Risk of Burns During Active External Rewarming for Accidental Hypothermia

Giesbrecht, Gordon G.; Walpoth, Beat H.

doi:10.1016/j.wem.2019.06.005

Cited by 4 publications

(3 citation statements)

References 25 publications

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“…70 There have been reports of burns associated with use of a hot water bottle with lukewarm water applied directly to hypothermic skin, 71 the HPMK, 64 water-perfused warming blankets, a Heat Pac, and hot pads. 72 Burns have been reported both in controlled settings while researching rewarming methods and during rescue of hypothermic patients. It is important to visually inspect the heated skin at regular intervals (eg, 20 to 30 min) to observe for excess reddening or other signs of pending burns; in these cases, active heating should be stopped in the affected areas.…”

Section: Protection Of Cold Skinmentioning

confidence: 99%

Wilderness Medical Society Clinical Practice Guidelines for the Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia: 2019 Update

Dow

Giesbrecht

Danzl

et al. 2019

Wilderness & Environmental Medicine

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121

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To provide guidance to clinicians, the Wilderness Medical Society convened an expert panel to develop evidence-based guidelines for the out-of-hospital evaluation and treatment of victims of accidental hypothermia. The guidelines present the main diagnostic and therapeutic modalities and provide recommendations for the management of hypothermic patients. The panel graded the recommendations based on the quality of supporting evidence and a balance between benefits and risks/burdens according to the criteria published by the American College of Chest Physicians. The guidelines also provide suggested general approaches to the evaluation and treatment of accidental hypothermia that incorporate specific recommendations. This is

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Section: Protection Of Cold Skinmentioning

confidence: 99%

Wilderness Medical Society Clinical Practice Guidelines for the Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia: 2019 Update

Dow

Giesbrecht

Danzl

et al. 2019

Wilderness & Environmental Medicine

Self Cite

121

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“…Para evitar las complicaciones derivadas de un recalentamiento incorrecto, el personal sanitario debe tomar las medidas oportunas para evitar posibles quemaduras de contacto [18,31] entre las que se encuentran: seguir las instrucciones del fabricante y controlar la zona en contacto con la fuente de calor la cual debe estar protegida mediante una capa aislante de modo que no haya un contacto directo sobre la piel [47].…”

Section: Técnicas De Recalentamientounclassified

Manejo prehospitalario de la hipotermia accidental; Una emergencia sanitaria en el Mediterráneo.

Grima

Deballon

2020

RIECS

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1) Antecedentes: Las diferentes rutas migratorias que atraviesan el Mar Mediterráneo son consideradas las rutas más mortíferas de 2019. Son varios los organismos que recopilan información sobre estos movimientos migratorios, refugiados y migrantes deben ser asistidos cuando se encuentren en peligro según el Derecho Marítimo y trasladados a un puerto seguro en el cual se respeten sus Derechos Humanos. La OMS resalta que la hipotermia se sitúa entre los problemas de salud más frecuentes en el Mediterráneo seguido de quemaduras y lesiones accidentales. Las muertes por ahogamiento e hipotermia representan más del 50% de los casos según la OIM convirtiendo esta patología en una emergencia sanitaria cuyo abordaje prehospitalario definirá los resultados clínico-asistenciales. 2) Métodos: Revisión sistemática de tipo exploratoria para describir el conocimiento sanitario actual sobre la hipotermia accidental tras inmersión y como el correcto triaje, clasificación del grado de hipotermia y tratamiento influyen en los resultados clínicoasistenciales prehospitalarios. 3) Resultados: El triaje debe ser llevado a cabo por profesionales experimentados en el ámbito marítimo. El tratamiento recibido debe ser acorde al grado de hipotermia que presente el paciente, el cuál será definido por la clínica. Los casos de HA severa y PCR por hipotermia cumplen los criterios para una derivación hospitalaria urgente. 4) Conclusión: La hipotermia accidental es una patología ambiental, se considera una emergencia y tiene unos principios básicos de clasificación, tratamiento y reanimación. Conocer estos principios asegurará un buen manejo prehospitalario del paciente hipotérmico.

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“…There is also a case report of burn injuries from heat pads in the treatment of hypothermia. 12 Finally, the manufacturer's instructions are to open the CHB to the air and allow 15 min to reach operating temperature. It is therefore common practice for MRTs to open the CHB and leave it loose on the top of a rucksack before arriving at the casualty, but it is unknown whether this compromises performance of the CHB.…”

Section: Introductionmentioning

confidence: 99%

Performance of a Chemical Heat Blanket in Dry, Damp, and Wet Conditions Inside a Mountain Rescue Hypothermia Wrap

Greene,

Long,

Greene

et al. 2023

Wilderness & Environmental Medicine

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Introduction-Casualties with accidental hypothermia are evacuated using multilayer wraps, typically including a chemical heat blanket (CHB), a vapor barrier, and an insulating outer bag. We investigated CHB performance against dry, damp, and wet fabric, in a multilayer wrap, in response to a case report indicating diminished performance when wet.Methods-We wrapped a torso manikin in a base layer, CHB, vapor barrier, casualty bag, and vacuum mattress, recording CHB panel temperatures at intervals of up to 7 h. Experimental conditions were dry, damp, and wet clothing, with 2 blankets tested in each condition. We subsequently used a forwardlooking infrared camera to assess whether the panels heated evenly and heat flux sensors to quantify heat transfer across 2 dry, 1 damp, and 1 wet fleece under CHB panels.Results-Chemical heat blankets maintained heat output for >7 h inside the wraps. Median (IQR) panel steady state temperatures were 52 • C (39-56 • C) against dry fleece, 41 • C (36-45 • C) against damp fleece, and 30 • C (29-33 • C) against wet fleece. Peak panel temperature was 67 • C. The heat flux results indicated that CHBs generated similar quantities of heat in dry and damp conditions, as the lower temperatures were compensated by more efficient transfer of heat across the moist clothing layer. Chemical heat blanket heat output was diminished in wet conditions.Conclusions-Rescuers should cut off saturated clothing in a protected environment before wrapping casualties, but damp clothing need not be removed. Because of the high peak temperatures recorded on the surfaces of CHBs, they should not be placed directly against skin, and compression straps should not be placed directly over CHBs.

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Risk of Burns During Active External Rewarming for Accidental Hypothermia

Cited by 4 publications

References 25 publications

Wilderness Medical Society Clinical Practice Guidelines for the Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia: 2019 Update

Wilderness Medical Society Clinical Practice Guidelines for the Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia: 2019 Update

Manejo prehospitalario de la hipotermia accidental; Una emergencia sanitaria en el Mediterráneo.

Performance of a Chemical Heat Blanket in Dry, Damp, and Wet Conditions Inside a Mountain Rescue Hypothermia Wrap

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