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Originally Posted by skippy3481
Just heard a Dr. from miami say they started the procedure within 15-20 minutes of the injury. Be interesting to see what doc says.
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The central line ( most likely a large caliber 16 french catheter ) can be placed enroute to the hospital by qualified folks of many disciplines.
Essentially the way the cooling works is that the solution is literally taken from a refrigerator as most university level or tertiary (large hospitals with teaching programs) all keep stock supplies of multiple liters of this cold or saline (salt water) solution.
All you do is run in 2 liters of this temperature saline into a catheter and we have essentially a 32 degree Celsius or 90F body within minutes. Healthy hearts like this young man handle the volume easily.
To be brief the idea of hypothermia as "brain sparring" comes from a very simple observation. Under 2 conditions and 2 conditions only is a physician prohibited from declaring a patient dead!!!
One is overdose or specifically phenobarbital overdose because phenobarb coma is a state very similiar to death .....very very.slow heart rate, low if not unmeasurable blood pressure etc......
The other is hypothermia......you aren't really dead no matter how long youv'e been without a heart beat unless you have been warmed to 90 degrees F. So unless you are warmed to 90F you are technically alive.....
So why is that??? There are credible reports of people survivng incredible insults in frozen temperatures deprived of traditional levels of oxygen we think are compatible with life only to have the "frozen ice fisherman" or "drowned" child submersed in extreme cold actually survive if warmed in an environment where they could be placed on a respirator and supported.
The neurologists of the world who's territory "death" is got sick and tired of these people coming back from the dead for lack of a better description and decided to try this "frozen state" as a therapy for heart attacks that lead to sudden stopping of a heart or sudden death. If we could start your heart and cool you to buy some time for the neurologic injury to subside as blood flow is re-established maybe we could use this to save lives.
The trials show about a 12-20% improvement in mortality if 1) CPR and the code get things going "quickly" 2) You lower the temp to 32C within 4 hours of the code.
Now you compare this to Mr Everett and it is easy to see why he did so well.
1) He was never really without a heart beat for an appreciable time 2) He was cooled instantly or within minutes.
SO placing a central line is a common procedure done routinely by paramedics,surgeons,intensivists,cardiologists etc...and the solution to do this is kept on hand in most institutions.
Enough for one night...