More than one way to cool a patient

The faster a person gets chilled, the better, but methods vary widely. Hospitals can cool a patient from the outside or the inside. Costs range from next to nothing to thousands of dollars.

• In the case of 26-year-old Alaina Dixon, doctors used the one of the most advanced types of outer cooling technology. They glued gel pads to her skin, then flowed cold water through the pads. One such device is the Arctic Sun from Medivance Inc. in Lousiville, Colo. The control units costs between $40,000 and $50,000.

• For an inside-out approach, doctors can insert a closed catheter into a vein. Cold water circulating through the device chills the patient’s blood. The InnerCool catheter, from Royal Philips Electronics in Amsterdam, ranges from $40,000 to $50,000.

• Doctors can also go with inexpensive options such as ice packs and cold fluid infusions, as was done recently with a soldier in Iraq. “Pack them like they’re a lobster from New England,” says Dr. Susan Stein, a pulmonary and critical care physician at the Olive View-UCLA Medical Center.

Although the more advanced techniques make it easier for doctors to control a patient’s temperature, there is no evidence that any one method works better than another.

Even for the pricey systems, “the cost is nothing” compared with the cost of caring for a brain-damaged person, says Dr. Lance Becker, director of the Center for Resuscitation Science at the University of Pennsylvania Medical School in Philadelphia. “The price of neurological damage is astronomical to society.... This is very, very, very cost-effective.”

—Amber Dance