Therapeutic Hypothermia

According to Avery, O'Brien, Pierce, and Gazarian (2015), “in the United States, 359,400 people experience an out-of-hospital cardiac arrest each year, and less than 9.5% of those people survive” (p. 29). So if any survivors survive, chances of recovering fully is very slim. Therefore, there survivors’ expectation of returning to a normal life are limited due to the neurologic outcome. According to Deckard and Ebright (2011), only about 20% of cardiac arrest survivors who remained comatose have awakened with a good neurologic outcome. Therefore, therapeutic hypothermia improved neurological outcomes after return of spontaneous circulation (ROSC) (Avery et al, 2015). Intensive care nurses need to know more about the benefit of therapeutic hypothermia,

The biggest impediment to achieving target temperature is shivering. The shivering reflex is triggered when the core body temperature drops. Shivering increases metabolic rate oxygen consumption, heart rate, and respiratory rate. If left untreated, shivering may negate any benefit of temperature management. Evidence-based protocols for temperature management must include shivering prevention (Presciutti, Bader, & Hepburn, 2012). The Bedside Shivering Assessment Scale which measures from 0 being no shivering, 1 is mild with shivering to neck and/or thorax, 2 being moderate with shivering including the upper extremities, and 3 being severe with shivering all over the body. Treatment ranges from skin counterwarming, Acetaminophen, Magnesium Sulfate, Dexmedetomidine, Propofol and lastly a neuromuscular blockade, Vecuronium (Presciutti et al, 2012). A therapeutic hypothermia checklist guideline helps to keep everything in check any up to