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Establishment of Deep Hypothermic Circulatory Arrest in Rats
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Delayed and intermittent CPR for severe accidental hypothermia
Les Gordon1, Peter Paal2, John A Ellerton3
1University Hospitals of Morecambe Bay Trust, Royal Lancaster Infirmary, LA1 4RP, United Kingdom; Langdale Ambleside Mountain Rescue Team, United Kingdom.
Resuscitation
|March 1, 2015
Summary
Guidelines for treating cardiac arrest (CA) in severe hypothermia are presented. Continuous CPR is recommended, but intermittent CPR may be feasible, especially in challenging prehospital scenarios.
Area of Science:
- Emergency Medicine
- Cardiology
- Toxicology
Background:
- Cardiac arrest (CA) in severe accidental hypothermia (<28 °C) presents unique challenges compared to normothermic CA.
- Prehospital cardiopulmonary resuscitation (CPR) may be difficult during patient evacuations.
Purpose of the Study:
- To develop evidence-based guidelines for managing severely hypothermic CA patients during evacuation.
- To provide recommendations for rescuers facing challenging prehospital scenarios.
Main Methods:
- A comprehensive literature search was conducted.
- Findings from the literature search were synthesized to formulate clinical guidelines.
Main Results:
- Prolonged CA in severe hypothermia can allow for full neurological recovery if the brain is pre-conditioned.
- Data support the feasibility of delayed and intermittent CPR in hypothermic CA patients, drawing from surgical and case report evidence.
Conclusions:
- Continuous CPR is the primary recommendation for hypothermic CA, utilizing mechanical devices to minimize interruptions.
- Intermittent CPR protocols are suggested when continuous CPR is not feasible, with specific timings based on core temperature: alternating 5 min CPR with ≤5 min without CPR for temperatures <28 °C, and 5 min CPR with ≤10 min without CPR for temperatures <20 °C.
Keywords:
Cardiac arrestCardiopulmonary resuscitationEmergency medical servicesHypothermiaMountain rescueTransportationMore Related Videos
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