Background: Aeromedical transport in northern areas may be associated with hypothermia. The objective of this study was to determine whether significant hypothermia (core temperature <35ºC) occurs in severely injured or ill intubated patients during transport by rotary wing aircraft. Methods: In this prospective cohort study, all intubated patients over 16 years of age who were transported by rotary wing aircraft from rural hospitals or trauma scenes in northern Alberta to regional hospitals in Edmonton were eligible for study. Esophageal thermometers were used to measure core temperature at 10-minute intervals during transport. Results: Of 133 potentially eligible patients, 116 were enrolled; 69 (59%) had esophageal thermometers inserted, and 47 (41%) had other temperature measurements. Severe hypothermia occurred in only 1% to 2% of cases, but 28% to 39% of patients met criteria for mild hypothermia prior to transport. Core temperatures did not fall during transport, despite the fact that warming techniques were documented in only 38% of cases. Conclusions: During brief (<225 km) rotary wing aeromedical transport of severely injured or ill patients, significant hypothermia is uncommon and body temperature is generally well maintained with the use of simple passive measures. These findings do not justify recommendations for more aggressive core temperature monitoring during this type of aeromedical transport.
RÉSUMÉ
Contexte :Le transport aéromédical dans les régions nordiques peut être associé à l'hypothermie. La présente étude avait comme objectif de déterminer si une hypothermie importante (tempéra-ture centrale <35ºC) se manifeste chez des patients intubés gravement blessés ou malades lors du transport par aéronef à voilure tournante. Méthodes : Dans cette étude de cohorte prospective, tous les patients intubés âgés de plus de 16 ans qui avaient été transportés par aéronef à voilure tournante à partir d'hôpitaux ruraux ou de scènes de trauma dans la région du nord de l'Alberta vers des hôpitaux régionaux à Edmonton étaient admissibles à l'étude. On eut recours à des thermomètres oesophagiens pour prendre la température centrale à des intervalles de 10 minutes pendant le transport. Résultats : Parmi 133 patients potentiellement admissibles, 116 furent inclus dans l'étude; on inséra un thermomètre oesophagien chez 69 de ces patients (59 %) et on eut recours à d'autres
Unpredictable patient factors were the most frequent reasons patients required secondary transfer; few protocol violations or system factors were identified. No modifications to the current NS triage criteria are recommended.
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