Chapter 1
1.1 Introduction
By synthesizing the data from various studies and research, this dissertation will aim to systematically review the current literature of evidence for therapeutic hypothermia (TH) post cardiac arrest. The research question is as follows: does therapeutic hypothermia treatment present positive neurological outcomes for post cardiac arrest victims?
1.1a Rationale: Whilst working in the Intensive Care Unit, I had the opportunity to witnessed a patient being cooled (therapeutic hypothermia concept) after experiencing out of hospital post cardiac arrest. I was intrigued to learn more about the concept as I had never heard or seen it done before. This prompted me to research further on the evidence based practice pertinent to TH treatment on post cardiac arrest victims.
Patients who have suffered post cardiac arrest are usually cared for in a critical care environment such as the intensive care unit (ICU), and the survival rate for in hospital incidents is considered to be poor (Gwinnut et al 2000). Furthermore, according to Becker (1993) and Rea (2004), approximately 0.04% to 0.19% of out of hospital cardiac arrest incidence occur each year in industrial countries. Around 14% to 40% of these victims regain Return of Spontaneous circulation (Giraud 1996, Finn 2001, Fischer 1997), and only 7% to 30% were able to attain good neurological outcomes on discharge (Jennings 2001, Westfal 1996, Weston 1997). By critically reviewing the literature of evidence on TH, I believe it will help to systematically develop an understanding of the issues concerning the intervention and encourage giving recommendations for care at a local level. This would also help to comply with the Nursing and Midwifery Council (NMC 2008), who suggested that nurses must practice and give care with the best available evidence at all times.
1.1b Background: In the past,