San Marcos Mercury | Local News from San Marcos and Hays County, Texas

September 22nd, 2009
New treatment for cardiac patients at CTMC


Central Texas Medical Center (CTMC) and St. David’s HealthCare formally joined forces in December of 2008 with St. David’s providing clinical support services including emergency department and neonatalology physician staffing.

CTMC recently announced that, working with St. David’s, it will begin to implement therapeutic hypothermia protocols in the emergency room to lessen or prevent neurological damage due to cardiac arrest.

The American Heart Association has recommended induced therapeutic hypothermia following cardiac arrest, after a patient’s pulse has returned, because the treatment has been shown to decrease a patient’s chances of brain damage.

When the heart stops beating during cardiac arrest, the brain’s supply of oxygen is cut off.  Originally, doctors believed that oxygen loss alone was responsible for a patient’s death or severe brain damage. Currently, doctors think that the oxygen loss sets off a series of other harmful processes. For hours, and even days, after the heart resumes beating, the body’s reaction to the trauma can make neurological damage worse. Induced therapeutic hypothermia treatment is introduced to slow that process down.

“This new service represents another good example of how collaboration between two cutting-edge healthcare providers can save lives,” said Gary L. Jepson, chief executive officer, Central Texas Medical Center.

The first step in launching the hypothermia, or “cooling” treatments, was the development of a formal protocol for treating post-cardia arrest patients whose heartbeat has resumed and who would be appropriate candidates for the treatments. St. David’s clinicians worked with CTMC to develop the protocols and provided onsite training to the medical center’s emergency room staff.

The patient appropriate for induced hypothermia treatment is a patient whose pulse has returned after a cardiac arrest. When the staff considers the patient a candidate for the treatment, Travis County’s Shock Trauma Air Rescue (STAR) Flight will be contacted to transfer the patients to a St. David’s HealthCare hospital that has been designated a Resuscitation Center of Excellence by Austin Travis County Emergency Medical Services. STAR flights are used because of the temperature controlled cabin and on-flight necessary refrigeration equipment.

As soon as STAR Flight arrives, CTMC staff members initiate “cooling” with an intravenous infusion of saline chilled to four degrees Celsius. Additionally, CTMC staff members will start the diagnostic process to identify the cause of the patient’s cardiac arrest as well as his/her risk factors in order to expedite the course of treatment upon arrival at a designated St. David’s HealthCare facility.

“Most hospitals that are not designated Resuscitation Centers of Excellence do not have protocols in place to begin induced therapeutic hypothermia or ‘cooling’ treatment before the patient is transported to an acute care hospital,” Steve Berkowitz, M.D., chief medical officer, St. David’s HealthCare, said. “It is very forward thinking for CTMC to initiate ‘cooling’ earlier in the course of treatment. We applaud them for taking this step because research has shown that the sooner a patient receives this treatment, the better his or her chances are of an improved neurologic outcome.”

Future service enhancements that are developing as a result of the CTMC-St Davids affiliation include the new Neonatal Intensive Care Unit (NICU) slated to start up at the end of November. This comes at the same time as the hospital’s $35 million expansion project opening.

Additional plans are underway for developing a certified Chest Pain Center and a primary Stroke Center at CTMC.

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