Published: November 13, 2009 11:22 pm      

Cooling patient can gain time with critical cases, doctor tells paramedics

TIRE HILL — Paramedics treating some critically ill or injured patients should keep it cool – literally – a trauma doctor told them Friday.

Induced hypothermia has proven to be a lifesaver in patients who survive initial cardiac arrest, and the technique is showing promise for some types of stroke and trauma, Dr. Robert Cooney told those attending Memorial Medical Center’s annual fall trauma conference.

Chilling the patient’s core temperature to between 90 and 93 degrees slows the body’s processes, allowing its natural healing to work, Cooney said.

“We are trying to add some time to that clock when we are resuscitating a patient,” Cooney told about 180 emergency responders and health-care workers at the conference in Conemaugh Township Volunteer Fire Department’s John Bracken Hall.

Ambulance workers can use ice packs to lower the body temperature or inject cold saline solution intravenously, Cooney said.

Memorial routinely uses hypothermia treatment on unconscious patients brought in after cardiac arrest, and emergency response guidelines recommend that cooling be started before arrival at the emergency room, he said.

Emergency response organizations should be discussing hypothermia treatment with the doctors who serve as their medical directors, Cooney said.

Paramedic crews are open to the new idea, said Terry Ruparcic, manager of the host organization, Conemaugh Township Emergency Medical Service.

“If there is any chance of reducing patient mortality rates, we should be interested in learning more,” Ruparcic said after Cooney’s lecture.

There are some logistical issues to consider, he warned, noting that ambulances are not equipped with refrigerators.

“There have been no protocols passed down from the Department of Health,” Ruparcic said. “How are we going to keep these (saline packs) cool? Who is going to think to grab a cooler every time we go out? It is going to take a little planning.”

Memorial sponsors two trauma conferences every year to update workers on the latest advances and research, trauma coordinator Tom Causer said at the event.

And there is always room for more knowledge and more research, trauma surgeon and conference emcee Dr. S. Lee Miller said: “As much as we think know about medicine, there is still a lot we don’t know.”

The conference also included a presentation on evaluating the urgency and conditions of multiple patients in the field by

Dr. James Gregory, who shared his experiences treating victims of Hurricane Katrina and as a military physician in Iraq.

Other topics included treatment of those with orthopedic injuries, presented by Dr. Christopher Donaldson; care for patients in shock, by Dr. Russell Dumire; legal issues, by lawyer Michael A. Sosnowski; and use of X-rays and other imaging, by Dr. Stanley Golden.