Therapeutic hypothermia has been shown to improve neurological outcomes for patients who survive cardiac arrest. Timely cooling can be achieved by rapid initiation of a comprehensive targeted temperature protocol, which includes shivering assessment and management. The purpose of the study was to evaluate an updated therapeutic hypothermia protocol for patients who survive cardiac arrest. The first 6 patients who met inclusion criteria were placed on the updated protocol. These cases were compared with historical cases. Upon discharge or death, cases were analyzed for time to reach the target temperature, the use of paralytic agents, and discharge disposition. Patients placed on the updated protocol cooled 2 hours faster than did the patients from the historical cases (median = 179 vs 285 minutes). The use of paralytic agents appeared to safely accelerate the time to goal temperature. Four of the 6 patients were discharged home or to rehabilitation compared with only 1 patient from the historical cases. Implementing this evidence-based protocol for therapeutic hypothermia led to faster cooling.