External warming

Emergency medical care often involves considerable patient exposure in an air-conditioned room, increasing thermal losses to the environment. Patients with burns or sepsis, those who are undergoing sedation, and those at the extremes of age, are at risk of developing hypothermia.

For most patients, providing a simple warmed blanket is adequate and will improve patient satisfaction as well as outcomes.

Active Warming / Bair Huggers

For patients who require more active warming, convective (forced-air) warming systems are readily available in most Emergency Departments.

To get started the following guides from the manufacturer are available:

Multimodal Approach

Patients should be managed in a warm environment and other warming modalities employed, such as warmed IV fluids or warm humidified oxygenation.

Hypotension Risk

In patients at higher risk for hypotension (including those with hypovolaemia, sepsis, or autonomic dysfunction), blood pressure can drop rapidly as the patient undergoes vasodilation in response to warming. Monitor these patients closely, and ensure that they are adequately fluid resuscitated. Also consider early initiation of vasopressors/inotropes if required.

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