Hypothermia and Emergency Trauma Care
Hypothermia and Emergency Trauma Care
USA- Over the last half a century, doctors have been seeking ways to utilize how cold affects the human body. They attempt to use therapeutic hypothermia to cool down the temperature of a patients body by a couple of degrees. This has been used for conditions such as bran injury or heart failure. At the University of Maryland in Baltimore, Dr. Samuel Tisherman is currently testing drastic ways to use hypothermia in an effort of saving severely injured people who have suffered from a stabbing or a gun shot wound who are in definite risk of loosing their life. Tisherman, a trained surgeon administer via injections salt water which is ice cold directly into the aorta, which is the largest artery in our bodies to to plunge down the regular temperature of 98.6 degrees fahrenheit to the low 50 degrees fahrenheit. When this cold water is administered the patients have no brain activity and no pulse, they are placed in limbo between being alive and dead for about an hour with no heartbeat or a single breath.
Generally 5-7 percent of people who are critically injured survive. They are racing against the clock as the doctors try to open the chest cavity to gain access to the aorta in order to have direct the blood towards the brain, followed by attempting to transfuse new blood to help them restart the heart. This is often an ineffective situation as most wounds and injury require at least five to 6 minutes to suture, which is more time than what the brain can survive from the lack of oxygen. Initial evidence shows that cooling down the patients prior to performing surgery preserves vital organs like the brain. Tisherman says it works by cutting down the need for oxygen, this way your body can tolerate the cardiac arrest and the deficient of blood flow.
Initial trials done through the last twenty years Tisherman has experimented this technique on pigs and dogs. Once the animals had gone into cardiac arrest after loosing blood he proceeds to cool them down to 50 degrees fahrenheit, sutures up the wounds then warms the body back to normal temperature. Follow up testing showed the animals had no detectable brain damage. Tisherman adds, these people have most likely lost half of their blood supply before they even reach the hospital for trauma care. He adds that he predicts this technique being available in the next couple of years. Once the doctors discover there is no pulse they must move fast to cool down the body. There is not a lot of choice for treating patients that are critically injured. Cooling down the body this way has its own risks involved. Lowering a body to such low temperatures is not normal, explains Dr. Lance Becker, an emergency medical specialist at North Shore University Hospital in Manhasset, New York. We have evolved to survive at 98.6 degrees fahrenheit and lowering our temperatures to 50 degrees fahrenheit or less affects our bodies abilities to clot. This can be challenging for a person who is bleeding out. There has been some studies done on bodies being put through a mild form of hypothermia for a longer stretch of time and this has proven to be very risky for contracting infections. If the trial is successful, Tisherman expects this to become a standard practice at hospitals across the United States. He estimates hundreds of thousands lives can be saved. He hopes that the survival rate will be from five to twenty percent higher and expects this to be a huge advancement.
Tisherman imagines a future where they use the hypothermia technique to more complicated cases in trauma, hoping to gain more time to do more research on the matter. He explains is very difficult to find the source of an injury in a patient who has just suffered a motor vehicle accident. They may have more complex and complicated injuries such a head trauma, broken bones and bleeding that could lead them to cardiac arrests. This is a more complex situation then just a bullet wound. It is possible for paramedic and trauma hospitals to receive the proper training to administer therapeutic hypothermia to trauma patients prior to them getting them to a hospital. As scientist begin to learn more on therapeutic hypothermia, they hope they can make the approach more personalized to give each patient the best temperature for their own bodies to protect themselves against injuries. If this is successful, surgeons might be able to prolong the life of someone who was on the brink of death upon arriving at the hospital and hopefully, bring them back to good health.