Posted on 10/12/2008

MARION, NC–McDowell's Emergency Medical Services (EMS) is on the pulse of up-to-date treatments. Beginning today, they'll be using therapeutic hypothermia – big words for a relatively simple procedure that could greatly increase the quality of life for cardiac arrest patients.

In layman's terms, it involves lowering a person's body temperature once he's been resuscitated from cardiac arrest.
"The idea behind this concept is to preserve brain and neurological function," said EMS Director William Kehler, "and to preserve or maintain the quality of life of the individual."

According to a recent article in EMS magazine, out of 24,000 EMS agencies in the nation, only about 100 have adopted this protocol. McDowell will be among very few, possibly only two, in the state to use the procedure.

"We're definitely the first in western North Carolina to implement it," Kehler stated. "This is just an example of how this agency is staying abreast of current research and implementing protocols based upon strong data and good patient outcomes. We are committed to bringing the most advanced pre-hospital care to the citizens of McDowell County."

When a person becomes lifeless and is not breathing, his body temperature rises, increasing the potential for swelling in the brain and cellular damage throughout the body.

Kehler said the goal with therapeutic hypothermia is to use cold IV solutions and ice packs to drop the person's temperature to 93 degrees and maintain it.

"This procedure is aimed at … decreasing the chance of brain damage and increasing the chance of survival for the patient," he stated.

When asked why so few EMS agencies were using therapeutic hypothermia, Kehler said he believes it deals in part with set-up costs and that the procedure has been widely studied but not widely published in the pre-hospital setting.
EMS magazine also contributed the lack of response to the low number of medical facilities that follow through with the treatment once paramedics begin it.

"We have partnered with Memorial Mission Hospital in Asheville and Spartanburg Regional Medical Center to accept patients we've initiated the protocol on," Kehler stated. "They already have the protocol in place to continue the treatment."

He added that the implementation is costing McDowell very little because the ambulances were already equipped with the required monitors.

Kehler said local paramedics have undergone extensive training for months on therapeutic hypothermia provided by a number of instructors, including Jim Mobley, the program director for Regional One Air Medical of Spartanburg, S.C. Mobley, whose agency was the first air medical program in the world to use the procedure, is considered an expert in the field of therapeutic hypothermia. Kehler stated that local EMS Maj. Eugene Edwards has played a vital role in getting the procedure in place locally. Regional One implemented the protocol in 2005, Mobley stated in a telephone interview last week.

"When the American Heart Association endorsed it, we decided to make the leap," he said. "So many people are reluctant to try it because it goes beyond the norm. This is therapy that few agencies offer, but everyone should receive. The benefits of it are beyond the wildest imagination, just short of a miracle."

He added that McDowell County citizens are lucky to have the procedure here and to have paramedics and health care providers who are willing to go the extra mile to offer the most up-to-date treatment.

Dr. Edward St. Bernard, the EMS medical director, stated that continuing to advance the level of care that paramedics provide is a top priority.

"Implementing this procedure is another step to ensure that citizens and visitors of McDowell County receive the most advanced and comprehensive care available in the pre-hospital setting," said the doctor.

Therapeutic hypothermia has been approved by the American Heart Association and the N.C. Office of EMS.

-Richelle Bailey, The McDowell News