Hypothermia After Cardiac Arrest Protocol
The American Heart Association recommended in 2005 that all ventricular fibrillation cardiac arrests that occur outside of a hospital be cooled to 32˚-34˚C. The procedure involves slowly cooling and then re-warming patients over a 48-hour period. The recommendation was based on evidence that cooling improves neurological outcomes in patients. In 2006, MUSC became one of the first hospitals in South Carolina to implement the Hypothermia After Cardiac Arrest Protocol.
MUSC’s implementation of the protocol was led by an interdisciplinary team, including: Alice Boylan, M.D., Pulmonary Critical Care Medicine; Julio A. Chalela, M.D., Neurology; Salvatore Chiaramida, M.D., Cardiology; and Jo Anne Naylor, RN, BSN, CCRN, of the Coronary Intensive Care Unit. In the last four years, MUSC has used the protocol to treat more than 50 cardiac arrest patients across its six intensive care units. More than 50 percent of patients who received the treatment survived with a good neurological outcome. Use of the protocol was expanded to MUSC’s Emergency Department in 2008 and to Emergency Medical Services, which began cooling patients in ambulances, in 2009. MUSC currently leads the state in hypothermia management and heads a committee for the South Carolina Hospital Association to ensure implementation of hypothermia protocols in hospitals across the state.
One of the most extraordinary survivors treated with the hypothermia protocol at MUSC is 19-year-old Stephen Brown, who received the treatment last fall after more than 37 minutes in sudden cardiac arrest (during which time he also received CPR and emergency services from an MUSC medical student and EMS personnel). Most patients do not survive after that length of time without a pulse and few regain full brain function after only six minutes. But Stephen, affectionately called "Miracle Boy" by the MUSC staff, has fully recovered, retains all of his neurological functions, attends the College of Charleston, and volunteers on the cardiac floor at MUSC, where he hopes to attend medical school to become a cardiologist.