How is external cooling performed in targeted temperature management (TTM)?

Updated: Jul 26, 2019
  • Author: Alex Koyfman, MD; Chief Editor: Karlheinz Peter, MD, PhD  more...
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Note the following:

  • Eligibility should be confirmed, and materials should be gathered.

  • Obtain 2 cooling blankets and cables (one machine) to “sandwich” the patient. Each blanket should have a sheet covering it to protect the patient’s skin.

  • Alternatively, place heat-exchange pads on the patient per the manufacturer’s recommendation.

  • Pack the patient in ice (groin, chest, axillae, and sides of neck); use additional measures as needed to bring the patient to a temperature between 32ºC and 34ºC. Avoid packing ice on top of the chest, which may impair chest wall motion.

  • Monitor vital signs and oxygen saturation and place the patient on a continuous cardiac monitor, with particular attention to arrhythmia detection and hypotension.

  • Once a temperature below 34ºC is reached, remove ice bags, and the cooling blanket or heat-exchange device is used to maintain temperature between 32ºC and 34ºC.

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