TEXAS MEDICAL ASSOCIATION HOUSE OF DELEGATES
Resolution 302 (A-07)
Subject: Hypothermia for Successful Out-of-Hospital Resuscitations
Introduced by: Harris County Medical Society
Referred to: Reference Committee on Science and Education
Whereas, Out-of-hospital sudden cardiac arrest is a major public health problem affecting all levels of society; and
Whereas, Out-of-hospital resuscitation rates have been relatively stable for a number of years with current methods of early defibrillation for ventricular defibrillation; and
Whereas, Hypothermia following successful resuscitation with return of spontaneous circulation (ROSC) in patients who are comatose appears to substantially increase survival and successful neurological outcome and return to work for those who receive the treatment; and
Whereas, Hypothermia for successful resuscitation with ROSC has demonstrated efficacy in controlled double blind studies, is an American Heart Association Class IIA recommendation for post arrest survivors with ROSC, and observational studies from Texas institutions appears to support a substantial benefit in survival with good neurological outcome; and
Whereas, Early delivery of hypothermia for successful resuscitations with ROSC in comatose patients faces substantial barriers to adoption, including coordination of prehospital and EMS care, identification and support by designated hospital facilities, and the support and effort of dedicated physicians involved in post resuscitation care; and
Whereas, "Diffusion of innovation" requires "drivers" to overcome barriers to delivery of care and innovations that lack the support of large corporations with vested economic incentives are often slow or delayed in adoption; and
Whereas, The Texas Medical Association is in a unique and important position to evaluate, coordinate, and promote effective diffusion and dissemination of innovations that can require integration of different systems, including prehospital, hospital and physician participation for effective delivery; therefore be it
RESOLVED, That the Texas Medical Association evaluate the science and efficacy of hypothermia for successful resuscitation of out-of-hospital cardiac arrests. If supported by evidence, TMA should evaluate the availability and appropriateness of the coordination of prehospital, hospital, and physician delivery of post arrest hypothermia in Texas, and, if warranted, work with appropriate organizations to implement and coordinate an effective delivery of this treatment to the citizens of Texas.
TMA House of Delegates: TexMed 2007