Keep ‘Em Warm Round II


Keep ‘Em Warm Round II


I once wrote a lengthy article about the value of keeping patients warm who had been involved in a traumatic incident. But the report was so long that I feel like my point got “muddied." Today's blog will be a quick down and dirty clarification.


  There is plenty of literature to support this argument of keeping patients warm who are suffering from a traumatic injury [1]. Most of which come through empirical evidence about the lethal triad and its effect on and from bleeding [2] [3]. The reason I am writing about it again is that I am concerned with providers and not keeping their patients warm.


  This is so easy! Do your assessment. Complete your intervention. Stop the bleed. Start blood products if needed (warmed). And wrap these people up, turn the heat on, and maintain normothermia at all costs. Do I really need to support this with evidenced-based medicine (EMB)?


  Frequently, I see and hear providers rationalize not replacing clothing because the patient will only be undressed again at the hospital. Or the heat does not get turned up because "it is too hot." These are poor excuses, and this translates to poor care - which will eventually lead to poor outcomes.


  Anyway, next time you have a patient who is potentially suffering from bleeding, and you want to be a better clinician - keep them warm.


Regards,

Aaron


References

[1] 

R. Perlman, J. Callum, and A. Alam, "A recommended early goal-directed management guideline for the prevention of hypothermia-related transfusion, morbidity, and mortality, in severely injured patients," Critical Care, vol. 20, 2017. 

[2] 

D. Stainsby, S. MacLennan, and P. J. Hamilton, "Management of massive blood loss: a template guideline," British Journal of Anaesthesia, vol. 85, pp. 487-491, 2000. 

[3] 

F. Bozorgi, I. G. Khatir, H. Ghanbari, F. Jahanian, and M. Arabi, "Investigation of the frequency of the lethal triad and its 24 prognostic value among patients with multiple traumas," Open Access Macedonian Journal of Medical Sciences, vol. 7, no. 6, pp. 962-966, 2019.