Cooling therapy saves brains

Registered nurse Carol Eaton and former newspaper editor Maxwell King have something in common: Their hearts stopped beating and they lived to tell the tale.

Eaton was at home in Massachusetts when it happened. King was speaking to civic leaders in Pittsburgh when he went into cardiac arrest.

Shortly after they collapsed, first responders sprang into action, performing cardiopulmonary resuscitation and restoring their heartbeats with automated external defibrillators.

That part of their treatment is no different than what Southern Nevadans have long experienced. But what happened after Eaton and King got to the hospital was.

Both went to medical centers where they were kept in a coma and had their bodies slowly cooled to around 91 degrees Fahrenheit.

Only about 6 percent of the 325,000 Americans who suffer sudden cardiac arrest each year survive it. Eaton and King are among an even smaller fraction — about 3 percent — who come through it without brain damage.

“I believe the induced hypothermia saved my brain,” Eaton said Thursday in a phone interview from John Glenn Middle School in Bedford, Mass., where she is the school nurse.

King, editor of the Philadelphia Inquirer from 1990 to 1997, is just as enthused about therapeutic hypothermia.

After essentially dying, “I have been able to go on with my life as though nothing happened,” said King, now an administrator at St. Vincent College in Latrobe, Pa. “Tests have shown I suffered no brain damage.”

It is that kind of personal testimony from survivors, coupled with scientific studies that show induced hypothermia makes a difference not only in survival rates but in their quality of life, that has made Las Vegas emergency room physician Dr. Ross Berkeley push for the chilling treatment in Southern Nevada.

Berkeley is in charge of quality control of the emergency department at University Medical Center, which is furthest along in developing the treatment locally, though Sunrise Hospital and Medical Center also has begun a program.

The cooling technique, research shows, preserves neurological function by decreasing the brain’s oxygen demand by decreasing the body’s metabolism.

Neurological function also can be preserved through cooling by preventing a secondary brain injury that often occurs after successful cardiac resuscitation.

Induced hypothermia has been used on four patients at UMC in recent months. One current patient will “walk out of the hospital just fine,” according to Dr. Dale Carrison, head of UMC’s emergency department. It’s too early to tell how the other three will fare.

The one patient treated at Sunrise recently with the new protocol did not do well, said Dr. Scott Selco, who did not elaborate.

In November, the Las Vegas Fire Department begins a partnership in the treatment with UMC. Fire responders will treat cardiac arrest patients in the field with both cold saline infusions and ice packs before bringing them to the public hospital.

Only six other fire departments in the nation are currently following the protocol.

“Dr. Berkeley kept pushing this for the last year until we did this the right way,” Carrison said. “By giving this treatment to patients in the field, we’re really on the cutting edge.”

Berkeley’s passion for the treatment was evident last week as he stood with paramedics in the UMC emergency room. Near them was both the saline solution that will be kept chilled in ambulances and the suit that patients wear in the hospital.

Chilled water circulates through the reusable suit, which costs only about $350, helping keep the body temperature about 7 degrees below normal.

“This is so exciting,” said Berkeley. “This will give us a much better chance of people not only surviving, but having enough neurological function to return to work and their normal lives. Time is of the essence and by starting this in the field, we have an even better chance of helping people. I’m hoping that in the coming years all ambulance units will be doing this with all hospitals in the Las Vegas Valley.”

Dr. David Slattery, medical director for the Las Vegas Fire Department, said all personnel are being trained in the protocol. He noted that the cases, which hold four bags of IV solution and keep them cold, are inexpensive, with a one time cost of $700.

“We have a back up battery so the paramedic can take the cooling case out of the rig if necessary,” he said. “We feel it is important to have the cold saline readily available, especially during the summer months.”

Therapeutic hypothermia is by no means a panacea for sudden cardiac arrest; relatively few patients are resuscitated in time for cooling to do any good. But Berkeley noted that the necessary 24-hour cooling treatment is the only intervention clearly shown to protect the brain from the devastating effects of cardiac arrest.

“It’s something so simple that can do so much good,” he said.

