ABSTRACT
OBJECTIVE: Infusion of cold fluids in a patient leads to a reduction of core temperature and subsequently worsens hypothermia. We evaluated the efficacy of a newly developed self-warming insulation device for use in pre-hospital rescue. METHODS: We studied 50 trauma patients with a rescue time of more than one hour. They were randomly assigned to either infusions taken directly from a warming box in the ambulance (Group A, n = 25) or infusions taken from the warming box and packed in an insulation device (Group B, n = 25). We recorded ambient temperatures, infusion temperatures in five-minute-steps and transport duration of the infusions from the ambulance to the site of accident. RESULTS: Ambient temperatures and transport duration did not differ significantly between both groups. In Group A the infusion temperature decreased from 36.0 +/- 6.4 degrees C to 19.8 +/- 6.8 degrees C during the transport from the ambulance to the site of accident. In Group B infusion temperature decreased only about 1 degree C. In Group A the temperature of the infusion continued to decrease until the end of measurements. In contrast in Group B the infusion temperature even increased by 0.5 degree C over the measurement period. These differences between the two groups were statistically significant. CONCLUSIONS: Our data show that even pre-warmed infusions from a warming box cool down considerably before they can be given to the patient. A self-warming insulation device can stabilize infusion temperature even under extreme conditions of prehospital trauma care.
