Page 268 - 2023 SMOG Digital

HYPOTHERMIA PREVENTION AND
MANAGEMENT

CLINICAL BACKGROUND:
• Hypothermia, acidosis, and coagulopathy constitute the “triad of death” in trauma patients. The
association of hypothermic coagulopathy with increased mortality has been well described. Over
80% of non-surviving patients have had a body temperature of less than 93.2 o F(34°C). This degree
of hypothermia causes dysfunction of coagulation proteins, thus exacerbating hemorrhage. The
mortality in combat casualties with hypothermia is double that of normothermic casualties with
similar injuries.
• Prevention of hypothermia must be emphasized in combat operations and casualty management at
all levels of care. Take early and aggressive steps to prevent further body heat loss and add
external heat when possible for both trauma and severely burned casualties.
• Hypothermia occurs regardless of the ambient temperature; hypothermia can, and does, occur in
both hot and cold climates.
• Prevention of hypothermia is much easier than treatment of hypothermia; therefore prevention of
heat loss should start as soon as possible after the injury. This is optimally accomplished in a
layered fashion with rugged, lightweight, durable products that are utilized at all subsequent levels
of care, including ground and air evacuation, through all levels of care.
CONTRAINDICATIONS:
• Hyperthermia patients that require active cooling
PROCEDURE: Tactical Combat Casualty Care principles should be followed for preventing hypothermia.
• Primary Equipment
o Hypothermia Prevention and Management Kits (HPMK). HPMK contains:
 strong, flexible, lightweight Heat Reflective Shell that is impervious to wind & rain
 Hood cover for Head
 self-heating, oxygen-activated shell liner (ReadyHeat)
o Blood Fluid Warmers
o ReadyHeat Blankets
o Wool or heat shield blankets
Take aggressive action to prevent hypothermia and maintain normothermic temperatures 97 ⁰ -99 ⁰ F (36 ⁰ -38 ⁰ C)
• Blood/Fluid Warmers: Utilize blood/fluid warmers for all IV/IO administration. Fluids should be warmed to
38 ⁰ Celsius.
• Head Cover: Cover patients head with hood or Thermo-Lite Hypothermia Prevention System Cap.
Greatest area of heat loss happens at the top of the patients head.

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