Treatment of trauma-associated hypothermia in children: evidence-based practice.
BACKGROUND
Hypothermia is a serious immediate consequence of traumatic injury in children. Although numerous studies have addressed the treatment of hypothermia in adults after trauma or surgery, few have examined this issue in injured children.


OBJECTIVE
To evaluate the research literature on when and how to treat hypothermia during emergency care of children with trauma and to apply these findings to clinical nursing practice.


METHODS
Electronic literature searches conducted periodically for 3 years yielded more than 50 publications on hypothermia and its treatment in trauma and surgical patients. Publications were grouped by cause of hypothermia and by warming methods. Single case reports and publications related to submersion injuries were excluded.


RESULTS
Three clinical trials of patients with head injuries included adolescents aged 15 years and older. One study compared peripheral and core warming methods used during operative management of infants and young children. Only one study evaluated core warming in children with trauma.


CONCLUSIONS
The treatments examined in the few research-based studies on the treatment of hypothermia during emergency care of children with trauma were given low recommendations. Although the warming methods were successful in selected surgical and adult patients, the methods cannot be recommended for treating children with trauma because of the lack of evidence-based findings.


CONCLUSIONS
Caution should be used when extrapolating published data on the treatment of hypothermia in injured adults to injured children. Ongoing clinical trials should evaluate in children with trauma those warming methods that have been used successfully in surgical patients.
Bernardo
L M
LM
School of Nursing, University of Pittsburgh, PA, USA.
Henker
R
R
O'Connor
J
J
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003422:Critical Care / Q000379:methods*; D016529:Emergency Nursing / Q000379:methods; D004638:Emergency Treatment / Q000379:methods* / Q000451:nursing*; D019317:Evidence-Based Medicine; D006358:Hot Temperature / Q000627:therapeutic use*; D006801:Humans; D007035:Hypothermia / Q000209:etiology* / Q000451:nursing*; D009104:Multiple Trauma / Q000150:complications*; D010371:Pediatric Nursing / Q000379:methods; D012307:Risk Factors; D013997:Time Factors