Foley Tubing as a Luer Adapter for Thoracic Lavage in Severe Hypothermia

Managing patients with severe hypothermia or hypothermic cardiac arrest presents unique challenges to emergency physicians as the prompt initiation of interventions rarely utilized in the emergency department (ED) are recommended. Patients with moderate hypothermia (34°C-30°C) without a perfusing rhythm, or severe hypothermia (< 30°C) should receive active internal rewarming. One recommended method for active internal rewarming is thoracic lavage.

Performing thoracic lavage presents several clinical challenges. Standard chest tube equipment does not have an i.v. tubing compatible connection port for instilling warmed fluids. Additionally, the traditional two-chest-tube approach requires placement of a lateral chest tube for drainage and an anterior chest tube to instill fluids, an uncommon ED procedure that may result in interruptions to chest compressions. We describe connecting Foley catheter tubing to easily allow infusion and drainage of warm fluids with a single, standard lateral chest tube.

Foley tubing can be used as a Luer adapter to easily instill warmed i.v. fluids and accurately monitor output through a single lateral chest tube during thoracic lavage. This approach may reduce the technical challenges, risks, and complications associated with the traditional two-chest-tube technique.