Hypothermic policy

Carrig RN · Jun 1, 2012

My hospital uses the arctic sun. I love it. You set it and it does everything automatically. Pts on the cooling protocol for cardiac arrest are usually 1:1.

MunoRN, RN · Jun 2, 2012

We use blanketrol, which does the job just fine, although I've heard there are better systems out there. We staff 1:1 only during the cooling phase, after the patient has cooled to goal temp they can be 1:2 (although we try for 1:1 if possible). We now go 48 hours minimum at 34 degrees, and while they still can be pretty busy once they get down to temp, I'm not sure that 48 hours of 1:1 is really necessary.

Altra, BSN, RN · Jun 2, 2012

Here's a link to one system/protocol:

http://www.med.upenn.edu/resuscitation/hypothermia/documents/ChristHospitalHypothermiaProtocol.pdf

In our unit, post-arrest patients being cooled are not necessarily 1:1, unless other things in the patient's condition make it necessary.

missnurse01, MSN, RN · Jun 4, 2012

Hi, our hospital is presently drafting a hypothermic policy for patients status post cardiac arrest, however there are quite a few cooling systems on the market. We would like to know what everybody is using ... Is the system user friendly? Is your nurse patient ratio 1:1 with patients on the hypothermic protocol? Any info helps.

we also use artic sun-trialed a cheaper one a few months ago and it was awful, back to artic sun we went. We do 1:1 until rewarmed nearly all the time. system is very user friendly and doesn't jump around temp wise, it is fairly consistent.

BelgianRN · Jun 4, 2012

Our hospital makes use of two cooling systems.

We have the Arctic Sun system and the Coolgard system. As nurses we generally prefer the Arctic Sun since it provides us with means of cooling immediately instead of having to wait for vascular access. I personally think the Arctic Sun system is far more user friendly compared to the Coolgard. The Arctic Sun system is faster to set up and easier to operate (less screens to work your way through).

Only reason for taking the Coolgard system over the Arctic Sun system, in my hospital, is a lack in availability of the Arctic Sun system (as our hospital admits many post-cardiac arrest patients it can happen we even have to rely on ice ). Or if for some reason we need femoral vascular access anyway.

Keeping in mind that health insurance in Belgium pays only 450 euros for cooling a patient the loss for the hospital by using Arctic Sun is less than when making use of Coolgard as the first is cheaper than the later.

In terms of performance I find both systems adequate. I personally feel that when cooling with the Arctic Sun my patients tend to have an initial dip in core temperature when cooling of about 1 °C below set target where the Coolgard lacks this dip. But rarely does this lead to problems.

We don't have cooled patients on a 1:1, the acuity and instability decides if they are 1:1. But I have to admit usually (lack of) staffing dictates the nurse:patient ratios.

umcRN, BSN, RN · Jun 5, 2012

We use the blanketrol. I haven't used another so I can't compare but it works pretty well. I have experienced two cooling protocols. One in our NICU which is theraputic hypothermia after hypoxic-ischemic injury - this must be a birth related injury and cooling must be initiated within 6 hours from birth (among other criteria). The other protocol I have done is THAPCA - theraputic hypothermia after prolonged cardiac arrest, this protocol is used in our pedi cardiac ICU & PICU. Both cooling protocols generally render the patient 1:1 but that is usually because they are also part of research studies and involved quite a bit of written and electronic charting as well as very frequent vitals & labs. These patients are also generally unstable anyways.