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January 6, 2010
Okla. EMSA installs therapeutic hypothermia refrigerators on ambulances
By Johnny Johnson
OKLAHOMA CITY — Normally, when single-digit temperatures and subzero wind chills are in the forecast, hypothermia is a dangerous condition paramedics are called to treat. But starting this week, EMSA medics are hoping they can save lives by forcing certain patients into a hypothermic state.
The medical technique of lowering body temperatures to help reduce the risk during a heart attack has been recommended by the American Heart Association since 2003, but EMSA officials admit it still sounds a bit like science fiction.
Cardiac arrest victim Jill Finley insists she would not be functioning today without the life-saving procedure.
"If they wouldn't have used 'the big chill' on me, honestly, I'd be laying in a nursing home with diapers," she said Tuesday in a news conference. "I don't know if you remember the Terry Shiavo case, but I was a lot like that ... and I believe that's how I would have ended up."
Finley suffered cardiac arrest two years ago while she slept. Her husband found her and began CPR.
After emergency medical technicians got a heartbeat, she was taken to Oklahoma Heart Hospital where her body was cooled with saline.
For 21 days after the procedure, she was on life support. When she was taken off life support, Finley awoke from the coma with no visible signs of distress and a recovery story she has since shared with NBC's "Today" show and ABC's "20/20."
Finley's story was one of the springboards that got EMSA officials looking at arming their emergency medical technicians with the tools to use the treatment in the field, before the patient even arrives at the hospital.
EMSA has installed therapeutic hypothermia refrigerators on all its 100 ambulances in Oklahoma, in the hopes the cooling procedure will save lives and help prevent brain damage, EMSA medical director Jeff Goodloe said.
"Already, patients who suffer cardiac arrest in Oklahoma City have a better chance of survival than patients living almost anywhere else in the nation," he said. "This new treatment will give us another advantage to save lives."
How it works
EMSA ambulances now carry refrigerated saline solution, which is kept just above 50 degrees. If a cardiac arrest patient meets a number of criteria, EMSA supervisor Jason Duncan said, a trained medic will induce therapeutic hypothermia with the cooled saline solution.
The saline will be delivered intravenously until the patient's body temperature is cooled to 89.6 degrees, well below the normal 98.6 degrees.
After getting a pulse, medics can use the method to slow the patient's metabolism and help preserve neurological function, Goodloe said.
"Cooling the patient's body down with cold packs and cold saline infusions gives those brain cells time to realize there's oxygen flowing," he said.
Copyright 2010 The Oklahoman, All Rights Reserved