Hypothermia Treatment at Methodist Hospital
Cooling Therapy Saves Cardiac Arrest Victims’ Brain Function
In a heartbeat, Jill Hisey’s life ended.
One heartbeat earlier, she was with her son Trent at his Little League game at Windsor Field in Arcadia. There in the dugout—without warning—Hisey’s heart went haywire. The attack was swift and catastrophic.
“As I was putting Trent’s catcher’s gear on him, I told him that my head hurt,” Hisey says. “Then I just collapsed.”
It had already been a busy Saturday morning for Steve and Jill Hisey and their family: a pancake breakfast fundraiser for their daughter, Allie, and a tee ball game for their son Jackson. When Jill arrived at Windsor Field, Steve, a former minor league baseball player and Arcadia High School standout, was already there, preparing to coach Trent’s game.
No one could have guessed what was coming for Hisey. She was a fit and healthy 44-year-old with absolutely no prior cardiac problems. Yet minutes later, there she lay, unconscious on the ground in the dugout, a victim of sudden cardiac arrest. Her heart quivered—powerless—unable to pump oxygen to her brain and other vital organs. Almost immediately, her skin began to turn purple, deprived of its supply of fresh blood.
Within seconds, three other people at the game—the mother of a player on Trent’s team, the mother of a player on the opposing team and a 17-year-old scorekeeper who had just learned CPR—leapt to Hisey’s aid. The trio’s efforts keep blood and oxygen moving through her body until paramedics arrived to take over.
“These three are heroes, and Jill wouldn't be here today without them,” Steve declares in a blog post about the ordeal.
Although Hisey recalls nothing of the next couple days, they were filled with intense efforts by a large group of physicians, nurses and staff at Methodist Hospital to save her life. When paramedics arrived with her at the hospital’s emergency department, Hisey was clinging to life by a thread.
“She was totally unresponsive, not speaking to or looking at people,” says neurologist Kenneth Wogensen, MD. “The Glasgow Coma Scale, which describes the severity of a coma, goes from 3 to 15. She was a 3—as low as you can be.”
The primary peril in a situation like Hisey’s is lack of oxygen to the brain. Minute by minute, brain cells literally starve to death as they are deprived of oxygen-rich blood. Eventually, the brain can go into shock, and death is imminent.
The emergency department team got Hisey’s heart beating again and inserted a breathing tube. During that time, Dr. Wogensen determined that Hisey was a good candidate for an exciting new technology available at Methodist Hospital.
In medical jargon, it’s called Code Freeze—or more formally as the hypothermia protocol. The objective is to lower the patient’s core body temperature, the familiar 98.6 degrees Fahrenheit, to approximately 89 degrees Fahrenheit. Those nine degrees can have a life-altering impact on the patient. A cooler brain needs less oxygen, which in turn reduces the chance of permanent brain damage.
So in Methodist Hospital’s coronary care unit, staff members wrapped cooling blankets—fitted with tubes that circulate ice-cold water—around Hisey’s limbs, chest and head. Her body temperature was slowly lowered to 89 degrees, where it stayed for the next 24 hours. Then over the course of a dozen more hours, she was brought back to a normal body temperature. Throughout the process, physicians and nurses continuously monitored her condition.
Methodist Hospital is one of only a few hospitals in Los Angeles County that employ the hypothermia technology. Currently it is approved for use only with patients like Hisey who are in a coma after suffering cardiac arrest.
“If you can step in and preserve the brain, you’ve done a tremendous service for the patient and their family,” Wogensen says.
After Hisey was stabilized, the search began into the cause of her sudden cardiac arrest. Interventional cardiologist Terrence Baruch, MD, conducted an angiogram in Methodist Hospital’s cardiac catheterization lab to look for blockages in the blood vessels in and around Hisey’s heart. Fortunately, he found none.
In the hospital’s electrophysiology lab, cardiologist and electrophysiologist Paveljit Bindra, MD, conducted a series of sophisticated chemical and electrical tests to determine the cause of Hisey’s heart attack. In addition to a drug infusion test, Dr. Bindra used an electronic mapping and recording system to gather extremely detailed information about Hisey’s cardiac muscle via wires threaded into her heart. Ultimately, her cardiac arrest was termed idiopathic, meaning that there is no explanation for what caused it.
To help ensure that Hisey survives any future heart rhythm issues, Dr. Bindra recommended an automatic implantable cardioverter-defibrillator (AICD). Surgically inserted around Hisey’s heart and powered by a long-lasting battery, the AICD will remain in place permanently to deliver a potentially lifesaving shock whenever it detects a threatening rhythm.
Due in part to her age and her overall health, Hisey made a near-miraculous recovery. Just nine days after nearly losing her life, she was discharged from Methodist Hospital. In another blog entry, Steve Hisey expressed his family’s gratitude to the physicians and staff of Methodist Hospital, as well as the others who participated in saving his wife’s life.
“To get from point A, where Jill collapsed at the baseball field, to point B, where she walked out of the hospital alive and able to start the recovery process, was an amazing example of teamwork in which everyone had to perform their roles to perfection,” he writes. “If there was one weak link in the chain, a life would have been lost.”
Hisey echoed her husband’s appreciation and said that she has discovered an aspect of Methodist Hospital that she never knew existed.
“Everyone I met at Methodist Hospital was completely accommodating and caring and nurturing,” she said. “I was really impressed by the caliber of doctors there, and I was surprised and grateful to learn that Methodist Hospital is really a leader in bringing in the newest technology, like the hypothermia treatment. It’s a fantastic place.”