Date on Paper
Therapeutic Hypothermia; Cooling; Targeted Temperature Management; Evidence-based Practice; Cardiac Arrest; Emergency Department
Therapeutic hypothermia (TH) is a treatment initiated by critical care providers for the management of cardiac arrest. It has been shown to lower the body temperature, reduce the inflammatory response, and suppress many of the pathways leading to delayed cell death. The American Heart Association (AHA) has strongly recommended to initiate cooling within 4-6 hours after return of spontaneous circulation (ROSC); however, despite the recommendation, the use of TH in emergency departments (ED) is not routine and it is commonly delayed. The purpose of this project was to evaluate the impact of an educational intervention on the timing of initiation of TH after ROSC in the ED. The overall aim of this project was to improve registered nurse (RN) knowledge of importance of TH in the ED by 20% and decrease door to TH initiation time to under 2 hours. Implementation began by conducting an educational intervention to the RN’s in the ED addressing the importance of TH using brochures during the February staff meetings. Fliers were used for supplementation as a reminder to initiate TH early and were posted around the ED. Pre and post-test scores were analyzed using a paired t-test and door to TH initiation times were compared using an independent t-test. Of all 72 participants, pre-test mean score was 81.48% and post-test mean score was 98.61%. Of all 10 TH cases, the mean time for door to TH initiation in the historical group was 111 minutes and mean time for door to TH initiation in the post-implementation group was 184 minutes. There should be ongoing education and collaboration between the ED and critical care to improve door to TH initiation times.
Purnsley, Taylor, "Early initiation of therapeutic hypothermia in the emergency department." (2020). Doctor of Nursing Practice Papers. Paper 63.
Retrieved from https://ir.library.louisville.edu/dnp/63