Hospital Introduces New “Code Frost” Protocol For Treating Heart Attacks

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OLD BRIDGE — Although New Jersey will soon enter the summer months, visitors to Raritan Bay Medical Center’s (RBMC) emergency departments in Old Bridge and Perth Amboy may feel a chill in the air as heart attack patients are cooled down as part of the medical center’s new patient care code – “code frost,” a hypothermia protocol for patients experiencing sudden cardiac arrest. Used together with the hospital’s new “see-thru CPR” defibrillators the new protocol gives RBMC an extremely effective resuscitation bundle not available at any other Central New Jersey hospital.

The code, first implemented in April, involves rapidly cooling the patient’s core body temperature during resuscitation to protect the patient’s brain and heart.  Each year, either out of the hospital or in an emergency department, approximately 310,000 people in the United States experience sudden cardiac arrest (American Heart Association, 2008) with brain injury being the most common cause of death after initial resuscitation. Cooling the body has been proven to lessen the damage done to vital organs during cardiac arrest and resuscitation.

During a code frost, medical center clinicians use the ThermoSuit in combination with cutting-edge R-Series “see-thru CPR” defibrillators during resuscitation. “Cooling the body a few degrees causes vital organs to operate more slowly and need less oxygen, reducing the chance of damage and increasing the odds that the patient will return to a normal life,” said Dr. Rayshma Ali, assistant director of emergency services at RBMC and chair of the code frost committee. “Also, our new defibrillators allow clinicians to continuously monitor heart rhythm, minimizing interruptions in cardio-pulmonary resuscitation to determine whether an organized, shockable rhythm has developed. These new pieces of state-of-the-art technology combine to give Raritan Bay Medical Center an extremely effective resuscitation bundle, enhancing our ability to save lives.”

The ThermoSuit, developed by Life Recovery Systems and purchased through a Norman and Marion Tanzman Foundation donation to the RBMC Foundation, is an inflatable cocoon-like non-invasive device that sprays the body with hundreds of icy-cold jets of water, reducing the patient’s temperature rapidly. The Thermosuit may be use in conjunction with the medical center’s Zoll Medical Corporation R-Series “see-thru CPR” defibrillators. RBMC is the first medical center is Central New Jersey to use these technologies in unison.

Code frost, known as therapeutic hypothermia, is applied to both out of hospital and inpatient cardiac arrest patients who meet certain criteria. Hypothermia is most beneficial when it is started within 2-6 hours after the patient arrests. A subcommittee of RBMC’s patient code committee ensured that the medical center implemented the new code based on American Hospital Association guidelines. An extensive hospital-wide training was also completed before the code was implemented, including emergency and critical care physicians and nurses.


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