Hypothermia in the trauma patient

Tsuei, Betty J.; Kearney, Paul A.

doi:10.1016/s0020-1383(03)00309-7

Cited by 219 publications

(134 citation statements)

References 59 publications

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“…6 Clinically significant levels of reductions in platelet function, aggregation and enzyme activity occur at core body temperatures of 33 C and below. 7 Drop in temperature by 1 C is associated with a 10% drop in platelet function.…”

Section: Hypothermiamentioning

confidence: 99%

The challenge in management of hemorrhagic shock in trauma

Jacob

Kumar

2014

Medical Journal Armed Forces India

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a b s t r a c tTransfusion and resuscitation practices in trauma have undergone a sea change over the past decade. New understanding of transfusion physiology and experiences in military trauma over the last decade has identified key factors taken as challenges in trauma. The most important challenge remains acute traumatic coagulopathy (ATC) which sets in early after a trauma and spirals the patient into shock and continued bleeding. World wide trauma is the leading cause of mortality. More than 6 million deaths occur due to trauma out of which 20% are due to uncontrollable bleeding. Out of the hospital admissions in trauma 20% develop coagulopathy. Mortality is three to four times higher in a patient with coagulopathy and thus prevention and correction of coagulopathy is the central goal of the management of hemorrhagic shock in trauma. Damage control resuscitation (DCR), a strategy combining the techniques of permissive hypotension, hemostatic resuscitation and damage control surgery has been widely adopted as the preferred method of resuscitation in patients with haemorrhagic shock. The over-riding goals of DCR are to mitigate metabolic acidosis, hypothermia and coagulopathy, This article looks at the importance of acute traumatic coagulopathy, its etiology, diagnosis, effects and resuscitation strategies to prevent it and to see the background behind this shift.ª 2014, Armed Forces Medical Services (AFMS). All rights reserved.

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Section: Hypothermiamentioning

confidence: 99%

The challenge in management of hemorrhagic shock in trauma

Jacob

Kumar

2014

Medical Journal Armed Forces India

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“…In one study conducted on post-operative patients, the best method for regaining warmth was to apply active warming from both above and below [32]. Tsuei and Kearney [15] describe that applying heat through convection and conduction is the best way of warming a patient. It should be obvious even in ambulance care that, when the air temperature drops below zero, a warm ambulance mattress that provides patients with heat is needed.…”

Section: Discussionmentioning

confidence: 99%

“…Patients at a greater risk of chilling include the elderly, who have a reduced capacity to shiver; young children, who have a large skin surface area in relation to their body weight; people under the influence of alcohol or drugs; people being treated with, for example, β-blockers or antidepressants; and people who have suffered trauma [12]. Chilling and hypothermia affects the body’s coagulation system, so patients bleed more [13,14] and this can, therefore, be lethal in connection with trauma [15]. Drugs or alcohol can contribute to chilling due to physiological causes or due to a deterioration in judgement [16].…”

Section: Introductionmentioning

confidence: 99%

The opinions of ambulance personnel regarding using a heated mattress for patients being cared for in a cold climate – An intervention study in ambulance care

Aléx

Uppstu

Saveman

2017

International Journal of Circumpolar Health

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The purpose of the study was to describe the opinions of ambulance personnel regarding differences between using a heated mattress and a standard ambulance mattress. This study was an intervention study with pre- and post-evaluation. Evaluations of the opinions of personnel regarding the standard unheated mattress were conducted initially. After the intervention with new heated mattresses, follow-up evaluations were conducted. Ambulance personnel (n=64) from an ambulance station in northern Sweden took part in the study, which ran from October 2014 until February 2016. There were differences in opinions regarding the standard unheated mattress and the new heated mattress. The evaluation of the proxy ratings by the personnel showed that the heated mattress was warmer than the standard mattress, more pleasant to lie on and that patients were happier and more relaxed than when the standard mattress was used. The ambulance personnel in this study rated the experience of working with the heated mattress as very positive and proxy rated that it had a good effect on patient comfort. A heated mattress can be recommended for patients in ambulance care, even if more research is needed to receive sufficient evidence.

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“…As such, using the rectal temperature is considered an -intermediate‖ measuring technique because it is not representative of the true core temperature (50,51) . Bladder probes and axillary measurements are even less consistent, up to almost 1 °C in variability (52) . Each technique can be disturbed by external temperatures, local blood flow, and incorrect placement (53) .…”

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confidence: 95%

“…Cardiovascular effects:-Mild hypothermia (<36 °C) causes increased sympathetic tone, heart rate, blood pressure, and cardiac output while moderate hypothermia will depress cardiac activity (52,55) . At 34 °C, hypothermia impairs diastolic relaxation.…”

mentioning

confidence: 99%