In message <002401c0ac05$993b7b00$36b37ad5@oemcomputer>, Dave Fletcher
<[log in to unmask]> writes
> Hypothetically, - of course! - You are air-lifting a patient in
> cardiac arrest as a result of hypothermia. Would you overfly an A/E
> hospital with a helipad:-
> to a hospital 15 miles away without a helipad
> where the landing site is half a mile from the A/E door by road
> but the hospital does have by-pass facilities?
> Regards
> Dave Fletcher
Would it depend partly on degree of coldness, speed of cooling and state
of patient. These supposedly make a difference to how rapidly you need
to rewarm. Hypothetically, lets say you had a young, fit patient sudden
immersion in freezing water, core temp<25, arrested (what rhythm? - does
it make a difference to overfly or not?). This punter probably should be
rapidly and actively rewarmed, maybe on bypass. At other extreme, frail,
old patient slowly cooled down overnight at home, core temp say 29 (deg
C). Slower active rewarming at DGH (bear-huggers, warmed gases, warm
lavage etc.) might be a better bet than heroics 15 miles away.
What do the pre-hospital lobby say?
and later, you wrote...
>I am particually interested in the recommendations from the Resus council UK
>that
>state " In the patient with cardiac arrest and hypothermia, cardiopulmonary
>bypass is the preferred method of active internal rewarming......."
Is this another case of the resus council using "best guess" in the
absence of (or in spite of the) evidence.
Gautam
ps: can someone educate me as to whether it is bear-hugger (as in nice
warm cuddle from a furry mammal) or Bair-hugger (as in invented by
Professor Bair, no doubt - who he?).
Dr G Ray
Staff Grade
A&E
Sussex
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