Drill Prepares Florida Hospital DeLand to Offer Therapeutic-Induced Hypothermia for Cardiac Arrest
DELAND – On Wednesday, October 17, Bill Jennings complained of chest pain before collapsing on the sidewalk on the corner of Rich Avenue and Woodland Blvd. in downtown DeLand.
Jennings, the owner of Bill & Frank's Brickhouse Grill in DeLand, wasn’t actually having a heart attack, but instead was simulating one, as part of a community drill for Florida Hospital DeLand.
The drill was just one step in a multistep process for Florida Hospital DeLand to provide a new kind of therapy for patients who have suffered from a cardiac arrest, often a result of a heart attack.
Nicknamed “code cool” at the hospital, this new therapy is called Therapeutic-Induced Hypothermia and it is an American Heart Association guideline for cardiopulmonary resuscitation and emergency cardiovascular care.
This treatment protects the brain and other organs during a cardiac arrest by lowering the body’s temperature, which then reduces the body’s oxygen requirements, decreases swelling and limits the release of damaging toxins that can cause cells to die.
Studied since the 1900s and known to be beneficial since the 1950s, Therapeutic-Induced Hypothermia (TIH) is a protocol endorsed by the American Heart Association. During TIH, a patient’s body temperature is cooled to 32-34 degrees Celsius (89.6-93.2 degrees Fahrenheit) for 24 hours using external cooling wraps or cooled intravenous fluids.
During the course of induced hypothermia, patients are closely monitored, intubated, ventilated and sedated. After 24 hours of induced hypothermia, the patient’s body temperature is slowly returned to normal. The goal of the treatment is to minimize any neurologic damage due to low blood pressure during a cardiac arrest and return a patient to their normal state upon re-warming.
Luckily for Jennings, his heart attack wasn’t real, but he said by participating in the drill, he’s gotten keen insight into how the emergency responders and Florida Hospital DeLand personnel work together to care for local residents.
“God forbid, if something did actually happen, I know I’d be in good hands,” he said.
During the drill, Jennings, who has no family history of heart disease, had two friends call 911 after he collapsed. The friends, Tom Calabro of DeLand and Tom Menzel of Port Orange, pretended to start CPR while they waited for emergency personnel to arrive. In addition to the standard lifesaving protocols, the emergency responders also started a cold saline IV in Jennings, to initiate the Therapeutic-Induced Hypothermia treatment.
Once EVAC arrived to Florida Hospital DeLand’s ER, the drill continued with ER staff performing tests to confirm that Jennings’ “symptoms” were in fact that of a cardiac event. Once confirmed, they placed cooling pads on Jennings chest and legs to further drop his body temperature. He was then whisked off to the hospital’s Cardiac Catheterization Lab, where Interventional Cardiologist Janak H. Bhavsar MD, was standing by, ready to open Jennings’ blocked artery.
At the same time, the hospital’s respiratory therapy team begins using an Arctic Sun temperature-controlling system to simulate dropping the patient’s temperature even further to the 32-34 degrees Celsius (89.6-93.2 degrees Fahrenheit) range. Through an intra aortic balloon, a cardiac assist device reduces the work of the heart muscle. This is important if the heart attack has affected a significant portion of muscle as it helps the muscle to recover.
All in all, it took less than 75 minutes from the time Jennings arrived to Florida Hospital DeLand’s ER to the time the balloon would have been inflated and opened his constricted artery – much shorter than the national gold standard of 90 minutes.
“Sudden cardiac arrest is a leading cause of death in the United States, affecting nearly 300,000 lives each year,” said John Horan, Florida Hospital DeLand Cardiac Catheterization Lab Manager. “During cardiac arrest, the heart stops abruptly and is no longer able to pump blood to the rest of the body. By cooling the patient’s body temperature, which thereby reduces the body’s oxygen requirements, we are able to protect the brain and other organs, decrease swelling and inhibit further release of damaging toxins that can cause cells to die.”
Bill Jennings, owner of Bill & Frank's Brickhouse Grill in downtown DeLand, simulated having a heart attack during a cardiac drill for Florida Hospital DeLand, a requirement for the hospital to provide Therapeutic-Induced Hypothermia. Once inside the hospital’s Cardiac Catheterization Lab, Interventional Cardiologist Janak H. Bhavsar MD, simulates performing cardiac catheterization to indentify the problem in Jennings’ heart and begin opening any blocked arteries. At the same time, the hospital’s respiratory therapy team begins using an intra-aortic balloon pump to simulate dropping Jennings’ temperature even further to the 32-34 degrees Celsius (89.6-93.2 degrees Fahrenheit) range.
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