Hypothermia in trauma patients is a common occurrence. Shock, injury and environmental exposure are contributing factors to the development of hypothermia.
“Early prehospital recognition and staging of hypothermia are crucial to triage to proper care to improve survival. Treatment of hypothermia should start in an early stage, especially the prevention of further cooling in the prehospital setting and during the primary assessment.” [1]
While the risk of hypothermia is present for all trauma patients, the elderly are at a particularly high risk. Research has indicated the elderly patients are more vulnerable to developing hypothermia. [2] One recent study found that “1-year mortality of all-cause hypothermia significantly increased with age from 1.7% in patients aged 18-20 years, up to 45% in patients aged >80 years.” [2]
To fully understand the role of hypothermia in elderly trauma patients, we explore the reasons, risk factors, and solutions available.
Hypothermia in the elderly: A unique challenge
We know that hypothermia can occur anywhere and happen to anyone. While the environment can play a significant role in the development of hypothermia, there are personal factors that increase the risk.
Some of the main reasons why the elderly are more prone to hypothermia include:
Reduced Thermoregulation: As we age, our body’s ability to regulate temperature weakens. The elderly have reduced subcutaneous fat, a slower metabolic rate, and impaired shivering response, all contributing to their inability to maintain core body temperature.
Chronic Health Conditions: Conditions such as diabetes, cardiovascular disease, and hypothyroidism can impair the body’s ability to generate or conserve heat. Many older adults also take medications, which can interfere with thermoregulation.
When trauma occurs, such as from a fall leading to fractures, the situation becomes even more dire, as the injury itself may exacerbate the loss of heat. Due to the physical effects of aging, the consequences of trauma can be more significant, and harder to recover from.
The Impact of Hypothermia on Trauma Outcomes in the Elderly
Hypothermia is not only dangerous because of the health problems it causes, but also because it worsens the outcomes of traumatic injuries.
The “lethal triad” in trauma – hypothermia, acidosis, and coagulopathy demonstrates how hypothermia plays a pivotal role in accelerating the deterioration of a trauma patient’s condition.
Coagulopathy: Hypothermia interferes with the body’s ability to form blood clots, which increases the risk of excessive bleeding after trauma. Even relatively minor injuries in elderly patients can lead to significant blood loss if hypothermia occurs.
Increased Risk of Infections: Hypothermia can suppress the immune system, making elderly patients more susceptible to infections. For patients with open fractures or who require surgery (such as for a neck of femur fracture), hypothermia can increase the risk of wound infections, and other complications.
Delayed Healing and Recovery: Hypothermia reduces tissue oxygenation and impairs cellular metabolism. This can result in delayed healing of wounds and fractures, making recovery from trauma even more challenging for elderly patients who already have compromised healing due to age and potential underlying conditions like osteoporosis.
Cardiac Complications: The elderly are already at a higher risk for cardiovascular disease, and hypothermia can further stress the heart. As the body cools, vasoconstriction increases, raising blood pressure and putting added strain on the cardiovascular system. Arrhythmias or cardiac arrest are more likely to occur, especially in elderly patients with pre-existing heart conditions.
Managing Hypothermia in Elderly Trauma Patients
Given the severe implications of hypothermia in elderly trauma patients, preventing and managing hypothermia should be a priority in trauma care. Here are some strategies to mitigate the risks:
Early Recognition and Prevention: In emergency settings, it is essential to monitor elderly trauma patients for signs of hypothermia from the moment of injury. Simple interventions, such as providing warming blankets or using external warming devices, can significantly reduce the risk.
Warm Environments: Ensuring that the environment where the elderly patient is treated or transported is warm is crucial. Prehospital care teams should be trained to focus on temperature regulation, particularly in cold climates. A warming blanket can be applied at the point of consent in elective surgery cases.
Post-Surgical Care: After surgery, keeping patients warm and monitoring for signs of hypothermia is essential for successful recovery. Warming techniques should be continued in post-op care, with a focus on avoiding sudden drops in temperature, especially during prolonged immobility.
For instance, a THERARMOUR blanket can remain with the patient throughout their entire pathway.
How to use THERMARMOUR in trauma care
THERMARMOUR Emergency Blankets are incredibly versatile and can be used at various points during trauma care.
There are several factors in a trauma situation that can exacerbate the development of hypothermia – such as the severity of the injury, cold environmental temperatures, wet clothing, and traumatic hemorrhage, among others.
In situations such as these, there is often little time to assess the risk of hypothermia, as injuries need to be treated, and pain requires management. This is why we recommend using an Emergency blanket as soon as possible as a preventative measure.
When can THERMARMOUR be applied?
Ideally, THERMARMOUR is applied as soon as the casualty is reached. It can be of great benefit even if the patient has not yet shown symptoms of hypothermia. The warmth is comforting in shock situations, and the water and windproof outer protect against the elements.
At the scene of the incident
As hypothermia in trauma patients can worsen with environmental exposure, applying an Emergency blanket at the scene of an incident, before transportation to the hospital is extremely beneficial to the patient. [8]
As THERMARMOUR is designed to remain with the patient, the blanket can remain with the patient during triage, or when waiting for a bed.
During transportation in an ambulance
If application is not possible at the scene, it can be used during transportation to the hospital. When responding to an emergency, there may be difficult circumstances or a challenging environment that makes warming difficult.
In this case, THERMARMOUR Emergency blankets are easy to store in an emergency vehicle, the compressed packaging is designed to make the most of your storage. It may then remain with the patient as they await further treatment.
In an Accident & Emergency waiting area
In many situations, a trauma may not be life-threatening but needs further care. For instance, a broken bone can increase the likelihood of hypothermia developing, but cannot be seen straight away, perhaps due to delays, lack of staffing, or no available beds.
In cases such as these, with longer waiting and triage periods, a THERMARMOUR Emergency blanket can be applied in the A&E waiting room. This reduces the risk of further complications from hypothermia.
The benefits of using THERMARMOUR in Emergency care
Preventing hypothermia has cost and operational benefits, as well as improved patient comfort and outcomes. A patient who develops hypothermia requires more care, resources, and a longer hospital stay.
The simplicity of THERMARMOUR is a major benefit to the hospital, and the patient – as it does not rely on additional equipment, space, or an energy source to work effectively. Therefore, it can be applied anywhere, by anyone.
Other benefits include:
Easy to store due to compressed packaging
Soft fleece inner layer
Waterproof and windproof outer layer
High visibility levels – ideal for outdoor use
Requires no additional heat source to work
Cost-effective and simple to use
If you are interested in THERMARMOUR Emergency products, you can contact our team to discuss your needs.
Categories: Emergency
