Why It's Important to Keep Trauma Patients Warm
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Medical conditions such as a heart attack or trauma caused by an accident may require emergency resuscitation whenever a patient is unable to breath or their heart stops beating. While cardiopulmonary resuscitation (CPR) is critical, hypothermia could occur, especially in instances of trauma and worsen the patient's condition, leading to long term complications and even death. Emergency Medical Technicians (EMTs) need to be cognizant of this risk, and if there's any indication of hypothermia or shock they take immediate steps to warm the patient.
What’s the Risk of Hypothermia?
Hypothermia occurs when an individual's core body temperature drops below 95 °F (35 °C). This happens when the body can't generate enough warmth to counter heat lost to the surrounding environment.
Initially, the body tries to counter this by shivering but if this doesn't work, the core temperature continues to fall and organs such as the brain and heart slow down, leading to difficulty in breathing. This results in oxygen deprivation and mental confusion, resulting in an inability to make rational decisions.
Factors That Contribute Toward Hypothermia
While exposure to cold temperature increases the risk of hypothermia, it can be caused by other factors as well. These include illnesses such as diabetes, heart disease, exhaustion, alcohol and medication. Homeless and poor people without adequate heating are susceptible, as are children, especially if they are inadequately dressed for the weather. Hypothermia as a result of trauma arising from vehicular and other accidents is another factor, particularly if there are serious injuries and bleeding.
Identifying Hypothermia
While the clinical definition of hypothermia is anyone whose core body temperature is below 95 °F, in the field it's not easy to determine this. Rather the best way is to check for physical symptoms such as:
- Shallow breathing
- Weak pulse
- Shivering
- Dizziness
- Slurred speech
- Poor coordination
- Confusion/Memory loss
- Drowsiness
- Pale skin coloration
If a patient is suffering from severe hypothermia they may:
- Lose consciousness
- Stop shivering
- Have no pulse
- Develop low blood pressure
If there's any doubt, the best, safest thing to do is to assume that a patient is suffering from hypothermia.
Dealing with Hypothermia
Move patients to a warm, dry shelter or location. When placing them in the ambulance, make certain it's been warmed to well above ambient temperature. If it's not immediately possible to move the patient, make sure they are adequately covered - insulate them as much as possible. Avoid removing clothing unnecessarily but if there's wet or damp clothing involved, it needs to be removed; covering the patient with a warm blanket is ideal.
If the patient is conscious, provide them with a warm nonalcoholic drink or soup. Measure the patient's temperature and monitor its trend. If there's a need for an IV, always use fluids that have been warmed to above room temperature to avoid lowering the core temperature any further. Keep them warm with a thermal, cotton or fleece blanket.
When resuscitating patients with hypothermia, it's important to keep them warm and to monitor their temperature constantly. For this reason, it's advisable to use the most appropriate blankets for the ambient conditions.
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