Extreme Chill for Trauma Patients

“Hi!  Welcome to the emergency department!  Take off your coat and shoes, your freezer is right over there.  Have a seat and we’ll be with you in a moment.”

I imagine that hospital welcome will be more unspoken and mostly mandatory in the coming years as we begin to realize, and accept, that our bodies are basically big bags of meat and freezing us preserves us while cooking us, ends us.

I’ll never forget a friend of mine who expressed a daily concern about a back strain I had many years ago.  She urged me not to use my heating pad on the highest setting because, she argued, “you’re meat, and that pad will cook you.”  I thought she was telling me not to burn the skin on my back, but I now realize she meant something much deeper and more troubling:  Our muscles are “meat” and you can quite easily damage a muscle by “cooking it” with too much heat!

In my article — Have a Stroke? Jump into the Freezer — published here in Dramatic Medicine on March 9, 2010, I reported this colding trend:

We know immediately cooling the brain after a stroke can help preserve neurological function by reducing swelling.  Making the brain chilly is also effective in saving lives and brain capabilities after heart attacks and after infant oxygen deprivation.  Products like Kool-Kit are already on the market to strategically lower the temperature of important parts of the body.

Imagine my delight when I read this week about “extreme hypothermic chilling” now happening in some advanced trauma centers:

Gunshot or stab wounds often cause so much bleeding that patients’ hearts stop beating, bringing them into cardiac arrest. Giving CPR to jumpstart the heart doesn’t help because there is not enough blood for the heart to circulate to revive patients.

Operating to repair these wounds is difficult, since the excessive bleeding keeps trauma surgeons from clearly seeing what they’re doing. These patients’ chances of survival hover at just 7 percent.

Using extreme hypothermia, doctors would try to slow down a patient’s bleeding and put the body’s blood-dependent systems on ice. The deep-chilling process would begin by injecting an ice-cold solution into trauma patients in cardiac arrest.

After about 15 minutes, the patient should be chilled to about 50 degrees, and surgeons can get to work repairing bleeding tissues, ideally taking no more than an hour to finish. Then patients would be gradually warmed back up again to a normal body temperature.

Putting the chill to the bone is a fascinating — and smart! — way to get the body to slow down and get cool and to cooperate with those trying to save a life.  “Cold Saves” is a good meme for doing some fast triage at home or on the way to the hospital when lifeblood is at stake and leaking.