South Jordan Fire Department Paramedics Seek Therapeutic Hypothermia Expansion - @ JEMS.com


South Jordan Fire Department Paramedics Seek Therapeutic Hypothermia Expansion


 
 

CARRIE A. MOORE | | Friday, December 4, 2009


Though hypothermia kills several Utahns each year in the backcountry, paramedics used "the big chill" to save Thomas Anderson's life - and he doesn't remember anything about it.

The 51-year-old South Jordan resident and his wife, Debra, were sitting in their living room during the noon hour on Nov. 4, reading and watching TV. Suddenly, Debra Anderson heard her husband "making strange breathing sounds. I looked over, and he was slumped in his chair" and unconscious, she said. "I started trying to get him talking. I'd never heard him make sounds like that before," she said. After he didn't respond, she called 911, and the dispatcher instructed her on how to perform cardiopulmonary resuscitation on her husband, which she did for less than five minutes until paramedics and firefighters arrived. Little did she know the emergency responders had just finished training in a technique called "therapeutic hypothermia," used on patients in cardiac arrest.

As six people began working to save her husband on the living room floor, one of them inserted an IV to run medication and fluid chilled to 40 degrees throughout his body. The procedure, which has been widely used in hospitals nationwide for several years, lowers the patient's body temperature, which can protect brain cells and other vital organs from being further damaged by a lack of oxygen. The South Jordan Fire Department is the first in Salt Lake County - and one of only about 100 departments nationwide - to train and equip EMS workers in the technique, allowing them to begin lowering body temperature before the patient is even transported to a hospital.

As Anderson was headed toward Jordan Valley Medical Center, paramedics were communicating with the cardiac team there, providing information not only on Anderson's vital signs, but working off of remote EKG results after performing the test on him before they reached the emergency room. Dr. Bart Johansen, the hospital's director of emergency medicine, had helped train the EMS team in the technique and was there to make sure Anderson went straight to the cath lab, where doctors cleared the blocked artery that had stopped his heart.

Cardiac team members also continued the therapeutic hypothermia using a cooling blanket, eventually lowering Anderson's body temperature to about 92 degrees, Johansen said. "Research has found that if you drop body temperature lower than 90 degrees, you begin to see complications." Johansen, the Andersons and South Jordan fire personnel explained the procedure at a news conference Thursday, noting the long-term partnership between the fire department and Jordan Valley Medical Center when it comes to emergency cardiac care. At this point, only Intermountain Medical Center, University Hospital and St. Mark's Hospital have the capability to interface with the therapeutic hypothermia EMS team, according to South Jordan Battalion chief Wayne Edginton. But he anticipates other cities will begin offering similar services in the future. The technique is only used on patients who are unconscious, Johansen said, noting medical personnel will continue to sedate them and provide medication to keep them from shivering - both when they're being cooled, and when they're being warmed again after about 72 hours. Only at that point can doctors determine what, if any, damage the patient has suffered from cardiac arrest. "This technique has been used for years, but usually only in a hospital ICU setting," Edginton said. "We've brought that down to the emergency department level now, where we come in the door and we've already started" the therapeutic hypothermia.

Thomas said he had never had heart trouble before but had some jaw pain a few days before he collapsed. He wondered if there could be a problem but decided it was nothing serious. Both he and his wife said they were happy for the chance to thank all those who helped save his life, noting he has suffered no long-term complications from an event that could easily have killed him. "I didn't wake up until three or four days later, and I didn't even know what had happened," Thomas said. "I had to ask. And I'm very grateful I live in South Jordan."




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