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CS37
Just Chill Out: Facilitating Induced Hypothermia Protocol in a Small Community Hospital
By J. Williamson; Seton Northwest Hospital, Seton Healthcare Network, Austin, TX
For further information, please contact: jwilliamson@seton.org
Purpose: Our ICU utilizes a protocol of induced hypothermia for management of coma post-cardiac arrest. In addition we must be prepared to treat hyperthermic states, i.e. malignant hyperthermia, neuroleptic malignant syndrome and heat stroke. To facilitate best practice, our goal is to cool these patients quickly and safely. Supplies need to be available on an emergency basis. We developed a prepackaged bundle which contains everything needed to start the cooling process immediately, including a copy of our protocols and a brief evaluation tool.
Description: We reviewed our institution's induced hypothermia protocol as well as treatment of malignant hyperthermia. Based on that information, we compiled a list of supplies that we must access immediately to quickly and safely cool these patients. In a 2.5 gallon "Hefty slider" bag (zip top) we placed: a disposable hypothermia blanket, esophageal/rectal probe, lubricating jelly, 6 large ice bags, a spray bottle for misting with tepid water, and a copy of our "induced Hypothermia" orders. Also included is a laminated flash card with a list of additional supplies that can be utilized and where to find them, i.e. nasogastric tube, irrigation set and saline for iced saline lavage, fan, location of ice machines, where to obtain the malignant hyperthemia cart and iced intravenous fluid from the surgery suites, and how to administer intravenous dantrolene for hyperthermia treatment per hospital policy.
Evaluation/Outcomes: We have utilized our bundle several times for induced hypothermia and once in a case of neuroleptic malignant syndrome with severe hyperthermia. The nurses utilizing the bundle report it has been very helpful both as a timesaving measure as well as a clinical reference tool. Data from the evaluation tool helps us fine tune the implementation of the protocol.
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