Facing Killer Heat, ERs Use Body Bags to Save Lives

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By JoNel Aleccia, Kaiser Health News

Thursday, July 22, 2021 (Kaiser News) -- As a deadly vigor question scorched the Pacific Northwest past month, overwhelming infirmary exigency rooms successful a portion unaccustomed to triple-digit temperatures, doctors resorted to a grim but applicable instrumentality to prevention lives: quality assemblage bags filled with crystal and water.

Officials astatine hospitals successful Seattle and Renton, Washington, said that arsenic much radical arrived experiencing perchance fatal heatstroke, and with cooling catheters and adjacent crystal packs successful abbreviated supply, they utilized the caller attraction to rapidly immerse and chill respective aged people.

Zipping heatstroke patients into ice-filled assemblage bags worked truthful good it could go a go-to attraction successful a satellite progressively altered by clime change, said Dr. Alex St. John, an exigency doc astatine UW Medicine’s Harborview Medical Center.

“I person a feeling that we’re looking astatine galore much days of utmost vigor successful the future, and this is apt to go much common,” helium said.

Despite the macabre connotation of assemblage bags, utilizing them is simply a cheap, convenient and scalable mode to dainty patients successful wide casualty emergencies caused by excessive heat, said Dr. Grant Lipman, a Stanford University prof of exigency medicine. He co-authored a pioneering lawsuit survey documenting the usage for heatstroke of what doctors telephone “human remains pouches.”

“When radical are this sick, you’ve got to chill them down fast,” Lipman said.

Heatstroke is the astir unsafe benignant of vigor illness, a aesculapian exigency that leads to decease successful up to a 3rd of hospitalized patients. It occurs erstwhile the assemblage overheats, either due to the fact that of exertion successful precocious temperatures oregon due to the fact that of prolonged vulnerability to vigor with nary relief. The halfway assemblage somesthesia rises to 104 degrees Fahrenheit oregon higher, which tin harm the encephalon and different organs.

Heatstroke tin beryllium peculiarly unsafe for children and older people, whose bodies don’t modulate somesthesia well. Also, aged radical whitethorn instrumentality medications that impair their quality to tolerate precocious temperatures.

Patients typically would beryllium treated with strategically placed crystal packs oregon misted with h2o and placed successful beforehand of immense fans. Some exigency country staffers immerse patients successful ample tubs of h2o oregon insert cooling catheters into the body’s ample veins.

During emergencies, however, equipment, crystal and clip whitethorn each beryllium successful abbreviated supply.

St. John treated astir 2 twelve heatstroke patients connected June 28, the hottest play of a six-day vigor wave, erstwhile temperatures successful Seattle changeable up to a record-breaking 108 degrees. That was much than he’d seen astatine 1 clip successful his decennary arsenic a doctor, including moving successful hospitals successful the Arizona desert, helium said.

Similarly, the University of Washington Valley Medical Center successful Renton saw much than 70 patients with heat-related illnesses, including 3 who were treated utilizing assemblage bags, said exigency section manager Dr. Cameron Buck.

“The ample fig who came successful precise rapidly taxed the system,” Buck said.

Overall, astir 2,800 exigency section visits for vigor unwellness were logged from June 25 done June 30 successful a portion that includes Oregon, Washington, Idaho and Alaska, including much than 1,000 connected June 28 alone, according to the Centers for Disease Control and Prevention. At slightest 112 deaths successful Washington and 115 deaths successful Oregon person been linked to the vigor wave, authorities officials said.

Among the sickest patients St. John saw was a pistillate successful her 70s who arrived astatine the Harborview ER connected June 28 confused and weak, with a halfway assemblage somesthesia of 104 degrees. A household subordinate had discovered her sick astatine home. St. John said a workfellow had mentioned the assemblage container method conscionable days earlier, truthful helium gave it a try.

The attraction involves filling a assemblage container with a slurry of h2o and ice, putting the diligent wrong and zipping the container conscionable up to the armpits to let entree for aesculapian instrumentality and adjacent monitoring. The self-contained container keeps the crystal and h2o adjacent to the patient’s skin.

Within respective minutes of being placed into the bag, the woman’s somesthesia dropped to 100.4 degrees, conscionable capable to “get her retired of that information zone,” St. John said. She was removed from the bag, dried disconnected and placed connected a gurney, allowing her body’s earthy cooling abilities to instrumentality over. After being admitted to the hospital, she recovered fully, helium said.

As the effects of clime alteration pb to hotter temperatures successful much places — including historically temperate zones wherever aerial conditioning isn’t successful wide usage — utilizing assemblage bags to rapidly dainty vigor unwellness is simply a logical solution, said Lipman, who directs Stanford’s Wilderness Medicine Fellowship and runs Global Outdoor Emergency Support, oregon GOES, which provides aesculapian guidance for outdoor travelers.

“Every infirmary has assemblage bags. Every infirmary has crystal machines,” Lipman said.

He and colleagues described the attraction of an 87-year-old pistillate with crab who was recovered unconscious successful a parking batch during a vigor question successful the San Francisco Bay Area, different portion not accustomed to sustained precocious temperatures. It was July 2019, which was past designated the hottest period recorded connected Earth. Using the ice-and-water-filled assemblage bags, doctors cooled her somesthesia from 104 degrees to 101.1 wrong 10 minutes. She, too, afloat recovered.

Immersing patients successful acold h2o has agelong been the golden modular for treating athletes with heatstroke caused by exertion, Lipman said. It’s the astir businesslike method, due to the fact that h2o conducts vigor distant from the assemblage astir 25 times faster than air.

For now, the assemblage container attraction has been studied mostly successful younger, healthier people, and immoderate doctors interest astir the effects of acold h2o connected older radical and whether the method mightiness induce shivering that really raises assemblage temperature. Lipman agrees further survey is needed but said his acquisition has recovered “the cooling benefits volition outweigh immoderate harm of shivering.”

And what astir patients who mightiness shudder astatine the thought of being zipped into a assemblage bag?

Because they’re mostly truthful sick erstwhile they get and get treated truthful quickly, it’s “unlikely they’re aware,” Lipman said, adding: “But you’d request to inquire them.”

KHN (Kaiser Health News) is simply a nationalist newsroom that produces in-depth journalism astir wellness issues. Together with Policy Analysis and Polling, KHN is 1 of the 3 large operating programs astatine KFF (Kaiser Family Foundation). KFF is an endowed nonprofit enactment providing accusation connected wellness issues to the nation.

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