Discussing therapeutic hypothermia and the ‘Cool it’ study

What about the ambulance services?Despite recommendations for early induction of TH within the 2005 and 2010 European Resucitation Council Guidelines (Nolan et al, 2005; 2010), there has been no published, high quality research performed by any UK ambulance trust into the effectiveness of TH in the prehospital setting.Some services have ‘dabbled’ with ice cold saline and cold packs, but not one single service in the UK has a prehospital therapeutic hypothermia standard protocol for use following return of spontaneous circulation (ROSC) after sudden cardiac arrest.‘The results from the ‘Cool it’ trial may well be a starting point to accelerate implementation into the prehospital arena’For those practitioners who are aware of the pathophysiology of therapeutic hypothermia and the outcome effects that cooling a patient can have, it becomes a frustration that these interventions are not becoming a common and rapidly introduced standard within the emergency setting. It can almost make one seem evangelical in their support of TH when trying to share the benefits that it can bring and persuade clinical managers to introduce the intervention into everyday guidelines.There has yet to be the momentum created for change in the ambulance service, but the results from the ‘Cool it’ trial published in August may well be a starting point to accelerate implementation into the prehospital arena (Mooney et al, 2011).

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