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Gaston County First in NC to Implement Induced Hypothermia in Cardiac Patients

JEMS.com Editor's Note: Gaston County, N.C. was not the first in the state to introduce induced hypothermia to treat cardiac arrest patients. Click here to read the November 2006 JEMS article "Wake County EMS Cools Down."

CHARLOTTE, N.C.-- Cardiac arrest patients in Gaston County, N.C., could be helped by a chilling new treatment paramedics hope to start as early as March.

Patients will be packed in ice, given cold IV fluid and medicated to produce hypothermia on their way to the hospital. The treatment is an emerging trend that has gained greater respect over the past few years as a way to save lives, said Clyde Cantrell, Gaston County EMS spokesman.

If state officials approve the plan, Gaston Countywill be among the first counties in the state to use the treatment, said Dr. Timothy Corvino, medical director for the EMSdepartment.

In 2007 Gaston County paramedics responded to 659 cardiac arrest calls, department records show.

Induced hypothermia calls for ice packs to be put on the patient, including under the arms, and a saline IV fluid chilled to at least 39 degrees into the blood stream. Chilling the body forces everything to slow down, giving the heart a chance to get back to its normal function, Cantrell said. Medication like sedatives and muscle relaxants combat shivering, the body's natural reaction to make heat.

The treatment, recommended to last a minimum of 12 hours, would continue once the patient reached Gaston Memorial Hospital, Corvino said.

Where the treatment has proven its worth is the protection it gives to the brain, Corvino said. Lowering the body temperature slows the rate of decay, lessening the chances of severe brain damage, he said.

"These are people who do not typically do well and it's anything we can do to make a difference," Corvino said.

Only in about the last two years has induced hypothermia been widely tested, Corvino said. That's why he's impressed the county wants to pursue the treatment now, long before it becomes more commonplace.

"It's really to (the department's) credit to be supportive of this at such an early stage," Corvino said. "They said, 'This is something we have to get on the bandwagon about.' "

There's talk of starting the treatment in Lincoln County too.

"We are actively researching that," said Lincoln County EMS spokeswoman Kim Green. "We do try to keep up the new trends and do the best we can for our patients."

Paramedics won't use the treatment on patients who suffer traumatic injuries in addition to cardiac arrest because the treatment could worsen other unknown injuries, Cantrell said.

Officials don't yet know the full cost, Cantrell said. The department will have to buy eight refrigerators, at $687 each, for the ambulances to store the IV fluid and medicines. The refrigerators are more expensive than household refrigerators because they are designed to cool to specific temperatures, he said.

To see more of The Charlotte Observer, or to subscribe to the newspaper, go to http://www.charlotte.com. Copyright (c) 2008, The Charlotte Observer, N.C. Distributed by McClatchy-Tribune Information Services. For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.

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