Date of Award
Fall 11-11-2024
Degree Name
Masters of Science in Nursing
Department
Wellstar School of Nursing
Committee Chair/First Advisor
Dr. Crobarger
Second Advisor
Dr. Ruegg
Abstract
Abstract
Background: An estimated 30-50% of severely injured patients with traumatic injuries will experience hypothermia. As a result of hypothermia, several clinical manifestations such as impaired coagulation, dissociation of the oxygen curve, cardiac arrhythmias, reduced cardiac output and death. Little evidence has been published promoting specific patient re-warming protocols and the best rewarming methods, active versus passive. Few studies have focused on the pre-hospitalization treatment for hypothermia and the overall effectiveness of interventions to mitigate hypothermia to reduce morbidity and mortality. Given this knowledge, the aim of this integrative review (IR) is to research and evaluate current practices regarding hypothermia prevention and treatment to optimize patient outcomes.
Methods: 398 articles were across multiple databases (CINAHL, World of Science, Health Source, Cochrane, Medline/Pubmed, and Ovid for inclusions criteria. Inclusion criteria consisted of peer-reviewed articles published in English within the last 10 years and available for acquisition, included adult patients ≥ 18 that had a traumatic injury prior to arriving the to the hospital which also had hypothermia. Only high-rated articles were chosen with an A or B rating determined by the John Hopkins EBP Tool. The data was then summarized into a chart matrix located in Appendix B.
Results: The IR findings were organized by theme and subthemes and presented in Tables 1 & 2. Results showed that rewarming methods applied in addition to wet clothes removal significantly reduced the risk of morbidity and mortality. Additionally, early intervention and application of rewarming methods improved patient outcomes and survival rates. A key limitation is the lack of data on healthcare professionals' knowledge levels, leading to uncertainty about the reasons for not applying effective hypothermia interventions. This knowledge gap potentially skews study results. However, a strength of this review is the thorough use of comprehensive databases, allowing extensive research on hypothermia across various patient conditions, broadening conclusions while maintaining specificity.
Conclusions: This review evaluated current practices and data regarding hypothermia prevention and treatment in trauma patients, highlighting the importance of early recognition, prompt interventions, and rewarming techniques. The findings reveal a knowledge gap in effective hypothermia interventions, emphasizing the need for integrating temperature monitoring into patient care. Early interventions like removing wet clothing, using warm blankets, and warmed IV fluids can significantly reduce hypothermia severity. However, further research is necessary to establish effective guidelines and best practices across various settings.
Included in
Critical Care Commons, Critical Care Nursing Commons, Trauma Commons