- •Rewarming patients subject to hypothermic cardiac arrest is difficult.
- •Forced air rewarming devices are 1 of the most effective noninvasive rewarming devices available to prehospital clinicians for increasing the core body temperature of casualties in cold environments.
- •Consideration must be given to the working environment of responders while ensuring as little passive heat loss from the casualty as possible.
Hypothermic cardiac arrest is rare and poses a challenge to prehospital responders. Standard cardiac arrest protocols advise treating reversible causes of arrest; however, rewarming the cold casualty is not easily achieved in the field. This article aimed to review the literature on hypothermia in order to produce evidence-based recommendations on rewarming that could realistically be applied to hypothermic cardiac arrest patients.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Air Medical Journal
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Accidental hypothermia.N Engl J Med. 2012; 367: 1930-1938
- Cardiovascular impact of hypothermia.Reanimation. 2015; 24: 129-139
- [Accidental hypothermia in Switzerland (1980-1987)–case reports and prognostic factors].Schweiz Med Wochenschr. 1991; 121: 1020-1028
- Wilderness Medicine.5th ed. Elsevier, Philadelphia, PA2007
- Accidental hypothermia [editorial].Can Med Assoc J. 1970; 103: 1388-1389
- Emergency treatment of accidental hypothermia.Drug Ther Bull. 1971; 9: 5-7
- Hypothermia improves defibrillation success and resuscitation outcomes from ventricular fibrillation.Circulation. 2005; 111: 3195-3201
Casagranda I, Lombardi G, Cecconi D, et al. Accidental hypothermia. Emergency Care Journal. 2006;2:9-17.
- The evaluation and management of accidental hypothermia.Respir Care. 2004; 49: 192-205
- Successful treatment of severe accidental hypothermia with cardiac arrest for a long time using cardiopulmonary bypass - report of a case.Int J Emerg Med. 2012; 5: 9
- The management of accidental hypothermia.Can Med Assoc J. 1967; 96: 214-218
- European Resuscitation Council Guidelines for Resuscitation 2015: Section 4. Cardiac arrest in special circumstances.Resuscitation. 2015; 95: 148-201
- Resuscitation from accidental hypothermia of 13.7 degrees C with circulatory arrest.Lancet. 2000; 355: 375-376
- Sequela-free long-term survival of a 65-year-old woman after 8 hours and 40 minutes of cardiac arrest from deep accidental hypothermia.J Thorac Cardiovasc Surg. 2014; 147: e1-e2
- Suspended animation for delayed resuscitation.Crit Care Med. 1996; 24: S24-S47
- Suspended animation: the molecular basis of metabolic depression.Can J Zool. 1988; 66: 124-132
- Suspended animation-like state protects mice from lethal hypoxia.Shock. 2007; 27: 370-372
Resuscitation Council. Quality standards for cardiopulmonary resuscitation. November 2013. https://www.resus.org.uk/quality-standards/. Accessed October 10, 2016.
- Grading strength of recommendations and quality of evidence in clinical guidelines: report from an american college of chest physicians task force.Chest. 2006; 129: 174-181
- Diagnosis and treatment of hypothermia.Am Fam Physician. 2004; 70: 2325-2332
- The utility of traditional prehospital interventions in maintaining thermostasis.Prehosp Emerg Care. 1999; 3: 115-122
- Pre-hospital torso-warming modalities for severe hypothermia: a comparative study using a human model.CJEM. 2005; 7: 378-386
- Accidental hypothermia: an evidence-based approach.Emerg Med Pract. 2009; 11: 1-26
- Comparison of three different prehospital wrapping methods for preventing hypothermia–a crossover study in humans.Scand J Trauma Resusc Emerg Med. 2011; 19: 41
- Protection against cold in prehospital care-thermal insulation properties of blankets and rescue bags in different wind conditions.Prehosp Disaster Med. 2009; 24: 408-415
- Wilderness Medical Society practice guidelines for the out-of-hospital evaluation and treatment of accidental hypothermia.Wilderness Environ Med. 2014; 25: 425-445
- Accidental hypothermia treated by central rewarming through the airway.Br J Anaesth. 1973; 45: 41-48
- Efficacy of forced-air and inhalation rewarming by using a human model for severe hypothermia.J Appl Physiol. 1997; 83: 1635-1640
- Efficacy and safety of prehospital rewarming techniques to treat accidental hypothermia.Ann Emerg Med. 1991; 20: 896-901
- Inhalation rewarming from hypothermia: an evaluation in -20 degrees C simulated field conditions.Aviat Space Environ Med. 1995; 66: 424-429
- Prehospital treatment of hypothermia.Wilderness Environ Med. 2001; 12: 24-31
- The effect of active warming in prehospital trauma care during road and air ambulance transportation - a clinical randomized trial.Scand J Trauma Resusc Emerg Med. 2011; 19: 59
- Inadvertent hypothermia prevention: the anaesthetic nurses' role.Br J Nurs. 1999; 8: 17-25
- Bair hugger forced-air warming maintains normothermia more effectively than thermo-lite insulation.J Clin Anesth. 1994; 6: 303-307
- Comparison of two convective warming systems during major abdominal and orthopedic surgery.Can J Anaesth. 2008; 55: 358-363
- Deep accidental hypothermia and cardiac arrest–rewarming with forced air.Acta Anaesthesiol Scand. 1997; 41: 1359-1364
- Forced air surface rewarming in patients with severe accidental hypothermia.Resuscitation. 1999; 41: 105-111
- Heat Loss From Animals and Man: Assessment and Control.1st ed. Elsevier, Philadelphia, PA2013
- The effect of air temperature on labour productivity in call centers – a case study.Energy Build. 2002; 34: 759-764
- Associated fluctuations in daily temperature, productivity and absenteeism.ASHRAE Trans. 1970; 76: 326-337
- Urban accidental hypothermia: 135 cases.Ann Emerg Med. 1980; 9: 456-461
- Outcome from severe accidental hypothermia with cardiac arrest resuscitated with extracorporeal cardiopulmonary resuscitation.Am J Emerg Med. 2014; 32: 320-324
- Severe accidental hypothermia treated in an ICU: prognosis and outcome.Chest. 2001; 120: 1998-2003
- Outcome from severe accidental hypothermia in Southern Finland–a 10-year review.Resuscitation. 2003; 59: 285-290
- Profound hypothermia in man; report of a case.Ann Surg. 1958; 147: 264-266
- Clinical Applications of Cryobiology.CRC Press, Boca Raton, FL1991
Published online: October 30, 2019
© 2019 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.