Click here for your Nurse Exam Online Tutoring needs. https://www.youtube.com/watch?v=o_6cuXKX7tE
by Charles Bankhead
Staff Writer, MedPage Today
Trauma-associated hypothermia evolves from a combination of injury severity and potentially modifiable environmental and treatment-related factors, French investigators reported.
Higher Revised Trauma Score (RTS) increased the odds of hypothermia by almost 70%. Intubation, lower temperature inside the transport vehicle, and lower infusion fluid temperature also increased the risk.
The risk declined significantly if patients were clothed and did not have a head injury, as reported online in Critical Care.
“Optimal patient management could contribute to limit heat loss or even to increase patient temperature when required,” Frederic Lapostolle, MD, of Hopital Avicenne in Bobigny, France, and co-authors wrote. “Undressing patients should be avoided. Mobile unit temperature and fluid infusion temperature were independently associated with hypothermia. They should be routinely measured.”
In addition, the group pointed out that mobile intensive care units should be equipped with “a warming system “to allow ‘body temperature’ fluid infusion, especially in severely injured patients.”
Trauma patients often have hypothermia on arrival to a hospital, and even moderate hypothermia can adversely affect prognosis. Causes of hypothermia remain unclear, and available data have come largely from hospital registries and retrospective studies.
To identify potential causes of hypothermia in trauma patients, Lapostolle and colleagues performed a prospective, multicenter, observational study involving a regional emergency medical service (EMS) and eight French hospitals.
EMS units in France are equipped for intensive care requirements, including anesthetics, catecholamines, laboratory facilities, and ultrasound, the authors noted. An EMS team consists of an emergency physician, critical care nurse, and a driver who has training in basic life support.
The study included all trauma patients older than 18 who received prehospital care from an EMS team and who were transported to a hospital by an EMS mobile unit.
Investigators recorded the following:
Patients’ demographic and morphologic information
Nature and circumstances of the trauma incident
Patient’s condition upon arrival of the EMS team
Environmental conditions (wind, rain, ground temperature)
Clinical characteristics (wound features, vital signs, RTS, oxygen saturation, tympanic temperature)
Investigators also recorded pertinent aspects of each patient’s care until arrival at the hospital.
The primary endpoint was hypothermia upon arrival at the hospital and the authors defined hypothermia as a body temperature of less than 35
