scholarly journals IS AN EMERGENCY DEPARTMENT A SAFER PLACE FOR HYPOTHERMIC VICTIMS THAN AN AMBULANCE? A COMPARISON OF THE KNOWLEDGE OF MEDICAL PERSONNEL CONCERNING HYPOTHERMIA

2019 ◽  
Vol 72 (2) ◽  
pp. 209-215
Author(s):  
Paweł Podsiadło ◽  
Adam Nogalski ◽  
Sylweriusz Kosiński ◽  
Tomasz Sanak ◽  
Kinga Sałapa ◽  
...  

Introduction: Improper initial management of a victim in severe hypothermia is associated with a risk of cardiac arrest. At the same time, an uncontrolled drop in core body temperature in trauma victims is an independent risk factor for mortality. Medical personnel require a thorough understanding of the pathophysiology and treatment of hypothermia. Gaps in this understanding can lead to serious complications for patients. The aim: To compare knowledge concerning hypothermia between medical personnel working in emergency departments (ED) and emergency medical services (EMS). Materials and methods: A total of 5,362 participants were included in the study. In this study, EMS and ED personnel were encouraged to participate in an e-learning course on hypothermia. Subsequently, the scores of a pre-test, lesson tests and post-test completed by participants of this course were compared. Results: Pre-test scores were significantly higher among personnel working in EMS compared with those working in EDs. Nurses employed in EDs had significantly more failures in completing the course than EMS nurses. The most difficult topics for all practitioners were post-traumatic hypothermia and hypothermia-related clotting disorders. Conclusions: EMS personnel have a higher level of knowledge of hypothermia than ED personnel. Moreover, an e-learning course is an effective tool for improving medical personnel’s knowledge of hypothermia.

2021 ◽  
Author(s):  
Masahiro Fukuda ◽  
Masahiro Nozawa ◽  
Yohei Okada ◽  
Sachiko Morita ◽  
Naoki Ehara ◽  
...  

Abstract Background This study aimed to investigate the association between level of impaired consciousness and severe hypothermia less than 28°C among accidental hypothermia. Severe accidental hypothermia (AH) is a life-threatening condition, and early identification can enable transport to an appropriate medical facility. The Swiss staging system has been used to classify patients with AH, but little is known regarding the association between the level of impaired consciousness and core body temperature (BT) in AH. This study aimed to clarify the association between level of impaired consciousness and core BT and determine whether the level of impaired consciousness could be used to predict severe hypothermia and in-hospital mortality among patients with AH. Results The study included 505 of 572 patients in the J-point registry. Relative to mildly impaired consciousness (Glasgow coma scale (GCS) 13–15), the adjusted odds ratios for severe hypothermia were moderate (GCS9-12) 3.26 (95% CI: 1.69–6.25) and severe (GCS < 9) 4.68 (95% CI: 2.40–9.14) for severely impaired consciousness. Relative to mildly impaired consciousness (GCS 13–15), the adjusted odds ratios for in-hospital mortality were moderate (GCS9-12) 1.65 (95% CI: 0.95–2.88) and severe (GCS < 9) 2.10 (95% CI: 1.17–3.78). Conclusions The level of impaired consciousness in patients with accidental hypothermia may predict severe hypothermia and in-hospital mortality.


2019 ◽  
Vol 91 (2) ◽  
pp. 25-29
Author(s):  
Paweł Podsiadło ◽  
Sylweriusz Kosiński ◽  
Tomasz Darocha ◽  
Katherine Zerebiec ◽  
Przemysław Wolak ◽  
...  

Background: An unintentional drop in core body temperature of trauma victims is associated with increased mortality. Thermoregulation is impaired in these patients, especially when treated with opioids or anesthetics. Careful thermal insulation and active warming are necessary to maintain normothermia. The aim of the study was to assess the equipment and procedures for diagnosing and managing post-traumatic hypothermia in Polish hospitals. Methods: Survey forms regarding equipment and procedures on monitoring of core temperature (Tc) and active warming were distributed to every hospital that admits trauma victims in the Holy Cross Province. Questionnaires were addressed to surgery departments, intensive care units (ICUs) and operating rooms (ORs). Results: 92% of surgery departments did not have equipment to measure core body temperature and 85% did not have equipment to rewarm patients. Every ICU had equipment to measure Tc and 83% had active warming devices. In 50% of ICUs, there were no rewarming protocols based on Tc and the initiation of rewarming was left to the physician’s discretion. In 58% of ORs Tc was not monitored and in 33% the patients were not actively warmed. Conclusions: The majority of surveyed ICUs and ORs are adequately equipped to identify and treat hypothermia, however the criteria for initiating Tc monitoring and rewarming remain unstandardized. Surgery departments are not prepared to manage post-traumatic hypothermia.


