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- W830784292 abstract "Every year over 62,000 people suffer severe injuries after a car accident in Germany alone. Both the personal traumatopathy for the patient and the economic costs are not inconsiderable. The Federal Statistical Office (Statistische Bundesamt) cites the annual sum of the incurred costs for treatment as 13.5 billion euros. Further expenses arise from the reduction in earning capacity due to the injuries incurred. Death and disability ultimately cause a total economic loss of 41 billion euros per annum (Statistische Bundesamt, 2012). Accidental hypothermia, which often accompanies the injuries, has a decisive influence on the course of the treatment within the hospital and is an independent mortality factor (Lier et al. 2007; Tryba and Leban 1996). Hypothermia is part of the “Trauma Triad of Death,” which describes the simultaneous occurrence of coagulopathy, acidosis and hypothermia and increases the mortality rate (Kashuk et al. 1982). According to a study by Helm et al. (Helm et al. 1995b), 49.6%, that is, every second trauma patient, is hypothermic when delivered to the emergency department of the admitting hospital. The severity of the hypothermia is independent on the outdoor temperature and weather influences. The target must thus be to prevent accidental hypothermia or at least to commence early rewarming. To date, there are however few approaches to rewarming the patient in the prehospital emergency care phase, excluding passive rewarming with blankets or the like. A possibility described in the literature is rewarming the patient with a halogen spotlight, as carried by firefighters and aid organizations as light source. The radiation should stabilize the patient’s body temperature. Another possibility described in many clinical studies is the use of convective air heaters, which are successfully utilized in intensive care and surgery within hospitals on a routine basis. These are however rarely used at the accident site to date. Studies on the efficacy of both methods under preclinical conditions are still lacking. This survey was to investigate this. For this purpose, we carried out a study on 30 healthy test subjects at a standardized ambient temperature of 3°C. The subjects had to participate in two study elements each, of which the first 21 minutes were always identical. During this time the participants sat – dressed in a t-shirt, shorts, socks, shoes and underwear – on a car seat and were exposed unprotected to the ambient temperature. This time was supposed to represent the delay in preclinical service between the time of the accident and the onset of emergency measures. This was followed by 39 minutes of rewarming with a halogen spotlight or convective air heater. Plastic foil was wrapped around the subject as hypothermia blanket during the rewarming with the convective air heater. The convective air heater selected was the “Polarn 4000” manufactured by Eberspächer, because this is intended for preclinical utilization. During the test period, the body temperature was measured at different predefined points every three minutes in addition to the monitoring of the heart rate, blood pressure and oxygen saturation. The result showed that rewarming with convective air heaters is highly effective and significantly better than with a halogen spotlight. Rewarming with a halogen spotlight did not lead to stabilization and an increase in body temperature could not be registered. The use of a convective air heater is basically also possible under preclinical conditions with the simplest of means. One criticism does however remain and that is the high temperature of the warm air generated. The manufacturer should improve this by incorporating a temperature control to prevent burning the patients. Until such time this method cannot generally be recommend in its current form." @default.
- W830784292 created "2016-06-24" @default.
- W830784292 creator A5004853748 @default.
- W830784292 date "2022-02-20" @default.
- W830784292 modified "2023-10-14" @default.
- W830784292 title "Vergleich präklinischer Behandlungsoptionen der akzidentellen Hypothermie nach Einklemmungstrauma - Eine Probandensimulation" @default.
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- W830784292 doi "https://doi.org/10.53846/goediss-4376" @default.
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