Therapeutic Hypothermia Flashcards
What percentage of Cardiac arrest occur outside of hospital and what percentage survive?
64% occur out of hospital with a 2-9% survival rate. Of these, 1/3 sustain irreversible cognitive dysfunction.
What were the current survival rate of in hospital arrest?
18%
What is the induction phase of therapeutic hypothermia?
The goal is to achieve target body temp as quickly as possible.
What means are used to achieve induction of hypothermia therapy?
Ie packs, ice lavage, rapid cold infusion, IV cath that circulates cold fluid in a closed loop.
What consideration should be made during induction TH?
Sedation and neuromuscular blockade to prevent shivering.
During induction of Hypothermia, What is expected to occur in regard to fluid balance.
Cold diuresis resulting in the loss of several liters of fluid in 1-2 hours.
What is the Goal of the Maintenance Phase of TH?
The goal is to maintain a core body temp between 32-34 Degrees C.
What is the goal of the Rewarming phase of HT?
Close control of the rewarming process.
What is the goal rate of rewarming in TH?
o.15 - 0.5C per hour is recommended.
Why is close control of the rewarming process so crucial?
Rewarming a patient too quickly may cause excessive shivering leading to deadly electrolyte shifts.
Name some considerations for monitoring during the rewarming phase of TH.
Close observation of electrolytes as they shift out of cells into serum. Close monitoring of fluid volume r/t vasodilation. Close monitoring of blood sugar (risk for hypoglycemia).
Do no perform TH on:
DNR/DNI, Underlying coagulopathy or bleeding disorder, Head injury, Core body temp of 30C prior to therapy, CPR/Unresponsive ≥60 min.
What is goal time for Induction phase of TH?
Goal = 6 hours.
What is recommended for Cannulation induction?
LR or NS 30mL/kg with pressure beg via large bore cannula.
What and How often should labs be drawn during the maintenance phase of TH?
BMP CBC Trop/CK/K-MB ABG’s every 6 hours.
