Keeping ‘Em Warm Pragmatic Application
The Keep ‘Em Warm blog by Aaron reminded me of a practical application of keeping a patient warm. I’d just completed a wilderness EMT course from SOLO and was working my normally scheduled shift. I was dispatched to a patient's residence for altered mentation. I arrived on the scene, along with first responders, to find the pt "pre-code." She had been vomiting blood all night and was a U on the AVPU scale. The patient was extremely cold to the touch, with a low BP, like 60/40 low. I got an EJ in the house and started the only fluid available to me, room temp normal saline.
As I was packaging the patient transport, I remembered the course I had just taken and the lethal triad. We, as truck medics cannot impact coagulation or acidosis as much as we would like without specific interventions. Still, we can knock one of the legs down with hypothermia prevention. I placed a space blanket on the stretcher along with a blanket, placed the patient, then finished it off with another space blanket and blanket on top.
During transport, the patient started to become more responsive, and after an initial temp of 94, her temp started to rise. As we pulled onto the ER, she was able to speak her name, and her temp was 98.1. In fact, another crew transported her to a higher care facility routine traffic for a GI bleed.
This goes to show the necessary skills used by paramedics and EMT's can change a patient's outcome greatly. We can't forget the simple things because they affect our practical, advanced skills. This patient was within minutes of being code, and we know the outcomes for codes are not positive most of the time. By preventing her from further decompensation, my partner and I changed a patient's life and outcome.