trauma-list Digest

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Since the concern is for the PATIENT and not either the surgeons nor the other OR personnel, the room should be kept as close to normal body temperature as possible (37o C)
 
The problem is that the patient's ability to produce significant amounts of energy (ATP) to maintain their core temperature is significant compromised. This is a basic part of shock. Hypothermia is not a CAUSE of shock but a RESULT of anaerobic metabolism and the reduction of ATP production from 38 to 2. Since one of the results of shock and that associated hypothermia is coagulopathy, then until the patient is out is shock and able to keep them selves warm, it is our responsible as patient care providers to keep the patient as close to their functioning core temperature as possible. At a minimum that assists in solving part of the coagulopathy problem that the patient has in the OR.
 
ATP production and a warm patient obviously does other things than to simply reduce coagulopathy. Keeping the patient as warm as possible until they can take over their own heat control is important on all fronts
 
Norman
 
Norman McSwain MD
Trauma Director, Charity Hospital
Professor of Surgery, Tulane University
New Orleans LA
504 988 5111
norman.mcswain at tulane.edu <mailto:norman.mcswain at tulane.edu> 

________________________________

From: trauma-list-bounces at trauma.org on behalf of Patrick McSherry
Sent: Thu 5/1/2008 7:57 AM
To: trauma-list at trauma.org
Subject: RE: trauma-list Digest




Hello,

We are designing a new dedicated trauma O.R. in the mid-Atlantic states.
We have a question for which members of this group may be able to
provide some insight.

Specifically, the question of room temperature was discussed. The staff
has indicated a desire for the ability to raise the temperature of the
space above the usual norms, indicating that trauma patients are often
already compromised, often with an already low body temperature. The
desire is to not have the room contribute to a continuing lowering of
the patient's body temperature.

Our question is, what is the optimum high temperature your members
desire to see in their trauma operatories.

Thanks!

Patrick McSherry


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