CPT® Code 99186

Deleted

1. Indications

Hypothermia; total body is indicated in specific medical scenarios where lowering the patient's metabolism is essential for treatment. The following conditions may warrant this procedure:

• Interrupted Blood Flow Hypothermia may be indicated when there is a need to save a limb that has experienced a cessation of blood supply, thereby preventing tissue damage.
• Severe Trauma In cases of severe trauma, inducing hypothermia can help in managing the patient's metabolic demands and protecting vital organs.
• Cardiac Arrest This procedure may be utilized in patients who have suffered cardiac arrest, as lowering body temperature can help in reducing neurological damage.

2. Procedure

The procedure for inducing total body hypothermia involves several critical steps to ensure the patient's safety and the effectiveness of the treatment. Each step is carefully executed by the medical team.

• Step 1: Patient Assessment The first step involves a thorough assessment of the patient to determine the appropriateness of inducing hypothermia. This includes evaluating the patient's medical history, current condition, and any contraindications to the procedure.
• Step 2: Preparation Once deemed appropriate, the patient is prepared for the procedure. This may involve securing intravenous access, monitoring vital signs, and ensuring that all necessary equipment is available for the induction of hypothermia.
• Step 3: Induction of Hypothermia The physician initiates the hypothermia by using cooling methods, which may include the application of cooling blankets, ice packs, or specialized cooling devices. The goal is to gradually lower the patient's core body temperature to the desired level.
• Step 4: Monitoring Throughout the procedure, continuous monitoring of the patient's vital signs, core temperature, and overall condition is essential. Adjustments to the cooling methods may be made based on the patient's response.
• Step 5: Maintenance Once the target temperature is reached, the patient is maintained at this temperature for a specified duration, as determined by the clinical protocol and the patient's condition.
• Step 6: Rewarming After the maintenance phase, the patient is gradually rewarmed to normal body temperature. This process must be done slowly to prevent complications associated with rapid rewarming.

3. Post-Procedure

Post-procedure care for patients who have undergone total body hypothermia is critical to ensure a safe recovery. After rewarming, patients are closely monitored for any signs of complications, such as arrhythmias or changes in neurological status. Vital signs continue to be assessed regularly, and supportive care is provided as needed. Additionally, the medical team may conduct follow-up evaluations to determine the effectiveness of the hypothermia treatment and to address any ongoing medical needs. It is essential to provide a comprehensive care plan that includes monitoring for potential side effects and ensuring the patient's overall stability.