True Hypothermic Arrest is thankfully rare in the UK. However, when it does happen it is resource intense and prolonged. The ERC 2021 guidance has introduced a new decision step HOPE score to the algorithm, once the Initial phase of resuscitation has been completed without ROSC.

If the is HOPE score is <0.1  the team may which to consider terminating CPR [Warning: Adults ONLY Children have better survival]

ECMO/ECLS would be ideal for those who score >0.1 – However, it tis not generally available locally, so we will generally rely on warming blankets, warm fluid, warm wash outs etc..

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