Hypothermia: why warm?
Treating hypothermia and patient warming is about more than providing comfort. With a decrease in temperature, important processes begin to stop in the body and vital organs fail. Symptoms of hypothermia progress from chills and drowsiness to confusion, coma and death. Therefore, it is so important to take into account the problem of unintentional hypothermia and take comprehensive solutions to its prevention in time.
Hypothermia is a condition where the body’s own heat production can’t match the heat loss to the environment resulting in a lowered body core temperature. Trauma patients do not die from hypothermia itself – they die of bleeding. Bleeding makes the body lose important red blood cells used to carry oxygen to the brain and other vital organs. Trauma patients with substantial bleeding are at risk of entering the deadly trauma triad of hypothermia, acidosis, and coagulopathy. This combination means that when the body core temperature drops, the acidity in the blood increases and the blood loses its ability to coagulate. Without coagulation, it is much more difficult to stop the bleeding and save the life of the patient.
By maintaining normothermia throughout medical interventions and hospital stays, medical workers can speed up the healing process and increase patient satisfaction.
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Environmental factors, operating room microclimate
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Infusion of cold IV fluids, blood, blood substitutes
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The effect of drugs used in anesthesia
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EvaporationBody heat turns sweat into vapor. Active work contributes to heat loss
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ConvectionHeat loss by air or water moving across the skin surface
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ConductionDirect contact with an object. For instance, sitting or lying on the cold ground
Methods of prevention and treatment?
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Preventing serious complicationsResearches show that perioperative hypothermia can lead to various complications from the cardiovascular, respiratory, and neuromuscular systems. Hypothermia slows down drug metabolism and increases the incidence of infection and mortality. Prevention of these serious complications can be achieved by maintaining normothermia by pre-warming patients before surgery and continuing warming during the procedure.
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Improving the comfort of hospital stayPatient comfort in the hospital can be achieved with additional warming, as patients experience anxiety and cold shivers in the pre and postoperative period. Hypothermia can also delay the patient's awakening after surgery and increase the time of hospital stay.
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Compliance with standards and clinical protocolsCarrying out measures to maintain the patient's thermal balance are a standard and have been included in the protocols for providing medical care in clinics in Europe and the United States for many years. The need to use medical equipment for the prevention and treatment of hypothermia is spelled out in the national clinical protocols of Russia, guidelines for the organization, maintenance and use of cold chain equipment for blood, and drug instructions contain direct instructions of the e need to warm up infusion solutions.