“Cool” Treatment Saving Lives at Archbold
Sunday, August 28, 2011
Hypothermia Protocol Critical Tool in Post-Cardiac Arrest
Cathy McIntosh had just returned from a pleasant family trip to Atlanta. On the way home, with her husband Billy driving, she decided to take a nap. This was nothing unusual for her on a long road trip.
Then she took another nap when they got home.
That evening, she unpacked laundry and watched television until she went to bed around 10p.m. A few minutes later, her breathing became labored. Within minutes her breathing stopped completely. Luckily, Billy noticed, called 911 and began CPR immediately.
As a resident of Moultrie, the ambulance took her to the closest hospital, but because of the interventional cardiology program at Archbold Memorial Hospital, she was quickly transferred to Archbold’s emergency room.
Two-and-a-half weeks later, Cathy McIntosh would be waking up from a very chilling experience.
Literally and figuratively.
McIntosh underwent a new hypothermia procedure for select patients who either have cardiac arrest away from or while in the hospital. The procedure, or protocol, involves “freezing” the patient, or lowering the patient’s body temperature in order to halt the body’s natural inflammatory response that can cause the death of brain cells after cardiac arrest.
The process itself involves lowering body temperature by using chilled IV saline, thermostatically controlled cooling blankets and ice packs. The goal of therapy is to reduce the patient’s body temperature to 89.6 degrees Fahrenheit as quickly as possible, maintaining mild hypothermia for 24 hours, then slowly re-warming the body at a controlled rate.
“When Cathy arrived we were not sure she would survive,” said Rudy Hehn, MD, program director for Archbold’s hospitalist group and the physician that admitted Cathy to the hospital. “Our first priority was to determine if she had an obstructed coronary artery that had led to the cardiac arrest. She went directly from the ER to the cardiac catherization lab, and we started the cooling process during her procedure. Once we confirmed her arteries were open, we transferred her to the Archbold Intensive Care Unit.”
“She fortunately had normal coronary arteries, so the determination was made that she had a primary heart rhythm problem,” said Archbold interventional cardiologist Clay Sizemore, MD, who also treated McIntosh. “Unfortunately, as is common in patients who experience cardiac arrest, even a short time with no blood pressure can result in multi-organ dysfunction. With the attentive care of ICU nurses and multidisciplinary doctors, these issues were stabilized and ultimately resolved.”
But, the first few days were touch and go. “She was very unstable, and her care was complex,” said Hehn. “We were not sure she would wake up. “ In addition to the threat of brain injury she developed pneumonia, kidney failure, and nutritional problems. The hospitalists coordinated a team including a neurologist, cardiologist, pulmonologist, and respiratory therapists and ICU nurses. On her fifth day in the hospital, Cathy began to respond to her family. Seven days after her admission she squeezed her husband’s hand. On day twelve, she came off the ventilator.
Archbold ICU nurse, Shelli Roberts, RN; Cathy McIntosh; Archbold ICU nurse Carrie Stanaland, RN.
Six weeks after going home, Cathy McIntosh returned to the ICU, this time to tell the nurses thank you. “As I look back on this whole journey, I am so thankful of the care and support I received from the doctors and nurses at Archbold. Now, I’m back at work and ready to live life at the fullest. The nurses in Archbold ICU went above and beyond to ensure that I was comfortable and receiving the best care possible. I am truly blessed to be alive.”
“The doctors and nurses were very diligent in their care for Cathy,” said Billy McIntosh. “They always kept us updated and allowed us to be involved in the entire process. I believe that the procedure helped save Cathy’s life, and I’m glad it was available at Archbold.”