NYC Endorses Cooling for Cardiac Arrest

Cities require ambulances to bring cardiac patients to centers with cooling.

Dec. 4, 2008— -- New York City announced that it will require all ambulances to take cardiac arrest patients not to the nearest hospital, but to those hospitals that use specialized cooling equipment to lower the temperature in the brain, even if they're farther away.

Starting Jan. 1, New York City ambulances will be re-routed to hospitals offering this "cooling therapy." About one third of city hospitals currently have the technology and some are working to get cooling operations before the deadline.

Typically, after someone suffers cardiac arrest, emergency technicians attempt to restore a pulse, and most patients head to the nearest emergency room in a coma. New York now joins eleven other cities, including Boston, Miami and Seattle, in re-directing cardiac arrest cases to hospitals offering cooling therapy – a technique that has been shown to reduce brain damage and deaths.

"We'll do everything we can in this city to make sure you survive," said New York City Mayor Michael Bloomberg.

In the cooling process called therapeutic hypothermia, doctors lower the temperature in the body and, more importantly, in the brain from 98 degrees down to 90 degrees. While it's just an 8 degree difference, the cooler temperature helps reduce brain damage.

"When you cool the brain, the brain cells go to sleep, go into a state of hibernation, where they don't work so hard," said Dr. Fink of New York-Presbyterian/Weill Cornell Medical Center. "They don't need to use oxygen anymore and it gives them a chance to rest and recover from their injury."

Studies in the New England Journal of Medicine show that cooling therapy reduces serious brain damage by 50 percent and lowers death rates by 25 percent.

Cooling Therapy Effective Not Expensive

Cooling therapy often works out to cost about $1,000 per patient for a state-of-the art cooling suit, but the treatment can be done using less expensive methods.

So why are most hospitals still not using this?

"It's been over five years since the American Heart Association endorsed this treatment and it simply baffles me why more hospitals don't do it," said Dr. Michael Sayre of Ohio State University. "I think part of the reason why they don't do the treatment is because they think it's harder than it really is. Actually all you need is an ice machine and a cooling blanket."

It made all the difference to Christine Newport from New Jersey, who, within hours of suffering a cardiac arrest was placed a cooling suit at Morristown Memorial Hospitals. As we reported earlier this year, 24 hours later, Newport was warmed up from the 91 degree temperature, and awoke with no last lasting brain damage.

Thousands of lives could be saved, Sayre said, if more hospitals offered cooling therapy. With the country's largest city now pushing the therapy, researchers predict more cities will soon follow suit.