How is hypothermia induced in the field?
In Seattle’s King County Medic One trial (2001), paramedics used two liters of ice-cold saline infusions (3°C) to lower core body temperature in the field. The study found that paramedics were able to lower core temperature by 1.4°C in 30 minutes using ice-cold saline alone. It is important to note that studies have concluded that rapid infusion of two liters of ice-cold saline will not induce pulmonary edema, even in the comorbid post-arrest patient.12 14 However, if the patient arrested because of pulmonary edema, infusion of two liters of fluid is contraindicated. At Regional One Air Medical Service in South Carolina (a Med-Trans Corporation flight program), we decided to implement a therapeutic hypothermia protocol in early 2005, when the AHA endorsed the practice. We believed that despite the limited evidence for therapeutic hypothermia in the prehospital arena, we would not selectively choose to adopt parts of the ACLS algorithms while ignoring other recommendations (i.e., the “a
