Show Me The Evidence

The Blog of Lippincott's Evidence-Based Practice Network

How many of us have taken care of someone who had experienced a cardiac arrest and ended up in the hospital on a ventilator never to wake up the same again. The frustration and sadness we as caregivers feel with caring for a patient in this situation and dealing with their family can be overwhelming. I can remember several years ago when I had several patients in one week who experienced cardiac arrest in the field and ended up on the ventilator and were diagnosed as being brain dead or severely neurologically impaired.

Luckily, research has taken us beyond this situation by using therapeutic hypothermia. The American Heart Association has guidelines in their Advanced Cardiac Life Support Guidelines that recommend healthcare providers consider therapeutic hypothermia for patients who have return of spontaneous circulation after cardiac arrest.

The Advanced Emergency Nursing Journal's October/December2011 issue published an article titled, "Pharmacologic Management During Therapeutic Hypothermia" that I have found to be very helpful in managing these patients. The article outlines how to handle pain/sedation requirements, rigors/shivering, electrolyte balance and anticonvulsant therapy. For those of you in emergency and critical care who care for patients who are receiving therapeutic hypothermia, this evidence-based article will be extremely useful to your practice.