By Kevin Kendall, MD
LifeFlight Medical Director of Quality

When treating patients in the field and on the helicopter, LifeFlight’s medical crew is guided by a comprehensive set of clinical protocols. When someone at LifeFlight, be it crew or medical director, wants to consider adding a new medication or technique, the idea is first brought to the Clinical Practice Committee (CPC). The CPC is a large body of multidisciplinary physicians that tracks state-of-the-art clinical care from around the world. The group meets quarterly to discuss and review current treatments and protocols, as well as new medications, devices and techniques appropriate to the care that LifeFlight gives.

When the CPC reviewed the first 9 months of data from LifeFlight’s post cardiac arrest Therapeutic Hypothermia protocol, the results were very positive. Hypothermia after cardiac arrest is the first new therapeutic intervention since defibrillation, and has been demonstrated in numerous recent scientific articles to improve survival and neurological outcomes in victims of sudden cardiac arrest.

The basic goal of the protocol is to achieve a body temperature of 33° C as soon as possible after the event, and to maintain that temperature for 24 hours. This is primarily accomplished through the rapid infusion of 30 ml/kg of 4°C Lactated Ringers IV fluid; in addition to the placement of cold packs to the groin, axilla and neck. Further cooling methods are introduced at the destination hospital.

To date, LifeFlight of Maine is only the second air medical service in the nation to start this simple, inexpensive and safe procedure for prehospital and interfacility transfer patients that have been successfully resuscitated from cardiac arrests. Central Maine, Eastern Maine and Maine Medical Centers have all developed post-resuscitation hypothermia protocols.

Since implementation of the procedure, seven patients have benefitted and the outcomes are truly impressive. New research has also begun to show that therapeutic hypothermia may be effective in treating patients with traumatic brain and spinal cord injuries as well. As part of our outreach, LifeFlight would be happy to visit your hospital or service to discuss the current literature and protocols, and answer any questions you may have about this simple and effective intervention. To schedule a visit, contact The LifeFlight Foundation at 207-785-2288 or info@lifeflightmaine.org.