Preventive Care in Nursing and Midwifery Journal
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Volume 11, Issue 1 (2-2021)
PCNM 2021, 11(1): 63-70 |
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Hassandoost R, Dinmohammadi M, Roohani M. Accidental Hypothermia and Related Risk Factors among Trauma Patients Admitted to the Emergency Department. PCNM 2021; 11 (1) :63-70
URL: http://nmcjournal.zums.ac.ir/article-1-715-en.html
URL: http://nmcjournal.zums.ac.ir/article-1-715-en.html
PhD in Nursing, Associate Professor, Department of Critical Care Nursing, Nursing and Midwifery School, Zanjan University of Medical Sciences, Zanjan, Iran , mdinmohammadi@zums.ac.ir
Abstract: (6250 Views)
Background: Early detection and management of hypothermia are determinants in the consequences of the injury. Various factors are involved in the progress of accidental hypothermia in these patients.
Objectives: This study was done to determine the prevalence of accidental hypothermia and its related factors in trauma patients admitted to the emergency department (ED).
Methods: In this prospective observational study, 123 trauma patients, who were transferred to the ED of Ayatollah Mosavi hospital, Zanjan, Iran by emergency medical technicians during November 2018, were selected. The patients' core body temperature (CBT) was measured through a calibrated tympanic thermometer on admission, 30 minutes after admission, and at the time of leaving the ED. Personal, clinical, environmental, and caring variables were evaluated as factors associated with hypothermia. Data were analyzed using descriptive statistics and multiple linear regression by SPSS16. The significance level was considered to be 5%.
Results: The prevalence of accidental hypothermia in the ED was 43.1%. The patient's arrival CBT (β: 0.333, P-value <0.001), the length of stay in the ED (β: - 0.174, P-value =0.011), arrival ambient temperature (β: 0.165, P-value =0.039), and Glasgow coma scale (GCS) (β: 0.413, P-value <0.001) were the risk factors identified as predictors of hypothermia.Conclusion: A significant proportion of trauma patients were hypothermic on admission to the ED. Arrival CBT, length of stay in the ED, arrival ambient temperature, and GCS had a significant role in the development or exacerbation of hypothermia. The results of this study highlight the need for giving special attention to the early detection and management of accidental hypothermia among trauma patients in the ED.
Objectives: This study was done to determine the prevalence of accidental hypothermia and its related factors in trauma patients admitted to the emergency department (ED).
Methods: In this prospective observational study, 123 trauma patients, who were transferred to the ED of Ayatollah Mosavi hospital, Zanjan, Iran by emergency medical technicians during November 2018, were selected. The patients' core body temperature (CBT) was measured through a calibrated tympanic thermometer on admission, 30 minutes after admission, and at the time of leaving the ED. Personal, clinical, environmental, and caring variables were evaluated as factors associated with hypothermia. Data were analyzed using descriptive statistics and multiple linear regression by SPSS16. The significance level was considered to be 5%.
Results: The prevalence of accidental hypothermia in the ED was 43.1%. The patient's arrival CBT (β: 0.333, P-value <0.001), the length of stay in the ED (β: - 0.174, P-value =0.011), arrival ambient temperature (β: 0.165, P-value =0.039), and Glasgow coma scale (GCS) (β: 0.413, P-value <0.001) were the risk factors identified as predictors of hypothermia.Conclusion: A significant proportion of trauma patients were hypothermic on admission to the ED. Arrival CBT, length of stay in the ED, arrival ambient temperature, and GCS had a significant role in the development or exacerbation of hypothermia. The results of this study highlight the need for giving special attention to the early detection and management of accidental hypothermia among trauma patients in the ED.
