Therapeutic Induced Hypothermia

Inter-Canyon Fire/Rescue now provides Therapeutic Induced Hypothermia (TIH) to patients after successful CPR and resuscitation.  The EMTs, EMT-Intermediates and Paramedics of ICFR work together to rapidly apply this therapy to assist the patient in recovery after cardiac arrest.

Approximately 300,000 people suffer a sudden cardiac arrest in the United States each year.  Historically, 2-8% of these patients will survive to be discharged from the hospital. Recent advances in pre-hospital treatment have increased the number of patients who experience a return of spontaneous circulation (ROSC), but less than half of these patients will survive to be discharged from the hospital. The main cause of death for these patients is due to anoxic brain injury. The use of induced therapeutic hypothermia may prove to be an important advancement in improving patient outcome.

The use of therapeutic hypothermia is not a new concept. Hippocrates, the father of Western medicine, noted the benefits of hypothermia in treating injuries. Napoleon’s surgeons recorded that wounded soldiers who were further from the fire had a higher survival rate that the wounded officers who stayed close to the fire. In the 1950’s, studies showed that inducing hypothermia in dogs decreased oxygen consumption, and that induced hypothermia after cardiac arrest in humans improved survival rates.

The goal of induced therapeutic hypothermia is to decrease the patient’s body temperature to 32-34oC, and then maintain that for 24 hours. After that time period, the patient will slowly be re-warmed, over 6-8 hours. ICFR uses several methods to cool the patient following the return of a pulse after cardiac arrest: cooled saline infusions and the application of cold packs.  These techniques are outlined in the Denver Metro Protocols, which outline the care for pre-hospital patients.

The most important predictor of a positive outcome following cardiac arrest is the rapid application of CPR, alerting 911 and a prompt use of defibrillation such as an Automated External Defibrillator (AED).  ICFR has an AED at each of our five stations, positioned on the ambulance or engine.