Comparing Warming Methods in the Trauma Bay: A Multi-center Cohort Study

Area of Science:

• Emergency Medicine
• Trauma Care
• Thermoregulation

Background:

• Hypothermia is linked to adverse outcomes in trauma patients.
• Warming methods in the trauma bay require further evaluation.
• Effective temperature management is critical for trauma resuscitation.

Purpose of the Study:

• To compare the effectiveness of three warming methods in trauma patients.
• To evaluate blankets, forced air underbody warming mattress, and mattress with head cap.
• To determine the best method for preventing or treating cold stress in the trauma bay.

Main Methods:

• Multi-site retrospective cohort study (August 2023 - July 2024).
• Compared warming methods: blankets, forced air underbody warming mattress, mattress + head cap.
• Used Cox hazard models and cluster robust standard errors to analyze temperature data.

Main Results:

• For normothermic arrivals, the mattress showed no significant advantage over blankets.
• For cold-stressed arrivals, the mattress was 4.7 times more likely to achieve normothermia than blankets (p <0.001).
• Head cap use was limited by contraindications and impracticality in trauma settings.

Conclusions:

• Forced air underbody warming mattress is feasible and effective for correcting hypothermia in trauma patients.
• Blankets are less effective than the mattress for treating cold stress.
• Head caps are impractical for routine use in the trauma bay due to head injury prevalence and imaging needs.