LOWERING THE TEMPERATURE

LOWERING THE TEMPERATURE;

HYPOTHERMIA TREATMENT POST CARDIO PULMONARY RESCUCITATION
Neil Mooney
Lewis-Clark State College

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This paper is going to examine systemic hypothermia treatment and its effects on
the body following cardio pulmonary resuscitation (CPR). This shows the actions an
acute care nurse can take based on evidence based practice when presented with patients
that fall within this category. Research is still being conducting in order to show the
effectiveness of hypothermia treatment for patients with other morbidities that cause
trauma to the central nervous system (CNS).
Arrich (2012) states around 30% to 50% of patients with coronary heart disease
suffer sudden cardiac death at some stage in their illness. With cooling methods initiated
post CPR, patients were 55% more likely to leave the hospital without major brain
damage (Arrich, 2012).
Using the PICO model to better understand this topic, I formulated the question,
What are the effects of hypothermia treatment in the acute care setting? This question
was formulated and then revised when finding that my population needed to be narrowed
to patients with sudden cardiac death. This treatment is relatively new and there has not
been the opportunity to test a variety of disease process in which hypothermia treatment
could slow the progression of neurological damage.
Do further my search criteria, I decided to focus on which situations would
present with the need for this treatment, how the nurse would educate patients as well as
other healthcare professionals on the use of hypothermia treatment, and the effectiveness
of the treatment.
Arrich (2012) states that of the reported cardiac arrests, in which resuscitation
were attempted, that happened in industrialized countries, 14% to 40% of the patients

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achieved return of spontaneous circulation and were admitted to the hospital. There is
data within the two studies reviewed that shows if therapeutic hypothermia is initiated
within 6 hours of resuscitation the chances of neurological damage are significantly
decreased (Jasmin, 2013). Therapeutic hypothermia is defined as a controlled mild
hypothermia that reduces body temperature below 32 degrees Celsius.
After understanding that the intervention is effective, it is important to show how
the nurse will integrate into the treatment. There appears to be two ways in which the
nurse can see this specific type of intervention. The first way would be an acute care
transport nurse either by ground or by air. Protocol could dictate this procedure being
initiated en route, especially in the case of longer transport times. The other instance
would be in the emergency room in which the patient would present post resuscitation.
This is most certainly not all encompassing, however these are the nurse roles in which
the scope of this paper will focus on.
Specific treatment includes cooling the patient core body temperature to target
temperature of 32 degrees to 34 degrees Celsius. This temperature will be maintained for
12 to 24 hours (Jasmin, 2013). Methods of cooling can include ice packs, cold air
mattresses, and water circulating cooling pads. Nursing interventions methods most
anticipated include intravenous (IV) cooling catheters as well as infusion of cooled fluids.
Hypothermia treatment through IV methods appears to be more controlled and reason for
most anticipated.
Teaching to the patient in most instances would not be necessary because in most
cases the patient is unconscious. However, for the patient that is conscious, it is important
for them to understand that they will be cold. The patient being cold will help slow the

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bodies processes in order for the brain to not become damaged. Important teaching to the
family would mostly be about the circumstances that made the hypothermic treatment
necessary. However, the treatment could be explained to them in the way it was explained
to the patient with some explanation of the patients skin being cold in the instance the
family does go to touch the patient.
Conclusion
For any nurse that is in or has interest in the acute care setting, it is vital to
understand this treatment as it has the high possibility of becoming more widespread.
This is speculation, however, with the percentages of success in use with patients post
CPR, it would be against the progression of healthcare to not use this intervention.
However, this intervention does need much more research in other types of
circumstances. There is conclusive research showing this intervention not working in
other, non-acute disease processes.

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5
References

Arrich,J.,Holzer,M.,Havel,C.,&Mollner,M.(2012).Hypothermiafor
neuroprotectioninadultsaftercardiopulmonaryresuscitation.
CochraneDatabaseofSystematicReviews.RetrievedMarch14,
2015,fromCochrane.
Jasmin,A.,Christof,H.,Michael,H.,&Harald,H.(2013).Prehospital
versusinhospitalinitiationofmildtherapeutichypothermiafor
survivalandneuroprotectionafteroutofhospitalcardiacarrest.
CochraneDatabaseofSystematicReviews.RetrievedMarch14,
2015,fromCochrane.