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The use of induced hypothermia after cardiac arrest: a survey of Canadian emergency physicians

Published online by Cambridge University Press:  21 May 2015

Joel Kennedy ,
Robert S. Green ,
Robert Stenstrom  and
on behalf of the CAEP Critical Care Committee
Joel Kennedy
Affiliation:
Department of Emergency Medicine, Dalhousie University, Halifax, NS
Robert S. Green*
Affiliation:
Department of Emergency Medicine, Dalhousie University, Halifax, NS Department of Internal Medicine, Division of Critical Care Medicine, Dalhousie University, Halifax, NS
Robert Stenstrom
Affiliation:
St. Paul's Hospital and the University of British Columbia, Vancouver, BC
*
Dalhousie University, Department of Medicine, Division of Critical Care Medicine, and the Department of Emergency Medicine, Rm. 377, Bethune Building, 1278 Tower Rd., Halifax NS B3H 2Y9; greenrs@dal.ca

Abstract

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Objective:

Inducing mild hypothermia in survivors of cardiac arrest has been demonstrated to improve outcomes. Despite this, other studies have found that few resuscitation physicians have used hypothermia in clinical practice. The objective of this study was to characterize the use of induced hypothermia by Canadian emergency physicians.

Methods:

An internet-based survey was distributed to all members of the Canadian Association of Emergency Physicians (CAEP). Participants were asked about their experience with, methods for and barriers to inducing hypothermia.

Results:

Of the 1328 CAEP members surveyed, 247 (18.6%) responded, with the majority working in academic centres (60.3%). Ninety-five out of 202 respondents (47.0%, 95% confidence interval [CI] 40.8%–53.2%) indicated that they had induced hypothermia in clinical practice and 86 of 212 (40.6%, 95% CI 34.0%–47.2%) worked in a department that had a policy or protocol for the use of induced hypothermia. The presence of a departmental policy or protocol was strongly associated with the use of induced hypothermia (unadjusted odds ratio 10.5, 95% CI 5.3–20.8). Barriers against induced hypothermia cited by respondents included a lack of institutional policies and protocols (38.9%), and of resources (29.4%). Lack of support from consultants was relatively uncommon (8.7%) in Canadian practice.

Conclusion:

Only one-half of Canadian emergency physicians report that they have used therapeutic hypothermia in practice. Emergency departments should develop policies or protocols for inducing hypothermia in cardiac arrest survivors to optimize patient outcomes.

Keywords

induced hypothermiaemergency medicinecardiac arrestpolicy protocol
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 10 , Issue 2 , March 2008 , pp. 125 - 130
Copyright
Copyright © Canadian Association of Emergency Physicians 2008

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