Target temperature management initiation.

[jppepito]

Hello! Good morning my fellow nurses. I have a question I hope you guys can answer. I am new to ICU. I had a pt who achieved ROSC. But no ttm was initiated in the ER. Our policy states TTM should be initiated within 4 hours for them to benefit from it. What if it has been 6 hours or more since the pt came up late to the floor and the pt is a candidate for TTM? But has not been started. Can we still initiate it? Would they still benefit from it? Thank you for your kind responses.

[CCU BSN RN]

Our TTM policy is to initiate within 6h of ROSC- gives you time to get a head CT and make your docs line your patient before they're cold and it's more difficult. Of course we try to cool people asap, but our policy is within 6h. That said, I've seen it started as much as 12h post-arrest. Not sure how much good it's doing at that point, but if the doc is insistent, they are allowed to override the general policy.

I'd see if you guys have a TTM or hypothermia policy at your institution