Body temperature of trauma patients on admission to hospital: a comparison of anaesthetised and non-anaesthetised patients

Langhelle, Audun; Lockey, David; Harris, Tim; Davies, Gareth E.

doi:10.1136/emj.2009.086967

Cited by 34 publications

(27 citation statements)

References 25 publications

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“…However, our study aimed to evaluate intrinsic properties of studied devices, and describe their capacity to prevent heat loss and the torso model ensured equal test conditions for each product. Patients with major trauma often require prehospital anaesthesia; in this group of patients physiological responses to heat loss are often diminished due to the severity of injuries and response to anaesthetic drugs so the torso model may apply more closely to anaesthetised than spontaneously ventilating patients 7 15. Further research using randomised clinical trials comparing studied devices on patients with major trauma is required to identify the best heat preservation strategy but informed consent would be challenging and such studies expensive to perform.…”

Section: Discussionmentioning

confidence: 99%

A torso model comparison of temperature preservation devices for use in the prehospital environment

et al. 2016

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Background Hypothermia is an independent predictor of increased morbidity and mortality in patients with trauma. Several strategies and products have been developed to minimise patients' heat loss in the prehospital arena, but there is little evidence to inform the clinician concerning their effectiveness. Methods We used a human torso model consisting of two 5.5-litre fluid bags to simultaneously compare four passive (space blanket, bubble wrap, Blizzard blanket, ambulance blanket) and one active (Ready-Heat II blanket) temperature preservation products. A torso model without any temperature preservation device provided a control. For each test, the torso models were warmed to 37°C and left outdoors. Core temperatures were recorded every 10 min for 1 h in total; tests were repeated 10 times.

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Section: Discussionmentioning

confidence: 99%

A torso model comparison of temperature preservation devices for use in the prehospital environment

et al. 2016

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“…This often involves temporary paralysis during rapid sequence induction procedures that predispose the patient to increased risk of body heat loss. Importantly, Langhelle et al and Lapostolle et al reported that patients who had been intubated before arriving at the hospital emergency department consistently had lower core body temperatures than those who had not been intubated (13,16). According to Andrzejowski et al, the administration of anaesthesia (including agents used for sedation and paralysis) for intubation can reduce the patient's core body temperature by 1.6°C via thermal redistribution (17).…”

Section: Discussionmentioning

confidence: 99%

Pre-Hospital Use of Intravenous In-Line Fluid Warmers to Reduce Morbidity and Mortality for Major Trauma Patients: A Review of the Current Literature

Collins

Daly

Johnson

et al. 2015

Australasian Journal of Paramedicine

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IntroductionIn-line fluid warmers are an established treatment for delivering warmed intravenous (IV) fluid in the hospital setting. Recently their potential application within the pre-hospital setting has been highlighted to potentially reduce mortality and morbidity. Currently ambulance paramedics only administer warmed fluid to patients assessed as hypothermic, and this fluid is subject to further cooling on exposure to ambient environmental conditions. This review examined the peer-reviewed literature to determine the available evidence for in-line fluid warmer effectiveness and potential inclusion in pre-hospital emergency care.MethodsA review of the electronic literature, including the Medline and Ebscohost databases was conducted using the terms “intravenous fluid warmers” “hypothermia”, “ trauma”, “ fluid”, “coagulopathy”, “ acidosis”, “hypothermia and trauma patients”, “accidental hypothermia”, “lethal triad” and “trauma care”. Articles were included if they represented a study of in-line fluid warmers within the surgical, general hospital or pre-hospital emergency care settings. Articles not available in English or as full text were excluded.ResultsThe review identified 23 relevant articles for analysis. Of note, up to 40% of trauma patients with signs of hypoperfusion were reported to arrive at hospital in a hypothermic state post-incident. Hypothermia plays a significant role in contributing to the ‘triad of death’- a condition that results in poor patient outcomes and high mortality rates.ConclusionThis review identified that current pre-hospital practice does not prescribe warmed fluid to the normothermic trauma patient. The review also identified that there is a need for in-line fluid warmers in ambulance practice to prevent or limit hypothermia and reduce patient morbidity and mortality associated with trauma.

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“…The main benefits of active re-warming are in these cases to reduce energy consumption and increase comfort [15,16]. In patients with impaired shivering response due to severe hypothermia, injury, disease, intubation or use of drugs, insulation alone may not be sufficient to maintain core temperature and these patients may require active warming [17,18]. …”

Section: Discussionmentioning

confidence: 99%

Equipment to prevent, diagnose, and treat hypothermia: a survey of Norwegian pre-hospital services

Karlsen

Thomassen

Vikenes

et al. 2013

Scand J Trauma Resusc Emerg Med

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IntroductionHypothermia is associated with increased morbidity and mortality in trauma patients and poses a challenge in pre-hospital treatment. The aim of this study was to identify equipment to prevent, diagnose, and treat hypothermia in Norwegian pre-hospital services.MethodIn the period of April-August 2011, we conducted a survey of 42 respondents representing a total of 543 pre-hospital units, which included all the national ground ambulance services, the fixed wing and helicopter air ambulance service, and the national search and rescue service. The survey explored available insulation materials, active warming devices, and the presence of protocols describing wrapping methods, temperature monitoring, and the use of warm i.v. fluids.ResultsThroughout the services, hospital duvets, cotton blankets and plastic “bubble-wrap” were the most common insulation materials. Active warming devices were to a small degree available in vehicle ambulances (14%) and the fixed wing ambulance service (44%) but were more common in the helicopter services (58-70%). Suitable thermometers for diagnosing hypothermia were lacking in the vehicle ambulance services (12%). Protocols describing how to insulate patients were present for 73% of vehicle ambulances and 70% of Search and Rescue helicopters. The minority of Helicopter Emergency Medical Services (42%) and Fixed Wing (22%) units was reported to have such protocols.ConclusionThe most common equipment types to treat and prevent hypothermia in Norwegian pre-hospital services are duvets, plastic “bubble wrap”, and cotton blankets. Active external heating devices and suitable thermometers are not available in most vehicle ambulance units.

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Body temperature of trauma patients on admission to hospital: a comparison of anaesthetised and non-anaesthetised patients

Cited by 34 publications

References 25 publications

A torso model comparison of temperature preservation devices for use in the prehospital environment

A torso model comparison of temperature preservation devices for use in the prehospital environment

Pre-Hospital Use of Intravenous In-Line Fluid Warmers to Reduce Morbidity and Mortality for Major Trauma Patients: A Review of the Current Literature

Equipment to prevent, diagnose, and treat hypothermia: a survey of Norwegian pre-hospital services

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