Citation

Lapostolle F, Sebbah JL, Couvreur J, Koch FX, Savary D, Tazarourte K, Egman G, Mzabi L, Galinski M, Adnet F. Crit. Care 2012; 16(4): R142.

Copyright

(Copyright © 2012, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/cc11449

PMID

22849694

Abstract

INTRODUCTION: Hypothermia is common in trauma victims and is associated with an increase in mortality. Its causes are not well understood. Our objective was to identify the factors influencing onset of hypothermia during prehospital care of trauma victims. METHODS: Multicenter, prospective, open, observational study in a prehospital setting. Trauma victims, over 18 years old, receiving care from emergency medical services (EMS) and transported to hospital in a medically staffed mobile unit. Study variables included: demographics and morphological traits, nature and circumstances of the accident, victim's presentation (trapped, seated or lying down, on the ground, unclothed, wet or covered by a blanket), environmental conditions (wind, rain, ground temperature and air temperature on site and in mobile unit), clinical factors, Revised Trauma Score (RTS), tympanic temperature, care provided (including warming, drugs administered, infusion fluid temperature and volume), and EMS and hospital arrival times. RESULTS: 448 patients included. Hypothermia (< 35degreesC) on hospital arrival was present in 64/448 patients (14%). Significant factors associated with absence of hypothermia in a multivariate analysis were RTS: Odds Ratio: 1.68(1.29-2.20) ; no intubation: 4.23(95%CI 1.62-11.02) ; infusion fluid temperature: 1.17 (1.05-1.30) ; mobile unit temperature: 1.20(1.04-1.38) ; patient not unclothed: 0.40(0.18-0.90) ; and no head injury: 0.36(0.16-0.83). CONCLUSIONS: The key risk factor for the onset of hypothermia was the severity of injury but environmental conditions and the medical care provided by EMS were also significant factors. Changes in practice could help reduce the impact of factors such as infusion fluid temperature and mobile unit temperature.

Language: en