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Miami County EMS

Area ambulances put the big chill on heart attacks; Dropping body temperature can slow damage to brain and help body heal.
By Joe Lambe

Monday,November 16, 2009

Your heart stops. Medics restart it. But you don’t regain consciousness.

A big chill could save your life.

More hospitals in the area and nationwide are taking such patients’ body temperatures down to about 90 degrees for 24 hours. That can slow or stop a cascade of brain and tissue damage and give the body a better chance to heal, staving off death or disabilities.

This month, two area providers of emergency medical services will start that treatment even faster by cooling such patients in ambulances.

Miami County EMS medics finished training Friday and will officially start using the procedure today -- becoming the first EMS unit in Kansas to do so.

Beginning Saturday, Central Jackson County Fire and EMS in Blue Springs will become the area’s only other EMS provider chilling patients in ambulances.

Johnson County Med-Act officials said they would start using the procedure in ambulances next year.

Only about 100 EMS providers out of 24,000 nationwide are using the treatment, according to a recent article in EMS Magazine.

In large cities, it often is not needed. EMS providers in Kansas City said it would make no sense to use it on ambulances so near so many hospitals.

But in Miami County, transport times can be up to 30 minutes, medic Matt Howard said, which gives EMS workers time to bring down patients’ temperatures. They use chilled IVs and ice packs.

Some studies said the treatment can double the 5 percent survival rate for those who suffer sudden cardiac arrest outside hospitals. Studies in 2002 showed almost twice as many such hospital patients made a full recovery with the treatment or suffered only mild disabilities.

Miami County medic Chad Oliver said for him, "It’s nice to be able to worry about saving brains instead of just saving hearts."

The American Heath Association has endorsed the procedure in hospitals since 2003, so why don’t all hospitals use it? One study reported that only about a quarter of them do.

Joe Salomone, EMS medical director in Kansas City, said hospitals had to invest money in equipment and training. The issue is complex, he said, because other changes also can improve outcomes.

Kansas City EMS providers, for instance, three years ago helped pioneer a new CPR technique of 100 chest compressions a minute that is saving many lives.

"A fair number of these folks who get their pulse back with this wake up," Salomone said, and do not need the chill.

Howard said Miami County EMS also uses the 100-compression CPR and credits it with getting the survival rate up from 5 percent to 7.6 percent. He said studies indicated that using the new CPR and the chilling could raise survival to about 12 percent.

Matthew Deedy, a cardiologist who works at St. Luke’s Hospital in Kansas City, said the hospital started using the chilling procedure about six months ago. Since then, he said, five of eight heart patients have survived and left the hospital.

Medical treatments tend to be slow to change, he said.

"It’s also very low-tech, and I think that’s why it hasn’t spread," he said.

Now there are more studies to support it, he said, and "more push behind it."

Daniel Thompson, EMS relations director for hospitals owned by HCA Midwest Heath Systems, said three of its area hospitals had started using the procedure and two more soon would.

They also have created a "code ice" for ambulance crews, he said. This signals the hospital staff to prepare for the long chill.

One person who supports all this talk of cold is Gary Pigott of Olathe. St. Luke’s South in Overland Park used the procedure on him in the summer after his heart stopped on the 18th hole of a golf course.

His wife, Pat Pigott, said she called her cold husband "the frozen man," and she and his doctors worried that he could die or be brain-damaged.

But he awoke fine, he said. "I just feel like I did before anything happened."

He hopes to be back on the golf course by summer.

To reach Joe Lambe, call 816-234-7714 or send e-mail to

Miami County EMS--32765 Clover Dr, Paola, KS 66071--(913)294-5010

Miami County, KS Official Website