Hostname: page-component-76fb5796d-2lccl Total loading time: 0 Render date: 2024-04-25T15:44:23.329Z Has data issue: false hasContentIssue false
  • English
  • Français

Preventing Post-injury Hypothermia During Prolonged Prehospital Evacuation

Published online by Cambridge University Press:  28 June 2012

Hans Husum ,
Tone Olsen ,
Mudhafar Murad ,
Yang Van Heng ,
Torben Wisborg  and
Mads Gilbert
Hans Husum*
Affiliation:
Tromsoe Mine Victim Resource Center (TMC), Norway
Tone Olsen
Affiliation:
Tromsoe Mine Victim Resource Center (TMC), Norway
Mudhafar Murad
Affiliation:
Trauma Care Foundation, North Iraq
Yang Van Heng
Affiliation:
Trauma Care Foundation, Cambodia
Torben Wisborg
Affiliation:
Tromsoe Mine Victim Resource Center (TMC), Norway
Mads Gilbert
Affiliation:
Tromsoe Mine Victim Resource Center (TMC), Norway
*
Tromsoe Mine Victim Resource Center (TMC), PO Box 80, N-9038, University Hospital of Northern, Norway Email hhusum@c2i.net
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Post-injury hypothermia is a risk predictor in trauma patients whose physiology is deranged. The aim of the present study was to examine the effect of simple, in-field, hypothermia prevention to victims of penetrating trauma during long prehospital evacuations.

Methods:

A total of 170 consecutively injured landmine victims were included in a prospective, clinical study in Northern Iraq and Cambodia. Thirty patients were provided with systematic prehospital hypothermia prevention, and for 140 patients, no preventive measures were provided.

Results:

The mean value for the time from injury to hospital admission was 6.6 hours (range: 0.2–72). The incidence of hypothermia (oral temperature <36°C) before prevention/rewarming was 21% (95% confidence interval: 15% to 28%). The Prevention Group had a statistically significant lower rate of hypothermia on hospital admission compared to the control group (95% confidence interval for difference: 6% to 24%).

Conclusion:

Simple, preventive, in-field measures help to prevent hypothermia during protracted evacuation, and should be part of the trauma care protocol in rural rescue systems.

Keywords

Cambodiahypothermiainjuryinjury severity scorelandminesNorthern Iraqprehospitalpreventiontrauma care
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 17 , Issue 1 , March 2002 , pp. 23 - 26
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Jurkovich, GJ, Greiser, WB, Lutherman, A, Curreri, PW: Hypothermia in trauma patients: An ominous predictor of survival. J Trauma 1987; 27: 1019–1024.CrossRefGoogle ScholarPubMed
2. Luna, G, Mailer, R, Pavlin, E, et al: Incidence and effect of hypothermia in seriously injured patients. J Trauma 1987; 27: 1014–1018.CrossRefGoogle ScholarPubMed
3. Gregory, JS, Flancbaum, L, Towsend, MC, et al: Incidence and timing of hypothermia in trauma patients undergoing operations. J Trauma 1991; 31: 795–798.CrossRefGoogle ScholarPubMed
4. Kochanek, PM, Safar, P, Marion, DW, et al: Therapeutic hypothermia after traumatic brain injury or hemorrhagic shock from mild cooling to suspended animation. In: Smith, CE, Grande, CM: Hypothermia in Trauma. Baltimore: ITACCS, 1997, pp 17–20.Google Scholar
5. Frank, SM, Bulcao, CF: Pathophysiology and consequences of hypothermia. In: Smith, CE, Grande, CM: Hypothermia in Trauma. Baltimore: ITACCS, 1997, pp 8–11.Google Scholar
6. Krishna, G, Sleigh, JW, Rahman, H: Physiological predictors of death in exsanguinating trauma patients undergoing conventional trauma surgery. Aust N Z J Surg 1998; 68: 826–829.Google ScholarPubMed
7. Hirshberger, A: Trauma damage control. Critical Care 1997; 3: 460–464.Google Scholar
8. Carillo, C, Fogler, RJ, Shaftan, GW: Delayed gastrointestinal reconstruction following massive abdominal trauma. J Trauma 1993; 34: 233–235.CrossRefGoogle Scholar
9. Sharp, KW, Locicero, RJ: Abdominal packing for surgically uncontrollable hemorrhage. Ann Surg 1992; 215: 467–474.CrossRefGoogle ScholarPubMed
10. Gentiello, LM: Hypothermia. In: Weigelt, JA, Lewis, RL: Surgical Critical Care. Philadelphia: WB Saunders, 1996, p 200.Google Scholar
11. Hirshberger, A, Mattox, KL: Planned reoperation for severe trauma. Ann Surg 1995; 222: 3–8.CrossRefGoogle Scholar
12. Committee on Trauma, American College of Surgeons: Advanced Trauma Life Support Program for Doctors. Instructor Manual. Chicago: American College of Surgeons, 1997.Google Scholar
13. Watts, DD, Roche, M, Tricarico, R, et al: The utility of traditional prehospital interventions in maintaining thermostasis. Prehosp Emerg Care 1999; 3: 115–122.CrossRefGoogle ScholarPubMed
14. Husum, H, Gilbert, M, Wisborg, T: Save Lives, Save Limbs. Life Support to Victims of Mines, Wars, and Accidents. Penang, Malaysia: Third World Network, 2000.Google Scholar
15. Husum, H, Ang, SC, Fosse, E: War Surgery. Field Manual. Penang, Malaysia: 1995.Google Scholar
16. Digitemp Servoprax®. London: Universal Hospital Supplies Ltd.Google Scholar
17. Association for the Advancement of Automotive Medicine: The Abbreviated Injury Scale 1990 Revision, Update 98. Des Plaines, US: Association for the Advancement of Automotive Medicine, 1998.Google Scholar
18. World Health Organization: Epi Info version 6.04b (computer program). Geneva: WHO, 1996.Google Scholar
19. Gardner, MJ: CIA version 1.2 (Confidence Interval Analysis, computer program). London: Gardner MJ & BMJ, 1995.Google Scholar
20. MedCalc, version 5, (computer program). Mariakerke, Belgium: MedCalc Software, 1999.Google Scholar
21. Obuchowski, NA, Lieber, M: Confidence intervals for the Receiver Operating Characteristics area in studies with small samples. Acad Radiol 1998; 5: 561–571.CrossRefGoogle ScholarPubMed
22. Smith, CE, Patel, N: Prevention and treatment of hypothermia in trauma patients. In: Smith, CE, Grande, CM: Hypothermia in Trauma. Baltimore: ITACCS, 1997, pp 11–16.Google Scholar
23. Giuliano, K, Giuliano, AJ, Scott, SS, et al: Temperature measurement in critically ill adults: A comparison of tympanic and oral methods. Am J Crit Care 2000; 9: 254–261.CrossRefGoogle ScholarPubMed
24. Husum, H: Effects of early prehospital life support to war injured: the battle of Jalalabad, Afghanistan. Prehosp Disast Med 1999; 14: 75–80.CrossRefGoogle ScholarPubMed
25. American Heart Association: Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2000; 120: I–180.Google Scholar
26. Senkowski, CK, McKennedy, MG: Trauma scoring systems: A review. J Am Coll Surg 1999; 189: 492–503.Google ScholarPubMed