Keywords: prevalence, accidental hypothermia, injury, core body temperature (CBT), emergency department (ED)
Type of Study: Orginal research |
Subject:
Nursing
Received: 2021/01/28 | Accepted: 2021/02/28 | Published: 2021/02/28
Received: 2021/01/28 | Accepted: 2021/02/28 | Published: 2021/02/28
References
1. Ireland S, Endacott R, Cameron P, Fitzgerald M, Paul E. The incidence and significance of accidental hypothermia in major trauma--a prospective observational study. Resuscitation. 2011; 82(3): 300-306. [Crossref]
2. Kosiński S, Darocha T, Gałązkowski R, Drwiła RJSjot, Resuscitation, Medicine E. Accidental hypothermia in Poland-estimation of prevalence, diagnostic methods and treatment. Scand J Trauma Resusc Emerg Med. 2015; 23: 13. [Crossref]
3. Lapostolle F, Couvreur J, Koch FX, Savary D, Alhéritière A, Galinski M, et al. Hypothermia in trauma victims at first arrival of ambulance personnel: an observational study with assessment of risk factors. Scand J Trauma Resusc Emerg Med. 2017; 25(1): 43. [Crossref]
4. Mommsen P, Andruszkow H, Frömke C, Zeckey C, Wagner U, Van Griensven M, et al. Effects of accidental hypothermia on posttraumatic complications and outcome in multiple trauma patients. Injury. 2013; 44(1): 86-90. [Crossref]
5. Perlman R, Callum J, Laflamme C, Tien H, Nascimento B, Beckett A, et al. A recommended early goal-directed management guideline for the prevention of hypothermia-related transfusion, morbidity, and mortality in severely injured trauma patients. Crit Care. 2016; 20(1): 107. [Crossref]
6. Tintinalli JE, Stapczynski JS, Ma OJ, Cline DM, Meckler GD. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 8th ed. New York: McGraw-Hill Education; 2015.
7. Block J, Lilienthal M, Cullen L, White A. Evidence-based thermoregulation for adult trauma patients. Crit Care Nurs Quarterly. 2012; 35(1): 50-63. [Crossref]
8. Hsieh T-M, Kuo P-J, Hsu S-Y, Chien P-C, Hsieh H-Y, Hsieh C-H. Effect of Hypothermia in the Emergency Department on the Outcome of Trauma Patients: A Cross-Sectional Analysis. Int J Environ Res Public Health. 2018; 15(8): 1769. [Crossref]
9. Haverkamp FJ, Giesbrecht GG, Tan EC. The prehospital management of hypothermia-An up-to-date overview. Injury. 2018; 49(2): 149-64. [Crossref]
10. Zafren K. Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia. Emerg Med Clin North Am. 2017; 35(2): 261-79. [Crossref]
11. Brown DJ, Brugger H, Boyd J, Paal P. Accidental hypothermia. N Engl J Med. 2012; 367(20): 1930-8. [Crossref]
12. Keane M. Triad of death: the importance of temperature monitoring in trauma patients. Emerg Nurse. 2016; 24(5): 19-23. [Crossref]
13. Rossaint R, Bouillon B, Cerny V, Coats T, Duranteau J, Fernández-Mondéjar E, et al. The European guideline on management of major bleeding and coagulopathy following trauma. Crit Care. 2016; 20(1): 100. [Crossref]
14. Balvers K, Van der Horst M, Graumans M, Boer C, Binnekade JM, Goslings JC, et al. Hypothermia as a predictor for mortality in trauma patients at admittance to the Intensive Care Unit. J Emerg Trauma Shock. 2016; 9(3): 97-102. [Crossref]
15. Waibel BH, Schlitzkus LL, Newell MA, Durham CA, Sagraves SG, Rotondo MF. Impact of hypothermia (below 36 C) in the rural trauma patient. J Am Coll Surg. 2009; 209(5): 580-8. [Crossref]
16. Kaafarani H, Velmahos G. Damage Control Resuscitation In Trauma. Scand J Surg. 2014; 103(2): 81-88. [Crossref]
17. Byun CS, Park IH, Oh JH, Bae KS, Lee KH, Lee E. Epidemiology of trauma patients and analysis of 268 mortality cases: trends of a single center in Korea. Yonsei Med J. 2015; 56(1): 220-6. [Crossref]
18. Aitken LM, Hendrikz JK, Dulhunty JM, Rudd M. Hypothermia and associated outcomes in seriously injured trauma patients in a predominantly sub-tropical climate. Resuscitation. 2009; 80(2): 217-23. [Crossref]
19. Beilman GJ, Blondet JJ, Nelson TR, Nathens AB, Moore FA, Rhee P, et al. Early hypothermia in severely injured trauma patients is a significant risk factor for multiple organ dysfunction syndrome but not mortality. Ann surg. 2009; 249(5): 845-50. [Crossref]
20. Hegarty J, Walsh E, Burton A, Murphy S, O'gorman F, McPolin G. Nurses' knowledge of inadvertent hypothermia. AORN J. 2009; 89(4): 701-13. [Crossref]
21. Saqe-Rockoff A, Schubert FD, Ciardiello A, Douglas E. Improving thermoregulation for trauma patients in the emergency department: an evidence-based practice project. J Trauma Nurs. 2018; 25(1): 14-20. [Crossref]
22. Khaji A, Ghodsi SM, Eftekhar B, Karbakhsh M. Trauma research in Iran: a report of the Sina Trauma Data Bank. Arch Iran Med. 2010; 13(1): 17-20.
