By Kevin McKenzie
The Commercial Appeal
MEMPHIS, Tenn. — In late July, an 82-year-old woman’s heart stopped beating as she sat in a car on Porter Street in South Memphis.
Traditional cardiopulmonary resuscitation helped restore her pulse. A newly adopted procedure that began cooling her core body temperature during the ambulance ride to a hospital has the Memphis Fire Department counting her as a success story.
“Patients who used to go into a vegetative state can walk out” of the hospital, said Memphis Deputy Fire Chief Gary Ludwig.
“Now this lady is going home,” Ludwig said.
The department’s 33 ambulances are now equipped with coolers used to chill saline solution that can flow into the veins of people who have suffered cardiac arrest but regain signs of life.
With “induced therapeutic hypothermia,” paramedics begin a cooling process that continues for 24 hours at properly equipped hospitals.
Lowering the unconscious patient’s temperature to about 92 degrees from the normal 98.6 helps limit brain-cell damage triggered by loss of oxygen and improves chances of recovery.
“The sooner you can begin the cooling therapy, the better as far as being able to prevent brain-cell injury,” said Dr. Paul Deaton, medical director of the intensive care unit at Methodist University Hospital.
The American Heart Association endorsed the therapy in 2005 and hospitals had to ramp up first. In Memphis, Methodist University, Baptist Memorial Hospital-Memphis and Saint Francis on Park are the three hospitals equipped for the intensive procedure.
Ambulance paramedics are extending the therapy’s reach to the streets. A 2008 article on EMSResponder.com estimated that about 100 of 24,000 emergency medical service agencies nationwide had adopted the practice.
The New York Times reported last month that paramedics in about one-third of New York City’s fire department ambulances will be trained to use the treatment.
Memphis officially joined the trend on July31.
Dr. Joe Holley, medical director for the Memphis Division of Fire Services Emergency Medical Services, said Memphis “is near the tip of the spear on this one.”
“It’s beginning to pick up all over the country,” Holley said.
He also is medical director for the Bartlett Fire Department and for the private ambulance company, Rural/Metro, which have embraced cooling therapy as well, he said.
Hospitals use water-cooled vests and leg pads to continue the therapy. Research shows it can dramatically improve the brain function outlook for between one in six to one in four patients who receive it, said Mark Ottens, director of emergency and pediatric services at Baptist.
“Prior to this, the only therapy we had was crossing our fingers and praying,” Ottens said.
At Methodist, of two dozen patients who received the treatment through April - which marked its first year of use at the hospital - 13 were able to go home, rather than failing to survive or going to a nursing home , Deaton said.
Nationally, only 5 percent of cardiac arrest victims are resuscitated, although that figure is 16 percent in Memphis, fire department officials said.
At Saint Francis, Carri Hutchens, nurse educator for the emergency room, said cardiac arrest patients must meet certain criteria to receive the cooling therapy, including one that is weight-related: Those with a body mass index greater than 40 don’t qualify for the hospital’s equipment.
That’s currently true, too, at Methodist, but Baptist’s equipment does not have that limitation, Ottens said.
Holley, Ludwig and Joseph Rike, division chief of emergency medical services, recently sat down at offices on Union Extended to tout the new therapy.
Memphis spent only about $70 for each refrigerated cooler, Ludwig said.
“Saving a life - priceless,” he said.
Success with the elderly woman whose heart stopped on Porter Street was particularly cool for the department. She is the mother of a firefighter.
Copyright 2010 The Commercial Appeal, Inc.