Next to the chief complaint of pain, “I am cold” is one of the complaints I hear most often and nearly any time of the year. For some patients, being cold could be the cause of their altered mental status. Hypothermia is a high risk problem for major trauma patients because it compromises clotting. EMS professionals have a variety of product options for preventing heat loss, retaining heat the patient is generating, and actively adding heat to the patient packaging system.
Remember, heat is transferred through conduction, convection, radiation, and evaporation. Patient warming products seek to either enhance or minimize these processes. Products to maintain patient warmth include the reusable linen available from hospitals. A standard bath blanket helps the patient retain their own heat by minimizing radiation to the air around them or conduction into the surfaces they are in contact with, like the cot or a backboard. A quilted blanket has the added benefit of loft. The dead space, created by woven layers, provides a limited amount of insulation.
There are many disposable linen products to choose, like those from Graham Medical, that have the added benefit of not having to be laundered after use. Disposable linens, if you have never used them, are surprisingly durable for single patient use and, like a bath blanket, minimize radiation and conduction. Also like a bath blanket they prevent convection of heat away from the patient’s body by moving air. Heat loss from convection is especially significant when the patient is outside of a building or ambulance.
Reflective disposable emergency blankets reflect heat that is radiating away from the body back towards the body. They also reduce convection from moving air. I was always skeptical about the effectiveness of these thin “space blankets” until I started receiving them at the finish line of marathons. I was surprised at how effectively it retained my heat and minimized heat loss.
Some EMS systems, because of prolonged transports and severe environmental conditions, require patient linens with more loft as well as water and wind resistance. Since most of these products, like the EMP Patient Cover Quilt are reusable they either require frequent rewashing or lining with a disposable sheet or regular bed sheet. Other reusable patient packaging systems include the +LifeBlanket system and the Rescue Wrap.
Warmed bags of IV fluid or chemical heat packs are simple methods to introduce a heat source into a patient packaging system. Placed near the core of the body – neck, chest, and axilla – these methods will mostly help the patient retain the heat they are producing. They are not likely to significantly change the patient’s core temperature. The Turley Backboard Pad can be pre-warmed and then used on a backboard for a trauma patient or placed in the packaging of a medical patient. At 10 feet by 36 feet the Turley Backboard Pad can transfer heat to the entire posterior core of the patient’s body.
The Geratherm Rescue Warming System is an active warming system that runs off a portable battery or electrical outlet. The controller can be set up to 105 degrees fahrenheit. The Geratherm is available in three different sizes from torso to full body. This is a system that produces heat for the patient.
What are other solutions and products for minimizing heat loss, retaining heat, and actively add heat to a patient packaging system? Share your tips, ideas, and resources in the comments area.
