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Hypothermia Therapy
 

Hypothermia Therapy

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    Hypothermia Therapy Hypothermia Therapy Presentation Transcript

    • Therapeutic Hypothermia following Cardiac Death Dr. Brian Bane Atalanta Wan, RN, CNS
    • Therapeutic Hypothermia following Cardiac Arrest
      • 40% higher rate of favorable neurological outcomes.
      • 25% improving in mortality.
      • Early induction of hypothermia (“time is brain”).
      • Mild hypothermia, goal is 32 – 34 0 C.
      • Using sedation and neuromuscular blockade to avoid adverse effects of chilling, such as shivering, catecholamine release, vasoconstriction, and thermogenesis.
    • Systemic complications of hypothermia
      • Cardiac arrhythmias – bradycardia, V. Fib
      • Coagulopathy – platelet dysfunction, abnormal coags.
      • UTI, pneumonia
      • SIRS if rewarming is too rapid.
      • Hypokalemia, hyperglycemia, pancreatitis, ileus
    •  
    • Cooling Blanket Set Up Module set to ‘Auto’ Attach cables and connect cables to the top cooling blanket Attach cables and connect cables to the bottom cooling blanket Temperature set at 33 0 C Connect to Foley Temperature probe
    •  
    • Placement of electrodes along the ulnar nerve - +
    • Placement of electrodes along the facial nerve + - -
    • Placement of electrode along the posterior tibial nerve + -
    • Rewarming
      • Rewarm to 37 0 C.
      • Turn room thermostat up to normal.
      • Turn on heater on ventilator.
      • Remove cooling blanket.
      • May use blanket.
      • Discontinue neuromuscular blockade.
      • Monitor patient for hypotension.
      • Monitor patient for hyperkalamia.