Cool' New Treatment - @ JEMS.com


Cool' New Treatment

NFL uses hypothermia for spinal cord injury


 
 

Mannie Garza | | Friday, July 25, 2008


Professional football player Kevin Everett escaped paralysis, likely thanks to a novel cooling treatment that was started in the Rural/Metro ambulance that took him off the field on Sept. 9, after he suffered a cervical fracture (between C-3 and C-4) and spinal cord injury during the Buffalo Bills_ opening game.

˙We cooled the patient in the ambulance as much as we could with the AC and ice packs, and gave him cooled saline,Ó says Rural/Metro of Western New York area manager Russell Dimitroff, EMT-P, who_s in charge of Rural/Metro_s stadium operations inBuffalo. In addition,Everett received a high dose of the steroid methylprednisolone in the ambulance.

The goal was to cool the patient to 92_ F to reduce inflammation and decrease cellular damage. In the hospital, after 48 hours of cooling,Everett_s temperature was raised one degree every eight hours.Everett ultimately had surgery to remove the injured disk and bone pressing on his spinal cord.

InitiallyEverett was quadriplegic, with zero movement and feeling in his limbs, and his physicians said he had little chance of recovery. But four days later, they reversed that prognosis after he began moving his arms and legs. ˙Walking out of this hospital is not a realistic goal, but walking may be,Ó Andrew Cappuccino, MD, the team_s orthopedic surgeon, said at a news conference. A week later,Everett was transferred to a rehab hospital inHouston. At press time, he was there, working to get back on his feet.

Everett was the first spinal cord injury patient treated with hypothermia within 15 minutes, says neurosurgeon Barth Green, MD, co-director of the Miami Project to Cure Paralysis at the University of Miami Miller School of Medicine, which has been researching hypothermia treatment for spinal cord injuries. ˙This was a touchdown for us,Ó he says.

Green says Buffalo Bills owner Ralph Wilson has contributed millions of dollars to the Miami Project, co-founded by Green and former Miami Dolphin_s linebacker Nick Buoniconti, whose son Marc was paralyzed during a 1985 football game at the Citadel.

A week before the opening game, Cappuccino briefed Rural/Metro employees who provide coverage at Bills games on ˙how we were going to do C-spine [care],Ó Dimitroff says. ˙We know what their hand signals are, then we go over treatment options. We_ve always known for the past couple of years that any spinal injury for a football player means they get steroids.Ó But hypothermia treatment was new this season.

The cold saline used onEverett was stored in the Buffalo Bills_ medical cache, not in the ambulance. ˙We don_t have cold saline for cardiac arrest,Ó Dimitroff says. ˙But this case certainly has brought that [option] to light.Ó

˙I am extremely proud of the professionalism displayed by our paramedics when called into action with the spotlight of national television upon them,Ó says Richard Schneider, division general manager, Rural/Metro Medical Services.


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Related Topics: Industry News, Ambulances, Provider Wellness and Safety, Head and Spinal Injuries, Operations and Protcols, Medical Emergencies

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