Therapeutic HypothermiaThe use of therapeutic hypothermia to treat patients with potential ischemia has existed for approximately 70 years. After declining in popularity over the past half-century, therapeutic hypothermia has re-emerged as a cutting-edge life-saving tool in the fight against potentially hypoxic brain injury. Although the evidence supporting this treatment is growing, more research is needed to decide whether this treatment will become the new standard of care for these patients or whether it will be abandoned. Over the past 25 years EMS has undergone drastic changes in the way we treat patients, with cutting edge emergency medicine and cutting edge equipment and with months of detailed and in depth training, today's paramedic is well equipped to handle any medical emergency they may encounter. But even though all this progress has been made, the chance that a patient will fully recover after an out-of-hospital cardiac arrest is extremely low. It is generally known that the brain does not respond well to hypoxic events. , the golden rule of the 5-7 minute “point of no return” is still recognized in most cases, but a big part of the problem is the fact that brain damage will continue to occur for several hours after resuscitation, only because the heart starts beating once again does not mean that the ischemia has stopped. One study shows that while 17-25% of cardiac arrest patients survived to hospital admission, only 4-9% (Bernard) left the hospital neurologically intact. Some research has shown, however, that therapeutic hypothermia can help increase the chances that these patients will regain 100% neurological function by the time they leave the hospital... middle of paper... immune system response, hypoglycemia, hyperkalemia, an overall lower cardiac index, a high risk of hospital-acquired pneumonia secondary to decreased immune system response, impaired clotting factors, and chills in patients who may cancel therapy itself. The role of EMS in therapeutic hypothermia is the one of great importance, who is the first to enter the scene with these patients? Nine times out of ten the EMS is at the patient's side within minutes and who better than paramedics to begin this therapy? The use of hypothermic fluids usually should continue for a minimum of 12 hours after sudden cardiac arrest. And because the powerful effects of therapeutic hypothermia can be reduced by withholding treatment for even a few minutes, EMS is by far the best position to begin treatment in the field, before arriving at the hospital..