Just a quick “Wrap-up” today. Lots of good talks about environmental emergencies today. Dr. Shin, during ICU conference, mentioned a video on EMCrit that showed a technique for placing the esophageal temperature probe using an ETT. Just wanted to share that video with everyone:
EMCrit Esophageal Temperature Probe Video
The big point for ICU conference was knowing how to prepare for a hypothermia (accidental not therapeutic!) patient and knowing what equipment you will need and how to setup the resus room. Would love to hear any comments from residents and faculty about their experiences dealing with hypothermia patients and what techniques you used to actively warm the patient including any tips or troubleshooting that was necessary in the process.
Happy Thanksgiving everyone! Please leave your comments below.
Thanks,
JK
Jay Khadpe MD
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One of the issues I had last time with mild hypothermia was the patient was on warmed fluids on the Level 1 but the fluids were not “wide open”. We did not want to flood the patient with fluid. We tried warm packs and warm blankets but the patient was persistently hypothermic. When checking the fluid’s temperature that was coming out of the Level 1, it was not warm because the flow rate was too low.
As we increased the flow rate, the fluid felt subjectively warmer, Pt was given 2L of warmed fluid at that time and the patient returned to normothermia.
Take Home point make sure that the level 1 gives the patient the appropriate temperature of fluid, in addition normal saline at room temperature will actually decrease core temperature.