Current practice of thermoregulation during the transport of combat wounded.
BACKGROUND
This study evaluated the progress in the treatment and prevention of hypothermia in combat wounded since the October 2, 2006 Joint Theater Trauma System Clinical Practice Guideline (CPG) publication and evaluated the frequency of use and effectiveness of the methods described in the CPG.


METHODS
The authors used data obtained from the Joint Trauma Theater Trauma Registry maintained by the US Army Institute of Surgical Research for our analysis.


RESULTS
The issuance of the CPG was associated with a decrease in the incidence of hypothermia (p value = <0.0001). None of the thermoregulatory methods were associated with significantly higher overall temperatures when compared with the others (p value = 0.1062-0.3686) or with hypothermia (p value = 0.1367-0.7992); however, lack of entered prehospital data resulted in a suboptimal number of patients for evaluation in this portion of the study. The wool blanket was the most commonly used thermoregulatory method (prehospital, 72%; interfacility, 49%).


CONCLUSIONS
(1) The incidence of hypothermia decreased after the issuance of the JTTS CPG. (2) The standard Army wool blanket is the most commonly used thermoregulatory method during transport in theater. (3) This study did not find a significant difference in the capability of maintaining temperatures between the different thermoregulatory methods used in theater during either prehospital or interfacility transport, or in the incidence of hypothermia between patients presenting from the site of injury or from interfacility transport. (4) Data collected before a Level III facility is not consistently entered into the Joint Theater Trauma Registry.
Nesbitt
Michael
M
Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas, USA. mike.nesbitt@us.army.mil
Allen
Paul
P
Beekley
Alec
A
Butler
Frank
F
Eastridge
Brian
B
Blackbourne
Lorne
L
D001512:Bedding and Linens / Q000706:statistics & numerical data*; D001833:Body Temperature Regulation / Q000502:physiology*; D006801:Humans; D007035:Hypothermia / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D008889:Military Personnel; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014187:Transportation of Patients / Q000379:methods*; D014481:United States; D014947:Wounds and Injuries / Q000150:complications* / Q000503:physiopathology