Exactly how cooling works is still unclear, but two clinical trials published in the same issue of the New England Journal of Medicine in 2002 demonstrated that inducing hypothermia in unconscious patients after cardiac arrest significantly improved their survival rate, as well as neurological outcomes.

One trial performed in Europe found a 14 percent improvement in survival rate, while a second trial in Australia showed a 23 percent improvement in neurological outcomes.

Once a patient arrives at the hospital, he is given sedating and paralyzing drugs to prevent shivering, is put on a ventilator, and then gradually is chilled both internally and externally over an eight-hour period.

For about 24 hours, body temperature is held at between 90 and 93 degrees while the patient is closely monitored.

Rewarming is very gradual — about a degree per hour — as sedation is reduced.

King, the former newspaper editor, developed a slight case of pneumonia.

“It took me a couple days to get over that,” he said.

Medical experts say fewer than one in four hospitals in the country use therapeutic hypothermia.

“You’ve got to get your staff trained,” said Selco, head of the stroke program at Sunrise.

Gretchen Papaz, a spokeswoman for the Valley Health System, said Valley hospitals will begin rolling out their induced hypothermia program in November.

Selco said statistics show that for about every six to eight patients treated with the therapeutic hypothermia, one life is saved.

“If we can save one for every eight we treat, I’ll take that any day of the week,” Selco said.

Contact reporter Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.

