Unintentional injuries are the fourth highest cause of death forAmericans and lead to an estimated 28.1 million visits to emergencydepartments (EDs) yearly ( Heron, 2016 ). Many trauma patients arehypothermic, defined as body temperature of less than 36 ° C(96.8°F; Block, Lilienthal, Cullen, & White, 2012 ).Hypothermia has been reported in as many as two-thirds of alltrauma patients, of this, 9% present with body temperatures of 33 °C (91.4 ° F) or lower ( Farkash et al., 2002 ). Extensive evidenceexists on the association between hypothermia and increasedmorbidity and mortality for trauma patients ( Balvers et al., 2016; Ireland, Endacott, Cameron, Fitzgerald, & Paul, 2011 ; Keane,2016 ; Langhelle, Lockey, Harris, & Davies, 2010 ; Simmons,Pittet, & Pierce, 2014 ; van der Ploeg, Goslings, Walpoth,& Bierens, 2010 ; Zafren & Mechem, 2017 ). Along withmetabolic acidosisand coagulopathy, hypothermia is a factor in the“triad of death,” a cycle that can decrease the success ofresuscitation efforts ( Keane, 2016 ; Simmons et al., 2014 ).Hypothermia leads to peripheral vasoconstriction, followed bylactate buildup and acidosis ( Keane, 2016 ). In addition,hypothermia leads to a decrease in thrombin production, inhibitionof fibrinogen synthesis, and impaired platelet aggregation andadhesion. These deleterious effects are seen starting at bodytemperatures of 36 ° C (96.8 ° F) and progressively worsen withfurther temperature drops ( Martini, 2009 ; Mitrophanov, Rosendaal,& Reifman, 2013 ;Wolberg, Meng, Monroe, & Hoffman, 2004 ).Hypothermia increases risk for arrhythmias, which arefrequently
unresponsive to cardioactive drugs, electrical pacing, anddefibrillation ( Soar et al., 2010 ). Other associatedcomplications include multiorgan failure, pulmonary edema,hypoglycemia, hyperkalemia, and infection.
- What is the problem that the research is addressing?
- Why is this problem significant to nursing practice?
