{"id":267,"date":"2024-10-30T20:17:44","date_gmt":"2024-10-30T20:17:44","guid":{"rendered":"https:\/\/iims.uthscsa.edu\/isrn\/?page_id=267"},"modified":"2024-11-07T16:33:10","modified_gmt":"2024-11-07T16:33:10","slug":"hypothermia-after-cardiac-arrest-implementing-an-evidence-based-protocol-abstract","status":"publish","type":"page","link":"https:\/\/iims.uthscsa.edu\/isrn\/resources\/ereading-room\/abstracts\/hypothermia-after-cardiac-arrest-implementing-an-evidence-based-protocol-abstract\/","title":{"rendered":"Hypothermia after Cardiac Arrest: Implementing an Evidence-Based Protocol"},"content":{"rendered":"

[vc_row][vc_column width=”2\/3″][vc_column_text css=””]<\/p>\n

Abstract<\/span><\/h1>\n
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Problem<\/h3>\n

Each year, many deaths occur in the US from out-of-hospital cardiac arrest. Of those that survive, a high percentage will later die or sustain severe neurological deficits; therefore, improvements in mortality and neurologic outcomes are needed. Therapeutic hypothermia (TH) is an evidence-based practice proven to have a positive neurological impact after sudden cardiac arrest. A hypothermia protocol should be utilized in the practice setting to improve patient outcomes.<\/p>\n

Evidence<\/h3>\n

In 2002, two landmark studies showed that TH improved mortality and neurological outcomes in adult patients who had an out-of-hospital cardiac arrest from ventricular fibrillation or pulseless ventricular tachycardia. As a result of the evidence, the AHA and ILCOR recommended the use of TH in these patients (IIa recommendation) as well as other cardiac arrest rhythms and in-hospital patients (IIb recommendation).<\/p>\n

Strategy<\/h3>\n

To adhere to the AHA & ILCOR recommended guidelines, in January 2009, Wilford Hall Medical Center (WHMC) formed a multidisciplinary team to review the literature and create an evidence-based protocol to be utilized in their ICU and ED.<\/p>\n

Practice Change<\/h3>\n

Prior to implementation, staff was educated on the protocol and Alsius Thermagard by a sales representative and Nurse Educator via PowerPoint presentations, bulletin boards, and hands on training. Recruiting champions, providing evidence, continuous education and training helped influence acceptance of change.<\/p>\n

Evaluation<\/h3>\n

The following data are collected on patients who receive the hypothermia protocol: date, time, age, sex, heart rhythm, time before ROSC, number of hours on therapy, and patient outcome. The data is reported to the South Texas Regional Advisory Council.<\/p>\n

Results<\/h3>\n

WHMC was first in Department of Defense and first in San Antonio, Texas to implement therapeutic hypothermia! Since January 2009, nine patients received TH with two patients discharged home and one discharged to LTAC.<\/p>\n

Recommendations<\/h3>\n

Therapeutic hypothermia is a necessary post-resuscitative treatment that should be a standard treatment strategy to preserve neurological status.<\/p>\n

Lessons Learned<\/h3>\n

ED and ICU need to have better collaboration.<\/p>\n

Bibliography<\/h3>\n