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City Pushes Cooling Therapy for Cardiac Arrest (NYC)
NY Times ^ | December 4, 2008 | ANEMONA HARTOCOLLIS

Posted on 12/03/2008 10:25:19 PM PST by neverdem

Starting on Jan. 1, New York City ambulances will take many cardiac arrest patients only to hospitals that use a delicate cooling therapy believed to reduce the chances of brain damage and increase the chances of survival, even if it means bypassing closer emergency rooms.

The move by the city’s Fire Department and Emergency Medical Service, after a year of preparation, indicates a shift away from the prevailing view among emergency workers and the public that how fast critically ill patients reach the hospital is more important than which hospital treats them.

It amounts to an endorsement by the Bloomberg administration of a labor-intensive, often expensive and still-developing therapy that smaller community hospitals say they lack the staffing and financial wherewithal to provide.

Some hospital officials fear that the policy could be unfair to these smaller hospitals, depriving them of income from emergency-room patients and hurting their reputations with the public.

Since the Fire Department sent letters to hospital chief executives this week informing them of the impending change, about 20 of the 59 hospitals with emergency rooms have said they will have cooling operations ready by the Jan. 1 deadline.

Dr. David J. Prezant, chief medical officer of the New York Fire Department, acknowledged the culture change and the possibility that some hospitals would feel slighted. But he argued that scientific data shows the survival rate of cardiac arrest patients treated with therapeutic hypothermia, as the cooling process is called, is so much better than with conventional treatment that it would be irresponsible not to provide it.

“Theoretically every closest 911-receiving hospital will be able to provide this service,” he noted. “Whether that will be a reality or not is not for me to say.”

New York joins a handful of other American cities, including Seattle, Boston and Miami...

(Excerpt) Read more at nytimes.com ...


TOPICS: Culture/Society; Government; News/Current Events; US: New York
KEYWORDS: cardiacarrest; coolingtherapy; health; hypothermia; hypothermiatherapy; medicine

1 posted on 12/03/2008 10:25:19 PM PST by neverdem
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To: neverdem

this is very interesting, but it doesn’t do much for those of us outside of major metro areas.


2 posted on 12/03/2008 10:34:28 PM PST by kms61
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To: neverdem

I applaude this excellent public health move.

Bloomberg may be a manipulative nanny, but at least he is minimally competent.


3 posted on 12/03/2008 10:35:12 PM PST by FormerACLUmember (When the past no longer illuminates the future, the spirit walks in darkness.)
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To: FormerACLUmember

A pitcher of ice water over the victim?


4 posted on 12/03/2008 10:45:28 PM PST by Oldexpat (Drill Here, Drill There..we must drill everywhere.)
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To: kms61
this is very interesting, but it doesn’t do much for those of us outside of major metro areas.

If you don't do anything, you'll by getting sued. You can start by hanging cooled IV solutions. Communities can start fund drives for local community hospitals. Think of the rehab costs that will be avoided.

5 posted on 12/03/2008 10:52:54 PM PST by neverdem (Xin loi min oi)
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To: cyborg; Clemenza; Cacique; NYCVirago; The Mayor; Darksheare; hellinahandcart; Chode; ...
Ethics Questions Still Hounding Rangel

Paterson Voices Support for M.T.A. Rescue Plan

FReepmail me if you want on or off my New York ping list.

6 posted on 12/03/2008 11:03:38 PM PST by neverdem (Xin loi min oi)
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To: kms61

sure, and there aren’t Level I trauma centers every 10 miles across the land but that doesn’t mean they aren’t incredibly beneficial where they can be funded

this does sound quite promising


7 posted on 12/03/2008 11:04:35 PM PST by Enchante (Countless Innocents in Mumbai, India Suffer the "Religion of Peace" in Action)
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To: neverdem
I wish we had gotten this treatment for my dad! He would have been a great candidate. They got his heart started 7 or 8 minutes after he fell over and had a couple of stents in place in under two hours. Now two weeks later, his body is in great health but he is still in a vegetative state. They let him have a low grade fever this entire time even though I've been trying to tell them how bad that is during reperfusion. When I asked his neurologist why they didn't use therapeutic hypothermia on him he said “we don't incorporate anything into our treatment regime that has not been proved to be over 50% effective”. Tonight the neurologist told me “He has at most a 10% chance of making a meaningful recovery mentally”. If the treatment would have increased those odds by 39% my dad would now have a 49% chance of a meaningful recovery. No doubt his treatment will cost over a million dollars before everything is over. Too bad they wouldn't shell out a few bucks for a couple bags of Ice to save his brain during reperfusion! They have been treating him like a goner from the moment he got there. And telling me that they are doing everything they can even though they all know that statistically folks who Code at home are goners.

Can you imagine when they're all government workers! They'll refuse to do anything and spend all day covering their butts.(even more so than now)

8 posted on 12/04/2008 4:56:11 AM PST by ME-262 (Stick it to the Man! - Down with Obama!)
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Dr. Prezant said that in deference to hospital finances, the city has set no requirements for the kind of cooling techniques hospitals must use — some may start with inexpensive saline solutions and plastic bags filled with ice, while others employ sophisticated equipment manufactured and aggressively promoted by companies like Alsius, Innercool Therapies and Medivance.

I worked for Medivance back in 2004-2005 until they lost their venture capital funding.

9 posted on 12/04/2008 8:20:21 AM PST by A.A. Cunningham
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To: neverdem

bump for later read


10 posted on 12/04/2008 2:59:43 PM PST by Cacique (quos Deus vult perdere, prius dementat ( Islamia Delenda Est ))
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To: ME-262

I’m sorry to read about your father. Prayers sent.


11 posted on 12/04/2008 3:30:28 PM PST by neverdem (Xin loi min oi)
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To: neverdem

Thank you.


12 posted on 12/04/2008 6:53:49 PM PST by ME-262 (Stick it to the Man! - Down with Obama!)
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To: neverdem

Thanks for the ping!


13 posted on 12/04/2008 9:01:10 PM PST by Alamo-Girl
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To: neverdem

Who sold the machines to the hospitals?

Who are the major stock holders?


14 posted on 12/05/2008 4:13:58 PM PST by bert (K.E. N.P. +12 . Save America......... put out lots of waferin)
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To: bert

I have no idea.


15 posted on 12/05/2008 6:35:07 PM PST by neverdem (Xin loi min oi)
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To: bert
Dr. Prezant said that in deference to hospital finances, the city has set no requirements for the kind of cooling techniques hospitals must use — some may start with inexpensive saline solutions and plastic bags filled with ice, while others employ sophisticated equipment manufactured and aggressively promoted by companies like Alsius, Innercool Therapies and Medivance.

I thought the makers were mentioned in the story. I linked back to the story. When I posted it, I used this URL for the printer friendly page.

http://www.nytimes.com/2008/12/04/nyregion/04cool.html?_r=1&hp=&pagewanted=print

It opened on the regular webpage.

http://www.nytimes.com/2008/12/04/nyregion/04cool.html

Next time I'll remove the _r=1&hp=& before pagewanted=print to see if that helps. Thanks for helping me catch their altering of URLs.

16 posted on 12/05/2008 7:01:00 PM PST by neverdem (Xin loi min oi)
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