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We are interested in starting to induce hypothermia status/post ROSC in the arrest patient. Are any of you doing this in the field? If you are how are you keeping the saline cold? This seems to be one of biggest logistical difficulties. Any suggestions would be helpful.

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As an RN I have been extensively involved in this during hospital resuscitation and have been involved in quality control research on protocols for induced hypothermia. We use a large number of ice packs initially. That is a possibility for you as well. Commercially prepared packs would be the best. Under axilla, arm-pits, under neck, over face etc. helps to cool them down faster. The packs need to be rotated frequently (q5-10 min) to prevent burns. And they need to be changed q15 min usually as the cold packs warm up and need replacing.

Of course the patient should be intubated or have good airway management because the act of intubating a hypothermic patient make them prone to ventricular arrhythmia.


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