “I don’t exactly remember being cooled but thank God it was there.”
This is a personal story, Henry is my husband. The decision for cooling was thrust at me during the first minutes, forms were signed and my husband survived. He is a walking miracle. There are risks. It is possible that the person will suffer another cardiac arrest when the warming process is started. It is possible that the person will not survive the cooling process. What is known though is that the cooling process gives cardiac arrest patients the best chance of survival, both for their heart and in the long term for their brain. The brain is affected by the loss of oxygen during cardiac arrest. Survivors generally have some form of brain injury when they recover. In Canada cooling heart attack patients is much more common than in the United States. Cardiac patients are transported to the closest hospital with the means to do the procedure as a norm, at least in Toronto.