help, experienced opinions needed!

Next time take it! Ask charge if they perhaps could help settle the patient and walk you through what you don't know. That way you will have backup while you are getting a quick hands on in what you don't know =)

You can't learn about everything you handle before you get it - sometimes you just have to learn as you go! Take the complicated patient with the new diagnosis next time, and pull up the policy and procedure on that diagnosis and go through it very carefully. I guarantee you will learn faster doing it than just reading about it.

Therapeutic hypothermia is done to prevent a reperfusion injury after ROSC. TH pts in the induction phase are two to one and one to one for the next 48 hours.

They need two core temps a central line and an aline. The temp MUST MUST MUST be controlled. Brady cardia and then SVT are very real possibilities if the temp drops below 31. If you are unfamiliar with the Artic Sun or Gaymar cooling unit you should not be responsible for this pt.

Shivering generates warmth and paralytics are given to maintain the temp of 33 C

Turn the warmer off on the vent. ABGs must be temperature corrected. Turn down the thermostat in the room.

If using wraps they must be readjusted and a skin check done every two hours to prevent a thermal injury.

TH turns lung secretions to cement and slows gastric secretions and peristalsis. These people at very high risk for pneumonia and SBO.

A hypothermia pt does not metabolize meds like a normal human and there is no research done on cooled pts. You have to be double super careful.

Electrolytes and ionized calcium must be sent every four hours. You will be replacing electrolytes like crazy. Hypothermia drives K Mag Phos and Ca into the cells.

The most precarious time is the rewarming phase when the electrolytes leave the cells. Rebound hyperthermia can set off the cascade of cytokines and interleukins and free radicals that destroy brain tissue.

Seizures are predictive of a poor neurological outcome.

One more thing, no one should neuro prognosticate until 36 hours post rewarming.

There is nothing wrong with saying you're not confident to look after a specific patient, especially when you've had very little exposure to them. However, as others have suggested, still try and get stuck in and help whoever takes the patient so that you can learn.