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Beth Furgurson photo
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Todd Van de Bussche, a flight paramedic from Stafford County, went into cardiac arrest while taking a shower on Election Day 2008. Despite having 20 years in emergency medical service, he says, "I never considered teaching my wife how to do CPR." She learned over the phone, performing chest compressions until paramedics arrived seven to 10 minutes later and defibrillated her husband's heart. Van de Bussche (at right) wound up at VCU Medical Center, where he underwent a special cooling procedure.
"With my downtime [until medical personnel arrived], I should be in a nursing home with someone taking care of me," says Van de Bussche, who works for LifeEvac of Virginia. Since then, he has provided at least one cardiac patient with ice-cold intravenous saline to start the patient cooling while in flight.
Called Advanced Resuscitation, Cooling Therapeutics, and Intensive Care, or ARCTIC, the protocol is designed to slow the body's metabolism to protect the brain after a catastrophic event such as a cardiac episode, says Dr. Joseph P. Ornato, chairman of VCU's Department of Emergency Medicine and operational director of the Richmond Ambulance Authority. When the heart stops pumping regularly, the reduced flow of oxygen-rich blood can injure brain cells and lead to a buildup of toxic waste products called free radicals. Cooling the body to about 93 degrees can limit the creation of free radicals, leading to improved survival rates for patients and better recovery of brain function. Rewarming the patient is done gradually.
VCU and the Richmond Ambulance Authority have teamed up to initiate the cooling process in the field. In life-or-death cardiac-arrest calls, an ambulance-authority supervisor is tasked with starting the 2 liters of frigid saline while paramedics handle resuscitation.
"We're seeing some really remarkable successes," says Ornato.