ad-high_impact_4
News
Henderson police bodycam footage of officer-involved shooting
Henderson police released body-worn camera footage of an officer-involved shooting in a grocery store parking lot at 2667 Windmill Parkway on Aug. 12, 2018. (Henderson Police Department)
Bicyclist suffers major head trauma in hit-and-run
A bicyclist was hospitalized with life-threatening injuries after a Thursday morning hit-and-run crash near the school formerly known as Agassi Prep. Police said the bicyclist was hit by a white SUV, which fled the scene. The injured man suffered multiple injuries including major head trauma. As of 9 a.m., Lake Mead remained closed between Martin Luther King and Revere Street while police investigate.
Las Vegas artist Dave Dave dies at 42
Dave Dave talks about his art and his life in 2016. (Michael Quine/Las Vegas Review-Journal)
Dave Dave, whose dad set him on fire in 1983, dies
Dave Dave, a respected Las Vegas artist who was badly scarred as a boy when his father tried to burn him to death in Southern California, died at Sunrise Hospital on July 15. He was 42. When he was 6, Dave's father tried to kill him by setting him on fire. He was given a sleeping pill and his bed at a Buena Park, California, motel was doused with kerosene. “I remembered being in a lot of pain,” Dave told the Review-Journal in 2016. “When stuff happens to you at that young of an age, you tend to block it out, but I remember the pain was excruciating.” Dave, who was born David Rothenberg, became close friends with Michael Jackson, who met him after the attack, which burned more than 90 percent of his body. “I wanted to meet him, and he wanted to meet me, and that just turned into a lifelong relationship that never ended,” Dave said. “It was amazing being friends with Michael Jackson. He was an amazing person.” Dave attended ArtCenter College of Design in Pasadena, California, and collaborated with various artists around Las Vegas, eventually selling his art to private collectors. Despite his challenges, he continued to live, thrive and create. Dave Dave
Homicide detectives investigate woman's death
Las Vegas police were called to Tahiti Village Resort early Wednesday after calls that someone had been shot. Police found a woman’s body between a parking garage and boiler room on the resort's property. A guest first reported hearing gunfire. There are no witnesses, but police will examine surveillance videos and look for clues. The woman was not identified, but a purse was found near the body. She did not appear to be a guest at the resort.
LVMPD Discusses Ross Dress for Less Shooting
LVMPD Assistant Sheriff Charles Hank discussed the 15th officer-involved shooting of the year at a press conference at Metro headquarters on Tuesday, Aug. 14. The active-shooter incident took place at the Ross Dress for Less store at the 4000 block Blue Diamond Road in the south Las Vegas Valley. (Madelyn Reese/ Las Vegas Review-Journal)
Metro Asst. Sheriff Brett Zimmerman on Aug. 8 officer-involved shooting
Metropolitan Police Department Assistant Sheriff Brett Zimmerman met with media Monday to discuss the details of the 14th officer-involved shooting of the year. (Madelyn Reese/ Las Vegas Review-Journal)
Clark County School Board president Deanna Wright on travel expenses
Clark County School Board President Deanna Wright says she followed proper expense protocol in trip to Florida last year.
Matt Kelly Elementary School hosted its third annual Back-to-School Red Carpet Program
Matt Kelly Elementary School hosted its third annual Back-to-School Red Carpet Program where community and business leaders joined to welcome students back with an inspirational welcome. Bizuayehu Tesfaye/Las Vegas Review-Journal @bizutesfaye
Shooting leaves 1 dead in southeast valley
A man was found fatally shot in the doorway of a squatter apartment after an argument ended in gunfire on Sunday night. Officers responded about 10:30 p.m. to the Silver Pines apartments and discovered the man in a breezeway in one of the buildings. The wounded man died at the scene, despite the efforts of another person, who tried to administer medical aid. Witnesses saw a man and a woman flee the scene, but were unable to give police a clear description.
North Las Vegas unveils new school crosswalk
North Las Vegas councilman Isaac Barron talks about the new school crosswalk in front of CP Squires Elementary School Monday, August 6, 2018. (Marcus Villagran/Las Vegas Review-Journal) @brokejournalist
LVMPD Briefing on OIS #13
Assistant Sheriff Tim Kelly held a press conference to discuss details of the 13th officer-involved-shoot for the department in 2018. Video shows the moments before the suspect was shot. The shooting, which has been edited out, occurred as the suspect lunged at an officer outside the apartment. (Madelyn Reese/Las Vegas Review-Journal)
Sedan and semitrailer collide in south Las Vegas
An early Wednesday morning crash has left one person in critical condition. A sedan and semitrailer collided around 4 a.m. at the corner of Spencer Street and Serene Avenue. Police do not believe impairment is a factor in the crash. Spencer has been blocked off north of Serene while police continue their investigation.
Cybersecurity Professionals Flock to Las Vegas for Black Hat
Black Hat USA, the largest annual cybersecurity conference, is expecting a record 17,000 attendees during its six-day run at the Mandalay Bay Convention Center this week. One thing attendees have in mind is making sure they don't get hacked while they're there. (Madelyn Reese/Las Vegas Review-Journal)
Police chase ends with suspects captured in east Las Vegas
