Evidence-Based Thermoregulation for Adult Trauma Patients

Abstract

The purpose of this project was to develop a staff nurse-led initiative to implement and evaluate evidence-based thermoregulation care for adult trauma patients. An evidence-based practice protocol was developed and implemented, addressing varying patient needs across the spectrum of hypothermia seen in practice, serving as a guide for improving thermoregulation care in trauma patients. There were 2 key pieces to the evidence-based practice protocol. The first piece consisted of an interdisciplinary thermoregulation flowchart to provide focused care based on patient temperatures. The flowchart outlined progressive interventions for increasing hypothermia. The second piece outlined the nursing assistant role, preparing the care area before patient arrival and assisting nursing staff during trauma care. Data from staff questionnaires and patient documentation were used in a pre- and postevaluation of the practice change. Improvements were demonstrated in staff feeling better prepared to identify patients with hypothermia, treat hypothermia, and document thermal care of trauma patients. Clinically important improvement in temperature control during emergency treatment in both moderate and severe hypothermic patients were observed. Ongoing monitoring is underway to promote integration of the practice change.

The Effect of Thermal Care Workshop on EMS Staff Readiness in managing Accidental Hypothermia in Trauma Patients

“…Hypothermia refers to a central temperature below 35 degrees Centigrade [9]. In trauma patients, accidental hypothermia refers to a drop in central body temperature below 36 degrees Centigrade and is categorized as: mild (34-36°C), moderate (32-34°C), and severe (below 32°C) [7,10,11]. Hypothermia can be caused by trauma, infection or other diseases.…”

Temperature Management and Nursing Care of the Patient With Acute Ischemic Stroke

“…This recommendation amalgamates more than a dozen of the 2011 recommendations for which the common thread is the need for structured monitoring during TTM. Two new citations 13,18 were added in support of this recommendation. There is no evidence that protocols are harmful, but it fails to meet the strength of evidence required for a level-A evidence rating.…”

“…15,18,19 Three articles provide evidence to support TTM practice protocols. 13,18,20 to support shivering assessment. 16 One provided evidence about temperature measurement.…”

“…Five articles were found that contribute to evidence-based nursing care of the patient with stroke during TTM. [13][14][15][16][17] Finally, a secondary search of articles included in the review of Rockett et al 11 was performed, which identified 2 additional articles that met inclusion criteria. 18,19 One additional article was identified during the peerreview process.…”

Atendimento pré-hospitalar móvel avançado para idosos pós-trauma: evidências para a construção de um protocolo assistencial de enfermagem

“…• Documentar a temperatura ambiental. Fornecer cobertores e aquecer produtos sanguíneos e outros fluídos (BLOCK et al, 2012).…”