Warming the oxygen with the rescuer’s body as a possible method of heat loss prevention in a prehospital setting. Initial report
, 1, 2, 3, 1, 2, 2
Abstract
INTRODUCTION: Discomfort from cold is a significant problem for trauma victims. Prehospital treatment of a hypothermic patient is hugely challenging for medical rescue teams. Preventing heat loss is a basic treatment in all levels of care. The main aim objective of this report was to examine the influence of low ambient temperature on cooling oxygen in a rescue set and to check whether heating the oxygen tube with the rescuer’s body is a legitimate method.
MATERIAL AND METHODS: In the control test, an oxygen tube was disposed of across a styrofoam board, whereas a study group was an oxygen tube hidden underneath the paramedic’s jacket. A thermographic camera was used to define oxygen’s temperature in different parts of the medical setting. The research was carried out in the winter season in the natural environment, which was comparable to the regular work conditions of the services.
RESULTS: In a control group, the oxygen temperature in an oxygen mask was similar to the ambient temperature. This research has found that warming up an oxygen tube underneath the paramedic’s jacket resulted in a 12.9 degree increase in temperature in an oxygen mask.
CONCLUSIONS: Keeping the oxygen tube underneath a jacket may serve as an additional method of preventing patients’ heat loss. The authors express the need for further research on providing hypothermic patients with warm oxygen. The authors believe that introducing such an easy method of warming up the oxygen may positively influence treatment results and give rise to a discussion on the presented method.
Keywords: oxygen inhalation therapyhypothermiaemergency medical services
References
- Chavala MLA, Gallardo MA, Martínez ÍS, et al. Management of accidental hypothermia: A narrative review. Medicina Intensiva (English Edition). 2019; 43(9): 556–568.
- Brown DJA, Brugger H, Boyd J, et al. Accidental hypothermia. N Engl J Med. 2012; 367(20): 1930–1938.
- Kosinski S, Darocha T, Jarosz A, et al. The longest persisting ventricular fibrillation with an excellent outcome - 6h 45min cardiac arrest. Resuscitation. 2016; 105: e21–e22.
- Fok P, Teubner D, Purdell-Lewis J, et al. Predictors of Prehospital On-Scene Time in an Australian Emergency Retrieval Service. Prehospital and Disaster Medicine. 2019; 34(03): 317–321.
- Henriksson O, Lundgren P, Kuklane K, et al. Protection against cold in prehospital care: evaporative heat loss reduction by wet clothing removal or the addition of a vapor barrier--a thermal manikin study. Prehosp Disaster Med. 2012; 27(1): 53–58.
- Kosiński S, Darocha T, Sadowski J, et al. Hypothermia. Clinical Aspects of Body Cooling Analysis of Dangers Directions of Modern Treatment. 2016.
- Paynter M. Trauma support: revolution in care. Emergency Nurse. 1993; 1(2): 7–9.
- Collicott P. ADVANCED TRAUMA LIFE SUPPORT (ATLS). The Journal of Trauma: Injury, Infection, and Critical Care. 1992; 33(5): 749–753.
- Kłosiewicz T, Zalewski R. Hipotermia pourazowa jako wyzwanie dla personelu zespołów ratownictwa medycznego. Pomeranian Journal of Life Sciences. 2018; 64(4).
- Weinberg AD. The role of inhalation rewarming in the early management of hypothermia. Resuscitation. 1998; 36(2): 101–104.
- Błażejczyk K. Heat transfer between man and the environment in different geographic environments. Warsaw: Polish Academy of Sciences. ; 1993.
- Sessler DI. Thermoregulatory defense mechanisms. Crit Care Med. 2009; 37(7 Suppl): S203–S210.
- Morrison JB, Conn ML, Hayes PA. Influence of respiratory heat transfer on thermogenesis and heat storage after cold immersion. Clin Sci (Lond). 1982; 63(2): 127–135.
- Fisher A, Foëx P, Emerson PM, et al. Oxygen availability during hypothermic cardiopulmonary bypass. Crit Care Med. 1977; 5(3): 154–158.
- Fontanari P, Zattara-Hartmann MC, Burnet H, et al. Changes in airway resistance induced by nasal inhalation of cold dry, dry, or moist air in normal individuals. J Appl Physiol (1985). 1996; 81(4): 1739–1743.
- Kilgour E, Rankin N, Ryan S, et al. Mucociliary function deteriorates in the clinical range of inspired air temperature and humidity. Intensive Care Med. 2004; 30(7): 1491–1494.
- Chidekel A, Zhu Y, Wang J, et al. The effects of gas humidification with high-flow nasal cannula on cultured human airway epithelial cells. Pulm Med. 2012; 2012: 380686.
- Williams R, Rankin N, Smith T, et al. Relationship between the humidity and temperature of inspired gas and the function of the airway mucosa. Crit Care Med. 1996; 24(11): 1920–1929.
- Richards GN, Cistulli PA, Ungar RG, et al. Mouth leak with nasal continuous positive airway pressure increases nasal airway resistance. Am J Respir Crit Care Med. 1996; 154(1): 182–186.
- Hayward JS, Steinman AM. Accidental hypothermia: an experimental study of inhalation rewarming. Aviat Space Environ Med. 1975; 46(10): 1236–1240.
- Morrison JB, Conn ML, Hayward JS. Thermal increment provided by inhalation rewarming from hypothermia. J Appl Physiol Respir Environ Exerc Physiol. 1979; 46(6): 1061–1065.
- Darocha T, Kosinski S, Podsiadlo P, et al. EMS, HEMS, ECMO Center, ICU Team: Are You Ready for Hypothermic Patients?: Extracorporeal Membrane Oxygenation in Severe Accidental Hypothermia. JACC Heart Fail. 2016; 4(10): 829–830.
- Comparison of four intraoperative warming devices.Ouellette RG. AANA J. 1993; 61: 394–396.
- Lloyd E. Equipment for airway warming in the treatment of accidental hypothermia. Journal of Wilderness Medicine. 1991; 2(4): 330–350.
- Park HJ, Moon HoS, Moon SeHo, et al. The effect of humidified heated breathing circuit on core body temperature in perioperative hypothermia during thyroid surgery. Int J Med Sci. 2017; 14(8): 791–797.
- Karlsen AM, Thomassen O, Vikenes BH, et al. Equipment to prevent, diagnose, and treat hypothermia: a survey of Norwegian pre-hospital services. Scand J Trauma Resusc Emerg Med. 2013; 21: 63.