23. Collins N, Daly S, Johnson P, Smith G. Pre-hospital use of intravenous in-line fluid warmers to reduce morbidity and mortality for major trauma patients: A review of the current literature. Australas J Paramedicine. 2015; 12(2): 1-5. [Crossref]
24. Hildebrand F, Giannoudis PV, van Griensven M, Chawda M, Pape H-C. Pathophysiologic changes and effects of hypothermia on outcome in elective surgery and trauma patients. Am J Surg. 2004; 187(3): 363-71. [Crossref]
25. Vincent-Lambert C, Smith CM, Goldstein LNJTPAmj. Hypothermia in trauma patients arriving at an emergency department by ambulance in Johannesburg, South Africa: a prospective study. Pan Afr Med J. 2018; 31: 136. [Crossref]
26. Lapostolle F, Sebbah JL, Couvreur J, Koch FX, Savary D, Tazarourte K, et al. Risk factors for onset of hypothermia in trauma victims: the HypoTraum study. Crit Care. 2012; 16(4): R142. [Crossref]
27. Pirnes J, Ala-Kokko T. Accidental hypothermia: factors related to long-term hospitalization. A retrospective study from northern Finland. Internal and emergency medicine. 2017;12(8):1225-33. [Crossref]
28. Klauke N, Gräff I, Fleischer A, Boehm O, Guttenthaler V, Baumgarten G, et al. Effects of prehospital hypothermia on transfusion requirements and outcomes: a retrospective observatory trial. BMJ open. 2016; 6(3). [Crossref]
29. Aléx J, Karlsson S, Saveman B-I. Effect evaluation of a heated ambulance mattress-prototype on body temperatures and thermal comfort-an experimental study. Scand J Trauma Resusc Emerg Med. 2014; 22(1): 43. [Crossref]
30. Torossian A, Bräuer A, Höcker J, Bein B, Wulf H, Horn E-P. Preventing inadvertent perioperative hypothermia. Dtsch Arztebl Int. 2015; 112(10): 166-172. [Crossref]
31. Vincent-Lambert C, Smith CM, Goldstein LN. Hypothermia in trauma patients arriving at an emergency department by ambulance in Johannesburg, South Africa: a prospective study. Pan Afr Med J. 2018; 31. [Crossref]
32. Vural F, Çelik B, Deveci Z, Yasak K. Investigation of inadvertent hypothermia incidence and risk factors. Turk J Surg. 2018; 34(4): 300-305.
33. Yi J, Xiang Z, Deng X, Fan T, Fu R, Geng W, et al. Incidence of inadvertent intraoperative hypothermia and its risk factors in patients undergoing general anesthesia in Beijing: a prospective regional survey. PloS one. 2015;10(9):e0136136. [Crossref]
34. Hardcastle TC, Stander M, Kalafatis N, Hodgson RE, Gopalan D. External patient temperature control in emergency centres, trauma centres, intensive care units and operating theatres: A multi-society literature review. S Afr Med J. 2013; 103(9): 609-11. [Crossref]
35. Inaba K, Berg R, Barmparas G, Rhee P, Jurkovich GJ, Recinos G, et al. Prospective evaluation of ambient operating room temperature on the core temperature of injured patients undergoing emergent surgery. J Trauma Acute Care Surg. 2012; 73(6): 1478-83. [Crossref]
36. van der Ploeg G-J, Goslings JC, Walpoth BH, Bierens JJJR. Accidental hypothermia: rewarming treatments, complications and outcomes from one university medical centre. Resuscitation. 2010; 81(11): 1550-55. [Crossref]
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