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HealthDealing with Killer Heat, ERs Use Physique Luggage to Save Lives

Dealing with Killer Heat, ERs Use Physique Luggage to Save Lives

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By JoNel Aleccia, Kaiser Health News

Thursday, July 22, 2021 (Kaiser News) — As a lethal warmth wave scorched the Pacific Northwest final month, overwhelming hospital emergency rooms in a area unaccustomed to triple-digit temperatures, docs resorted to a grim however sensible instrument to save lots of lives: human physique luggage crammed with ice and water.

Officials at hospitals in Seattle and Renton, Washington, stated that as extra folks arrived experiencing doubtlessly deadly heatstroke, and with cooling catheters and even ice packs in brief provide, they used the novel remedy to shortly immerse and funky a number of aged folks.

Zipping heatstroke sufferers into ice-filled physique luggage labored so nicely it might turn into a go-to remedy in a world more and more altered by local weather change, stated Dr. Alex St. John, an emergency doctor at UW Medicine’s Harborview Medical Center.

“I have a feeling that we’re looking at many more days of extreme heat in the future, and this is likely to become more common,” he stated.

Despite the macabre connotation of physique luggage, utilizing them is an inexpensive, handy and scalable solution to deal with sufferers in mass casualty emergencies attributable to extreme warmth, stated Dr. Grant Lipman, a Stanford University professor of emergency medication. He co-authored a pioneering case examine documenting the use for heatstroke of what docs name “human remains pouches.”

“When people are this sick, you’ve got to cool them down fast,” Lipman stated.

Heatstroke is essentially the most harmful sort of warmth sickness, a medical emergency that results in dying in as much as a 3rd of hospitalized sufferers. It happens when the physique overheats, both due to exertion in excessive temperatures or due to extended publicity to warmth with no aid. The core physique temperature rises to 104 levels Fahrenheit or increased, which may injury the mind and different organs.

Heatstroke will be significantly harmful for kids and older folks, whose our bodies don’t regulate temperature nicely. Also, aged folks could take drugs that impair their capability to tolerate excessive temperatures.

Patients usually can be handled with strategically positioned ice packs or misted with water and positioned in entrance of giant followers. Some emergency room staffers immerse sufferers in massive tubs of water or insert cooling catheters into the physique’s massive veins.

During emergencies, nonetheless, tools, ice and time could all be in brief provide.

St. John handled practically two dozen heatstroke sufferers on June 28, the most well liked interval of a six-day warmth wave, when temperatures in Seattle shot as much as a record-breaking 108 levels. That was greater than he’d seen at one time in his decade as a physician, together with working in hospitals within the Arizona desert, he stated.

Similarly, the University of Washington Valley Medical Center in Renton noticed greater than 70 sufferers with heat-related sicknesses, together with three who have been handled utilizing physique luggage, stated emergency division director Dr. Cameron Buck.

“The large number who came in very quickly taxed the system,” Buck stated.

Overall, practically 2,800 emergency division visits for warmth sickness have been logged from June 25 by way of June 30 in a area that features Oregon, Washington, Idaho and Alaska, together with greater than 1,000 on June 28 alone, in accordance with the Centers for Disease Control and Prevention. At least 112 deaths in Washington and 115 deaths in Oregon have been linked to the warmth wave, state officers stated.

Among the sickest sufferers St. John noticed was a girl in her 70s who arrived on the Harborview ER on June 28 confused and weak, with a core physique temperature of 104 levels. A member of the family had found her ailing at house. St. John stated a colleague had talked about the physique bag approach simply days earlier, so he gave it a attempt.

The remedy includes filling a physique bag with a slurry of water and ice, placing the affected person inside and zipping the bag simply as much as the armpits to permit entry for medical tools and shut monitoring. The self-contained bag retains the ice and water near the affected person’s pores and skin.

Within a number of minutes of being positioned into the bag, the lady’s temperature dropped to 100.4 levels, simply sufficient to “get her out of that danger zone,” St. John stated. She was faraway from the bag, dried off and positioned on a gurney, permitting her physique’s pure cooling talents to take over. After being admitted to the hospital, she recovered absolutely, he stated.

As the consequences of local weather change result in hotter temperatures in additional locations — together with traditionally temperate zones the place air-con isn’t in vast use — utilizing physique luggage to quickly deal with warmth sickness is a logical answer, stated Lipman, who directs Stanford’s Wilderness Medicine Fellowship and runs Global Outdoor Emergency Support, or GOES, which offers medical steerage for outside vacationers.

“Every hospital has body bags. Every hospital has ice machines,” Lipman stated.

He and colleagues described the remedy of an 87-year-old girl with most cancers who was discovered unconscious in a car parking zone throughout a warmth wave within the San Francisco Bay Area, one other area not accustomed to sustained excessive temperatures. It was July 2019, which was then designated the most well liked month recorded on Earth. Using the ice-and-water-filled physique luggage, docs cooled her temperature from 104 levels to 101.1 inside 10 minutes. She, too, absolutely recovered.

Immersing sufferers in chilly water has lengthy been the gold commonplace for treating athletes with heatstroke attributable to exertion, Lipman stated. It’s essentially the most environment friendly methodology, as a result of water conducts warmth away from the physique about 25 instances sooner than air.

For now, the physique bag remedy has been studied principally in youthful, more healthy folks, and a few docs fear in regards to the results of chilly water on older folks and whether or not the approach would possibly induce shivering that really raises physique temperature. Lipman agrees additional examine is required however stated his expertise has discovered “the cooling benefits will outweigh any harm of shivering.”

And what about sufferers who would possibly shudder on the considered being zipped right into a physique bag?

Because they’re usually so ailing after they arrive and get handled so shortly, it’s “unlikely they’re aware,” Lipman stated, including: “But you’d need to ask them.”

KHN (Kaiser Health News) is a nationwide newsroom that produces in-depth journalism about well being points. Together with Policy Analysis and Polling, KHN is without doubt one of the three main working packages at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit group offering info on well being points to the nation.

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