2018 ◽  
Vol 115 (3) ◽  
pp. 501-509 ◽  
Author(s):  
Erik Sveberg Dietrichs ◽  
Torkjel Tveita ◽  
Godfrey Smith

Abstract Moderate therapeutic hypothermia procedures are used in post-cardiac arrest care, while in surgical procedures, lower core temperatures are often utilized to provide cerebral protection. Involuntary reduction of core body temperature takes place in accidental hypothermia and ventricular arrhythmias are recognized as a principal cause for a high mortality rate in these patients. We assessed both clinical and experimental literature through a systematic literature search in the PubMed database, to review the effect of hypothermia on cardiac electrophysiology. From included studies, there is common experimental and clinical evidence that progressive cooling will induce changes in cardiac electrophysiology. The QT interval is prolonged and appears more sensitive to decreases in temperature than the QRS interval. Severe hypothermia is associated with more pronounced changes, some of which are proarrhythmic. This is supported clinically where severe accidental hypothermia is commonly associated with ventricular fibrillation or asystole. J-waves in human electrocardiogram recordings are regularly but not always observed in hypothermia. Its relation to ventricular repolarization and arrhythmias is not obvious. Little clinical data exist on efficacy of anti-arrhythmic drugs in hypothermia, while experimental data show the potential of some agents, such as the class III antiarrhythmic bretylium. It is apparent that QT-prolonging drugs should be avoided.


2012 ◽  
Vol 26 (2) ◽  
Author(s):  
Joanna Pawlak ◽  
Paweł Zalewski ◽  
Jacek J. Klawe ◽  
Monika Zawadka ◽  
Anna Bitner ◽  
...  

2020 ◽  
Author(s):  
Tamil Selvi

BACKGROUND HIV infection is one of the most leading infections in the world. According to WHO HIV constitutes to be a major global public health issue, having claimed almost 33 million so far. There were an estimation of 38.0 million people living with the HIV at the end of 2019. As a result of concerted international efforts to respond to HIV , coverage of services has been steadily increasing. In 2019, 68% of adults and 53% of children living with HIV globally were receiving lifelong antiretroviral therapy (ART). There is no cure of HIV infections , however effective antiretroviral drugs can the control of virus and help onward transmission to other people. The knowledge regarding HIV infections in the public is a not much. The study focuses on the effectiveness of self instructional module on knowledge regarding the HIV among the drivers in Kancheepuram, Chennai. The objectives of the study was to assess the pre and post test of the self instructional module. For the study 60 samples were adopted by purposive sampling technique. The pre test was conducted by giving the structured questionnare then the module was given and then the post assessment was conducted. The study was conducted for 1 week. In the pre assessment 52(86.7%) were having inadequate knowledge and 8(13.3%) had moderately inadequate knowledge. In the post test 50(83.33%) had moderately adequate knowledge and 10(16.67%) has adequate knowledge. The effectivess of self instructional module was calculated by the paired t test (t=12.880) was found to be statistically highly significant at p<0.001 OBJECTIVE To assess the pre test level of existing knowledge on HIV among drivers. (2)To determine the effectiveness of self instructional module on HIV among drivers. (3)To find the association between the level of knowledge with their selected demographic variables METHODS Quantative research approach and pre experimental one group pre test post test design was used to assess the effectiveness of self instructional module on HIV to drivers. After obtaining permission from Saveetha College Of Nursing , the investigator selected 60 drivers by using purposive sampling technique. The sample who met the inclusion criteria were selected by purposive sampling technique . The investigator introduced and explained the purpose of the study to the samples and obtain the written confirmed. The purpose of the study were explained to the drivers. Section A: It consist of the demographic variables which include Age, sex, education. Occupation, monthly income, religion, marital status, type of family and dietary pattern.Section B- It consist 25 multiple choice questions to assess the effectiveness of self instructional module. RESULTS The drivers most of them 26(43.3%) were in the age group of 41 – 50 years, all 60(100%) were male, 45(75%) were private employee, 21(35%) had monthly income of 9000 – 11000 and above 11000 respectively, 45(75%) were married, 32(53.3%) belonged to nuclear family 45(75%) were non-vegetarian. Section B : Assess the pretest level of existing knowledge on HIV among drivers. The finding of the pretest 52(86.67%) had inadequate knowledge and 8(13.33%) had moderately adequate knowledge. Whereas in the post test, 50(83.33%) had moderately adequate knowledge and 10( 16.67%) had adequate knowledge on HIV among drivers CONCLUSIONS The findings revealed that the existing level of knowledge on HIV among drivers was improve the knowledge about HIV to be effective awareness by administered self instructional module


Sign in / Sign up

Export Citation Format

Share Document