Spring 2013 - Memorial Hospital of South Bend

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saVINGLIVESThe Big, Lifesaving ChillHypothermia helps heart patients weather the neurological stormMisty Vaughn looks at life a little differently these days,thanks to some everyday heroes and a not-so-everydaymedical procedure that put her heart problem “on ice.”In August 2012, without warning, the then 29-year-oldmother of two went into cardiac arrest while at hersons’ football practice. Fortunately, the coaches sawher collapse and ran to her aid, performing CPR untilparamedics arrived and shocked her heart into a stablerhythm. They then immediately started an IV of chilledsaline, the first in a series of steps that make up what’sknown as the therapeutic hypothermia protocol. It’s acutting-edge procedure that’s proving remarkably successfulat reducing the risk of brain damage commonlysuffered by survivors of cardiac arrest.Once at Memorial Hospital’s Emergency Department,Vaughn was swathed in material that looked like bubble-packand then attached to the Arctic Sun ® , a devicethat circulates cold fluid around the outside of thebody, placing her in a state of controlled hypothermia.How It WorksThe idea behind “the big chill” is to cool a patient’score body temperature to 92 degrees Fahrenheitfor about 24 hours, then slowly rewarm it back tonormal. It may not sound very cold, but it’s enough toslow a patient’s metabolism and help shield the brainfrom the harmful effects of toxic chemicals releasedduring and immediately after cardiac arrest, explainsRamey Seifert, R.N., critical care nurse specialistin Memorial’s Intensive Care Unit.After only five days in the ICU, Vaughn was homeagain with her family, just in time for her kids’ footballseason. She has no memory of the event and still hasoccasional short-term memory lapses, but nothing thatis expected to be permanent.“I have definitely changed as aperson and appreciatethe little stuff.”- Misty VaughnFrom left, sonsTucker and James,Misty Vaughn, andhusband Mike8 PULSE | Memorial Hospital of South Bend • 574.647.6800
Vaughn honored the football coaches, many of whomshe has known since she was a young girl, with anAmerican Heart Association ® Heroes Award in October.She plans to take a CPR course so she can pay forwardthe gift of life that started with her sons’ coachesknowing what to do that day.“If it was going to happen, I’m glad it happened the wayit did, or I wouldn’t be here,” says Vaughn, who turned30 in September. “I have definitely changed as a personand appreciate the little stuff.”The Biggest Advancement Since CPRSince 2006, the survival rate among patients broughtto Memorial after suffering ventricular fibrillation, asVaughn did, is almost 73 percent. Nearly all returnedhome within three to five days of admission with little tono long-term neurological problems. By contrast, a fiveyearstudy published in 2011 by the Centers for DiseaseControl and Prevention placed the overall survival rateat just above 30 percent for patients like Vaughn. “Thisis the biggest advancement in resuscitation medicine indecades, possibly since the advent of CPR more than50 years ago,” Seifert says.Memorial was a leader in implementing the hypothermiaprotocol locally in late 2006. Emergency physicians andEMS medical directors Keith Sherry, M.D., and BruceSpeicher, M.D., and Gary Fromm, M.D., medical directorof Memorial’s ICU, championed the cause, whichrequired the support of both local hospitals to ensurethat the benefits of therapeutic hypothermia areavailable to everyone in this area. Drs. Sherry andSpeicher then reached out to the EMS community inSt. Joseph County, authorizing the procedure forstarting the protocol in the field. Almost alladvanced life support ambulances in St. JosephCounty now have refrigerators on board thatcontain the cold saline needed to begin thecooling process, which is continued onarrival to the Emergency Department.Therapeutic hypothermia is a valuableand powerful tool in promotingneurological recovery in victims ofcardiac arrest who are successfullyresuscitated. However, health carepersonnel and the American HeartAssociation continue to emphasizethe importance of high-quality CPRand early defibrillation to givepatients a chance of resuscitationand an opportunity to benefit fromtherapeutic hypothermia.Tough Call Wasthe Right CallUse of the hypothermia protocol on pregnant womenhas not been widely embraced because of a lack of dataabout how it affects the fetus.But one February night in 2009, Memorial emergencyphysician Rajalakshmy Sundararajan, M.D., inconsultation with other physicians, made the tough callto use the technique on 33-year-old Cindee Goodling, whowas 20 weeks pregnant and had been resuscitated from aprolonged cardiac arrest in a local church. This is particularlysignificant in light of a recent study presented at theAmerican College of Cardiology that indicated changesbrought about by pregnancy can increase a woman’srisk of heart attack during pregnancy. High-quality CPR,provided by community members prior to the arrival ofparamedics, was also an important factor in her successfulresuscitation.Not only did both mother and baby survive, but Goodlingwas back to work within days after leaving Memorial. Fourmonths later, she gave birth to a healthy baby boy, Collin,now 3 years old. During resuscitation, Goodling was alsoshocked several times. In a fitting recognition of this,Collin’s nickname is “Zap.” During EMS Night at CoveleskiStadium in 2011, Goodling and Zap threw out the firstpitch in appreciation of all those who had made theirsurvival possible.Goodling’s story was featured on MSNBC’s websiteand documented in an article in the international journalAnnals of Emergency Medicine, collaboratively authored byAakash Chauhan, M.D.; Harsha Musunuru, B.S.;Michael Donnino, M.D.; Michael T. McCurdy, M.D.;Vinod Chauhan, M.D.; and Mark Walsh, M.D.Simple Steps That Can Save Your LifeTake a free, confidential risk assessment that couldsave your life or greatly improve your quality oflife. Go to whatsmyrisk.org, where you can learnmore about your health and whether you’re at riskfor conditions such as heart disease, joint pain,diabetes, sleep disorders, obesity and stroke. Eachassessment is quick and easy. If you are at risk, call800-647-6800 to speak with one of The HealthProfessionals at Memorial Hospital of South Bend.Spring 2013 | qualityoflife.org9
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Spring 2013 - Memorial Hospital of South Bend

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