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A Guideline-Based Policy to Decrease Intensive Care Unit Admission Rates for Accidental Hypothermia.

Herman R Sequeira1, Hesham E Mohamed2, Neal Hakimi3

  • 1Section of Pulmonary and Critical Care Medicine, Norwalk Hospital, Norwalk, CT, USA.

Journal of Intensive Care Medicine
|September 22, 2017
PubMed
Summary
This summary is machine-generated.

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A new policy reserving active rewarming for moderate-to-severe accidental hypothermia significantly reduced intensive care unit admissions. This change safely managed patients with mild hypothermia on medical floors.

Area of Science:

  • Emergency Medicine
  • Critical Care Medicine
  • Internal Medicine

Background:

  • Guidelines recommend passive rewarming for mild accidental hypothermia (AH).
  • However, patients with mild AH are often admitted to the intensive care unit (ICU) for active rewarming.
  • A new policy was implemented to reduce unnecessary ICU admissions for AH.

Purpose of the Study:

  • To evaluate the impact of a new policy on ICU admissions for accidental hypothermia.
  • To compare institutional practices with other acute care hospitals in Connecticut.

Main Methods:

  • Retrospective chart review of 203 patients with AH.
  • Policy recommended passive rewarming for mild AH (>32°C) and ICU admission for moderate AH (<32°C).
  • Survey of ICU nurse managers and medical directors at 29 Connecticut hospitals.
Keywords:
accidental hypothermiaactive rewarmingdermal burns

Related Experiment Videos

Main Results:

  • ICU admissions for AH decreased from 64% to 15% post-policy (P < .001).
  • Mean ICU length of stay decreased from 2.75 to 2.11 days (P = 0.005).
  • No complications were reported with forced-air warming device use.

Conclusions:

  • Reserving active rewarming for moderate-to-severe AH (<32°C) effectively reduced ICU admissions.
  • The policy change safely managed patients with mild hypothermia on medical floors.
  • Significant variation exists in rewarming practices among hospitals.