Issn Print: 0090-3493
Publication Date: 2005/12/01
UTILIZING A HEATED, HIGH FLOW NASAL CANNULA SYSTEM TO WARM A NON-INTUBATED HYPOTHERMIC PATIENT IN THE EMERGENCY CENTER.: 278-M
Michael J Hewitt; Jamie S Hartley; Debra McGinnis; Maria Brooks
Excerpt
For years, various methods of rewarming hypothermic patients in the Emergency Center have been employed. The methods range from warm blankets to heated I.V. solutions via Rapid Transfuser to instilling warmed solutions directly into the chest via chest tubes. The utilization of the Vapotherm 2000i High Flow System for the purpose of rewarming a non-intubated hypothermic patient is an effec- tive option. The Vapotherm is a heated, and humidified nasal cannula system, capable of warm and humidified flows up to 40 lpm via spcially designed nasal cannula at FIO2's ranging from 21–100%. The patient is a homeless 59 yo male who was found down on an exceptionally cold Houston morning. The patient was confused and somewhat lethargic. PMH includes Diabetes Mellitus and Dementia. He appeared to have no obvious injuries. Vital signs were stable, but the patient was noticeably shivering and cold. Upon arrival in our EC, he was covered in warmed blankets and placed on a Bair Hugger device. A foley was placed revealing a core temperature of 89F. RT was contacted to assist with this patient. His RA saturation was 97%. His temperature rose to 90.7F after 45 minutes of the blankets and Bair Hugger. We placed the patient on the Vapotherm at a flow of 40LPM, FIO@ of 21%, and a temperature of 104F. The now coherent patient voiced no complaints throughout the treatment. The pt. was transferred to our MICU 1 hour and 40 minutes after the treatment began, with a core temperature of 95.6F. The Vapotherm was D/c'd upon arrival to MICU and his temperature normalized. This is the second successful application of this device in our Emergency Center. A formal, controlled trial of the Vapotherm as a warming device is indicated.
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