The transport team arrived on Medication Administered: the evening of February 6, 1997. Time: Mr. Kuhrt was experiencing un- ____________________________________________________________ 60,000 IU heparin (for anticoagulation) controllable pain and was not able no record 120,000 IU streptokinase (lysis of hemostatic fibrin ) to communicate well, but he did 04:34 no record 250 cc Maalox (to neutralize gastric hydrochloric acid) seem to recognize and respond 700 mEq sodium bicarbonate (to combat acidosis) positively to the two team mem- 04:37 04:40 patient’s head packed with ice bags bers who had met previously (Linda Chamberlain and Tanya ____________________________________________________________ Jones). CryoTransport medica- Figure 2: Medications Administered by Hospital Personnel. tions were drawn and put on ice, and washout equipment was set up medications. After saying farewell February 8, 1997, the patient was at the mortuary. (For Vital Signs, to Mr. Kuhrt and his family, the attended by his son, daughter, and Alcor team retired to a nearby lounge daughter-in-law. As the patient’s see Figure 1.) Mr. Kuhrt and his family (wife, at 10:00 PM. Thereafter, Linda level of consciousness (LOC) had son, and daughter, their respective Chamberlain checked the patient ap- been declining over the early mornspouses, and Anne’s two sisters) re- proximately once per hour. The ing hours, they were watching him quested that medical life support ef- patient’s son and daughter-in-law closely. When his rate of respiraforts be terminated. On doctor’s or- remained at his bedside. tions dropped to less than 1 per 15 ders, at 11:19 AM on February 7, seconds, they summoned the Alcor 1997, the nursing staff discontinued Remote Transport: team and the attending nurse. When CPR, Medication, and Initial, the author arrived in the patient’s the IV insulin drip. The patient was kept on oxygen, and his morphine External Cooling room, the nurse was ascultating the was increased. The patient’s urine Participants: patient’s chest for lung sounds. The output (to Foley catheter) was nearly Steve Bridge, Logistics author stepped out into the hall to nonexistent; extant urine was dark Fred Chamberlain, Logistics talk with other team members and brown. Linda Chamberlain, Transport team heard the code called. An Emergency Room code team The nursing staff agreed to leave Hugh Hixon, Transport team responded, took an EKG, and prothe patient’s subclavian catheter and Tanya Jones, Transport Manager nasogastric tube in place for the adnounced the patient at 04:25 EST. At approximately 4:15 AM on From prior arrangement with Alcor, ministration of Alcor cryotransport the code team then began manual cardiopulmonary reTime: Medication Administered: suscitation with 10 li(Dosages determined for a 160 lb. patient.) ters of oxygen per ____________________________________________________________________ minute by bag valve 04:49 2.6 cc metubine iodide (to inhibit shivering) mask from 04:25 un04:51 37.5 cc potassium chloride (reduce cerebral metabolic demand) til 04:49. Simulta04.54 15 cc epinephrine (to improve perfusion and blood pressure) neously, cryotrans04:55 4 cc deferoxamine (to reduce free-radical damage) port medications 04:55 2 cc gentamycin (to inhibit microbial overgrowth) (Figure 2) were ad04:55 75 cc sodium citrate (to reduce cerebral reperfusion injury) ministered by IV 04:56 8 cc methylprednisolone (to stabilize cell membranes) push. 04:57 9 cc chlorpromazine (to stabilize cell membranes) Hospital regulations 04:58 30,000 IU additional heparin (to inhibit clotting) did not allow the pres04:57 250,000 IU additional streptokinase (lysis of hemostatic fibrin ) ence of non-hospital 05:05 manual cardiac compression discontinued personnel in the ____________________________________________________________________ patient’s room during Figure 3: Medications Administered by Alcor Transport Team initial resuscitation 2nd Qtr, 1997
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