Hypothermia as a means of protecting patients in critical condition has been used in hospitals across the Czech Republic for years. Now, first aid workers are introducing it in emergency care. A pilot project, which is currently underway in several Czech regions, aims to prevent brain damage in patients suffering from a heart attack with the help of hypothermia. Karel Cvachovec is the chairman of the Czech Society of Anaesthesiology and Intensive Care Medicine:
“The technique of hypothermia is used in medicine, or in intensive care, quite often. It’s the basis for cardiac surgery and many other serious procedures. But its use in pre-hospital care is a fairly novel thing. Its use in the Czech Republic is based on recommendations which appeared in specialist literature about a more favourable long-term outcome in patients who suffered heart attack and were resuscitated successfully. To help the survival of the brain and other organs with as little damage as possible it’s very useful to cool the patient down.”
So the method is quite widespread in the Czech Republic, but there are currently some pilot projects trying to introduce this method in first aid. Is that right?
“That’s correct. The novel element is that our colleagues from emergency medical services are trying to cool down the patients even before they reach the hospital, provided that the patients have been successfully resuscitated from cardiac arrest.”
So if I understand it correctly, it is important to cool the patient’s body as fast as possible, once the patient has suffered a heart attack.
“Exactly, time is of paramount importance. If you cool the patient with some delay his chances of successful recovery are apparently much smaller.”
Could you describe the technique? How do you induce hypothermia?
“Basically there are two major approaches which are being used and which are available for pre-hospital care. You can use ice packs which are packed tensely around the patient’s body – that’s surface cooling. Or you can infuse the patient with ice cooling intravenous solution. Both of these methods are possible and we are still not sure which one is more effective.”
How demanding is this method, for example in terms of money?
“I think that method is relatively cheap. The cooling and the use of cooling solutions really doesn’t cost that much and I don’t think that it increases the cost of care. Basically it can be said that this is a very cheap approach.”