Ask A Magnet Nurse: Excellent Teamwork Is At The Heart Of Therapeutic Hypothermia

Heather Heldreth, RN and Melanie Foss, RN of the Coronary Care Unit, St. Joseph's Hospital

Smart Living: Therapeutic hypothermia is the cooling of a patient who has just had a cardiac arrest. What is the nurse's role in this process?

Heather Heldreth: We immediately get everything we need into place. It's a huge team effort. We only have a window of 4-6 hours to get the patient cooled. We call the attending physician and get approval to start the protocol.

Melanie Foss: The protocol that we follow allows everything to be ready and available when the patient arrives. We get as much information as we can, such as the patient's weight, so we know what type of cooling pads to use. The pads are very quick and easy to put on, and the whole process is non-invasive.

Heldreth: Once the patient comes in, we make sure they are adequately sedated and put on a breathing machine. These are necessary because the pads will cover the patient's body and cool them down to the shivering point.

Foss: As Heather said, it's a big team effort among the nurses to treat these patients because the cooling is only one part of the process. The pads are great because they don't impede any other therapies we need to do. You can even X-ray through them.

SL: So these pads are placed all around the patient's body, and then chilled water is circulated through them?

Melanie Foss: Yes, they are able to bring the patient's body temperature down to 92 degrees Fahrenheit and maintain that temperature until we are ready to start the re-warming process.

Heather Heldreth: While the other nurses are completing this process on the patient, one of us will explain the cooling procedure to the patient's family. Family education is very important to us. We know they're on edge and we want them to know what steps we're taking to give their loved one a chance at a full recovery. We also must explain to them that this process cannot reverse any brain damage that has already occurred, but it does give us a chance to save as much of the brain as we can.

Foss: Families have been very accepting of the reality of the damage cardiac arrest can do. We know that we cannot save everyone, but when we do help a patient and see them recover, it's an indescribable feeling.

To learn more about how therapeutic hypothermia works, click on "A Better Chance" with Dr. Anthony Costrini.

If you witness a cardiac arrest, the American Heart Association (AHA) recommends that you give chest compressions immediately. Pump on the person's chest hard and fast and have someone call 911. "Push Hard - Push Fast" is the AHA's new motto for helping maintain blood flow to the brain.
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