Use of extracorporeal life support for active rewarming in a hypothermic, nonarrested patient with multiple trauma

A 53-year-old man was driving in the winter when he was involved in a single-vehicle collision in the early morning hours (around 4:30). The vehicle traveled down a six-meter embankment and struck several large trees. The man was not wearing a seatbelt and was ejected through the windshield, ending...

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Bibliographic Details
Published in:Canadian Medical Association journal (CMAJ) 2018-06, Vol.190 (23), p.E718-E721
Main Authors: Ting, Daniel K., MD, Brown, Douglas J.A., MD
Format: Article
Language:English
Subjects:
Blood pressure
Cardiac arrhythmia
Care and treatment
Case studies
Coma
Emergency medical care
Emergency services
Esophagus
Heart rate
Hospitals
Hypothermia
Intensive care
Internal Medicine
Life support care
Medical imaging
Medicine
Mortality
Patient outcomes
Patients
Practice
Surgeons
Trauma
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Summary:A 53-year-old man was driving in the winter when he was involved in a single-vehicle collision in the early morning hours (around 4:30). The vehicle traveled down a six-meter embankment and struck several large trees. The man was not wearing a seatbelt and was ejected through the windshield, ending up pinned under a tree. The ambient temperature was about -20°C. The initial assessment by the paramedics documented a Glasgow Coma Scale score of 8, a heart rate of 42, and a blood pressure of 61/43. They placed a tibial intraosseous line and intubated the patient under direct laryngoscopy. They measured an esophageal temperature of 23.5°C. The patient was transported via air ambulance under full spinal precautions to the regional trauma and extracorporeal life support center. Here, Ting and Brown report the case of a nonarrested patient with severe accidental hypothermia and multiple trauma who had a full neurologic recovery after undergoing extracorporeal life support for primary rewarming.
ISSN:0820-3946
1488-2329
DOI:10.1503/cmaj.180117