It's a hot one this week! 🌶 ☀ Let's cool off...
...with a little Target Temperature Management (TTM). ❄
If a patient does not follow commands after a cardiac arrest, the AHA recommends cooling the patient to 32-36 degrees Celsius for at least 24 hours.
❔ Why ❔
➡ Preserve brain function
➡ Reduce Mortality
TTM should be initiated ASAP. Once the gel pads are applied, they DO NOT come off for 72 hours. The goal is to cool the patient for 24 hours, gently rewarm for 24 hours, and then maintain normothermia for 24 hours.
Any interruption is TTM will undue the therapy and can be detrimental for the patient ⚡
After the 72 hour mark, the pads can be removed as long as the patient DOES NOT have a fever. If they have a fever, keep the pads on to maintain normothermia. A rapid increase 📈 in temperature can cause fluid and electrolyte shifts, leading to arrythmias ❤️ and cerebral edema 🧠
Labs 💉 must be carefully monitored during this time to ensure electrolyte shifts are managed appropriately.
If the patient is shivering ☃, place a warming blanket on top of the patient (sounds counter-intuitive, I know) and administer medication to stop the shivering. Shivering warms the body up quickly, which we DO NOT want.
Facilities providing TTM should have specific policies in place. This can be immensely helpful if reviewing a TTM case or caring for a post-arrest patient.
Next week, I'm going to dive more into the critical electrolytes & new changing research around TTM. It gets a little WILD so stay tuned!
What's your experience with TTM?
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Need help reviewing a post-arrest case? Wondering if the patient should've received TTM? Contact me below
Hannah Welk, BSN, RN, CCRN, LNC
🌹 Red Rose Legal Nurse Consulting
🌹 welkhannah@redroselnc.com
🌹 (717) 940-3717