Equipment to prevent, diagnose, and treat hypothermia: a survey of Norwegian pre-hospital services

Abstract

IntroductionHypothermia is associated with increased morbidity and mortality in trauma patients and poses a challenge in pre-hospital treatment. The aim of this study was to identify equipment to prevent, diagnose, and treat hypothermia in Norwegian pre-hospital services.MethodIn the period of April-August 2011, we conducted a survey of 42 respondents representing a total of 543 pre-hospital units, which included all the national ground ambulance services, the fixed wing and helicopter air ambulance service, and the national search and rescue service. The survey explored available insulation materials, active warming devices, and the presence of protocols describing wrapping methods, temperature monitoring, and the use of warm i.v. fluids.ResultsThroughout the services, hospital duvets, cotton blankets and plastic “bubble-wrap” were the most common insulation materials. Active warming devices were to a small degree available in vehicle ambulances (14%) and the fixed wing ambulance service (44%) but were more common in the helicopter services (58-70%). Suitable thermometers for diagnosing hypothermia were lacking in the vehicle ambulance services (12%). Protocols describing how to insulate patients were present for 73% of vehicle ambulances and 70% of Search and Rescue helicopters. The minority of Helicopter Emergency Medical Services (42%) and Fixed Wing (22%) units was reported to have such protocols.ConclusionThe most common equipment types to treat and prevent hypothermia in Norwegian pre-hospital services are duvets, plastic “bubble wrap”, and cotton blankets. Active external heating devices and suitable thermometers are not available in most vehicle ambulance units.

Measuring core temperature using the proprietary application and thermo-smartphone adapter

“…Karlsen et al have described the equipment of different rescue services in Norway, especially the devices designed to prevent, recognize and treat accidental hypothermia, and showed that as little as 12% of ground ambulances have the opportunity to read the core temperature [15]. In Poland, Tc measurement is not possible in ground ambulances, but 28% of air rescue teams have appropriate thermometers [Darocha, unpublished data].…”

Accidental hypothermia in recreational activities in the mountains: A narrative review

“…Based on data from hospitals in Northern Sweden in the period 2000‐2007 temperature was measured pre‐hospitally in 12.3% of cases (30/244) and the body site was recorded in 7% of these cases (rectal or epitympanic) . A survey of 42 pre‐hospital medical service providers in Norway found that air ambulances and search and rescue services were better equipped to measure body temperature than ground ambulance services . Thermometers were carried by all fixed wing air ambulance, helicopter air ambulance and search and rescue services, whereas they were present in only 12% of the ground ambulance units.…”

Prise en charge du traumatisé grave en secours en montagne

“…L'objectif de prise en charge est d'obtenir une température centrale supérieure à 34°C. Plusieurs dispositifs au-delà de la simple couverture isotherme sont utilisés par les équipes de secours en montagne pour éviter l'hypothermie comme des couvertures textiles, chauffantes, hot packs ou bubble wrap [28]. Il sera toujours utile d'installer le patient dans un hélicoptère préalablement chauffé.…”