Treatment of accidental hypothermia at a Level I trauma center: a retrospective cohort [poster]
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Study Objectives: Accidental hypothermia causes significant morbidity and mortality in cold climates. There is some controversy about how to best treat hypothermia mostly focused on the method of rewarming and the rate of rewarming. We sought to describe the experience at Regions Hospital where a unique option exists to immerse patients in a large bath of warm water. Methods: Research assistants reviewed the medical records of all patients age =18 seen at Regions Hospital from 2003-2012. Patient demographics, vital signs, method and rate of rewarming and other clinical parameters were gathered. Descriptive statistics were used. Results: 123 patients were included (81 male, 42 female). Median age was 51. 104 were outdoor exposures including 9 water immersions and 4 drownings while 14 were indoor exposures. Alcohol or drugs were known to be present in 74 patients. Median initial temperature was 32.8 (min=24.7, max=36.6). Most patients received external rewarming including warm lamps, warm blankets, warm IV fluids and warm air circulation (Bair Hugger). Internal catheter (Coolgard) was utilized in 12 patients and 17 patients were immersed in the hot water bath (Hubbard Tank). The rate of rewarming could be ascertained for 65 patients - median 1.47 ºC/hour (min 0.38, max 5.81). The external rewarming rate was 1.2 ºC/hour, the Coolgard Catheter was 1.90 ºC/hour and the Hubbard Tank was 1.89 ºC/hour (P<0.05). 26 patients died. Conclusion: More aggressive methods of rewarming patients with hypothermia led to statistically quicker rates of rewarming. The clinical significance of this is unclear.