Nursing and medical staff knowledge regarding the monitoring and management of accidental or exposure hypothermia in adult major trauma patients

Authors

  • Sharyn Ireland RN Dip.HSc B.Nurs CritCareCert ACCN M.Ed,

    Corresponding author
    1. Clinical Nurse Specialist, Emergency and Trauma Centre, The Alfred, Melbourne, and Doctoral Student, La Trobe University, Melbourne, Victoria, Australia
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  • Katie Murdoch RN PostGradCert. Advanced Nursing Critical Care,

    1. Clinical Nurse Specialist, Emergency and Trauma Centre, The Alfred, Bayside Health, Melbourne, Victoria, Australia
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  • Paul Ormrod Cert-of-Tech-Teaching RN EmergCert B.Ed.St MBA,

    1. Clinical Nurse Educator, Emergency and Trauma Centre, The Alfred, Bayside Health, Melbourne, Victoria, Australia
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  • Emma Saliba RN B.Nurs CritCareCert Grad.Dip. Business Administration,

    1. Associate Charge Nurse, Emergency and Trauma Centre, The Alfred, Bayside Health, Melbourne, Victoria, Australia
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  • Ruth Endacott RN DipN MA(ResMeth) PhD(MedSci),

    1. Professor of Clinical Nursing, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia and Professor of Critical Care Nursing, University of Plymouth, Plymouth, UK
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  • Mark Fitzgerald MBBS FACEM MRACMA,

    1. Director, Emergency and Trauma Centre, The Alfred, Bayside Health, Melbourne, Victoria, Australia
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  • Peter Cameron MBBS MD FACEM

    1. Director of Research, Emergency and Trauma Centre, The Alfred, Bayside Health, Melbourne, Victoria, Australia
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Sharyn Ireland, Emergency and Trauma Centre, The Alfred, Bayside Health, Commercial Road, Melbourne, Vic. 3004, Australia. Email: sharyn_i@atronics.com.au

Abstract

Recording a patient’s vital signs is a basic requirement that in part informs clinical decision-making. Practice suggests that recording a trauma patient’s temperature is occasionally overlooked in the emergency department. A staff survey was undertaken to gain an appreciation of knowledge and understanding of the issues that surround accidental or exposure hypothermia in trauma patients. Results demonstrate that nurses and doctors are unsure of how to define hypothermia and are not conversant with simple ways to prevent heat loss or rewarm patients. Complications from hypothermia such as coagulopathy and metabolic acidosis were seldom identified. Issues that limit staff recording temperature include patient access and acuity, lack of knowledge and confidence and access to temperature-measuring devices. These results emphasize the need for regular education. Implications for clinical practice were considered; an algorithm to guide staff on ways to improve the monitoring and management of temperature in trauma patients was developed. Opportunities for ongoing and further research were identified.

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