An early Tuesday morning chase ended with a car crash in an east Las Vegas neighborhood. Police were pursuing the vehicle, which they say was involved in robberies in Las Vegas and North Las Vegas, when the driver crashed at Owens and Statz Street. A man was taken into custody. A woman was ejected from a vehicle and taken to a hospital with non-life threatening injuries. The intersection at Mojave Road and Owens Avenue was shut down while police officers searched for the suspect and investigated. The intersection will remain closed for most of the morning.
Record number participate in Touro University Nevada White Coat Ceremony
Three hundred sixty-five medical students received their white coats during the Touro University Nevada White Coat Ceremony at the M Resort in Henderson Monday. The ceremony was developed to honor students in osteopathic medicine, physician assistant studies, nursing, occupational therapy and physical therapy as they accept the professional responsibilities inherent in their relationship with patients. (K.M. Cannon/Las Vegas Review-Journal)
Stop for school buses, urges CCSD
Clark County School District Police Department hold a mock traffic stop at Centennial High School in Las Vegas, Monday, Aug. 6, 2018. (Marcus Villagran/Las Vegas Review-Journal) @brokejournalist
Work Begins at Las Vegas Community Healing Garden
Crews moved the wooden Remembrance Wall at the Las Vegas Community Healing Garden on South Casino Center Boulevard Monday. Construction on a permanent wall is set to begin within the week. (Madelyn Reese/Las Vegas Review-Journal) @MadelynGReese
Man wounded outside Cottages apartment
Las Vegas police don't have a motive after a man was shot early Monday morning outside a northwest valley apartment. The man's mother called police to say her son had been shot. She called police around 1:15 a.m. Other people were inside the apartment but no one else was injured. Police are still looking for the shooter.
Ride new Interstate 11 segment in one minute
Interstate 11 opens to the public Thursday, providing sweeping views of Lake Mead, art deco-style bridges and a mural illustrating the construction of Hoover Dam. (K.M. Cannon/Las Vegas Review-Journal)
Miss El Tiempo 2019
Miss Teen El Tiempo and Miss El Tiempo 2019 were crowned at Sam's Town Saturday, August 4, 2018. (Marcus Villagran/Las Vegas Review-Journal) @brokejournalist
Las Vegas Woman Raises Awareness for Anxiety and Depression
Cassi Davis was diagnosed with anxiety and depression after the birth of her second child. After seeking help and support, she felt that there wasn't enough for support for those living day in and day out for those with mood disorders. She created the Crush Run, set for Sept. 22, to raise money for the Anxiety and Depression Association of America and bring together a community of people who live with the same conditions she does. (Madelyn Reese/Las Vegas Review-Journal)
North Las Vegas marks the opening of Tropical Parkway connector
The City of North Las Vegas, Nevada Department of Transportation and other partners celebrated the opening of the Tropical Parkway connector to Interstate 15 and the Las Vegas Beltway. The stretch of road will make access easier for distribution centers for Amazon, Sephora and other companies moving into an 1,100-acre industrial area rising near the Las Vegas Motor Speedway. (K.M. Cannon/Las Vegas Review-Journal)
Bighorn sheep with West Temple in background at Zion National Park
A bighorn sheep walks through Zion National Park (National Park Service)
Adult Superstore location closes after 45 years
The Adult Superstore on Main Street has closed its doors for good after 45 years. The shop, which offered a multitude of adult toys, novelty items and movies, opened in 1973. Four other locations remain open. A note on the front door tells customers, “We can’t fully express our sorrow.” Adult Superstore was awarded Best of Las Vegas adult store by the Review-Journal in 2016 and 2017 .
Funeral held for Las Vegas corrections officer
Department of Public Safety Correctional Officer Kyle Eng died July 19 after a fight with an inmate at the Las Vegas Jail. A funeral was held for Eng at Canyon Ridge Christian Church Monday, July 30, 2018. (Marcus Villagran/Las Vegas Review-Journal) @brokejournalist
What Back-To-School Shopping Is Like For a CCSD Parent and Teacher
Laura LeBowsky, a CCSD special education teacher and mother of two, set out to shop for her children's supply lists at her local Walmart and Target. She was looking for deals to try to keep the total under $150, while also allowing Chloe, 8, and Brady, 6, some choice in what they wanted. (Madelyn Reese/ Las Vegas Review-Journal) @MadelynGReese
Businesses struggle to fill food manufacturing jobs
Chelten House is a family-owned food manufacturing company from New Jersey. They created a facility in Vegas five years ago and have struggled to find experienced workers in the area. (Marcus Villagran/Las Vegas Review-Journal)
LeBron heckler crosses line, altercation erupts
NBA superstar LeBron James, his wife, Savannah, and daughter Zhuri were at Liberty High School to watch Bronny James in action Wednesday night. But an unruly fan wearing a Michael Jordan Chicago Bulls jersey heckled the newest Los Angeles Laker. The man screamed at event security with LeBron and his family about 150 feet away. The man had to be restrained, triggering a brief altercation with security. James and his family were escorted out a side door along with Bronny's team, the North Coast Blue Chips. Event officials canceled the game between the Blue Chips and Nike Meanstreets.
Las Vegas Oddities Shop in Downtown Las Vegas
Las Vegas Oddities shop owner Vanessa VanAlstyne describes what's for sale in one of the weirder and wackier stores in Downtown Las Vegas. The store opened less than a year ago and carries everything from human bones to "rogue" taxidermy to Victorian death photography. (Madelyn Reese/ Las Vegas Review-Journal)
TOP NEWS
News Headlines
Add Event
Home Front Page Footer Listing
Circular
You May Like

You May Like