Facing Killer Heat, ERs Use Body Bags to Save Lives

By JoNel Aleccia, Kaiser Health News

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

Officials at hospitals in Seattle and Renton, Washington, mentioned that as extra other people arrived experiencing doubtlessly deadly heatstroke, and with cooling catheters or even ice packs briefly provide, they used the unconventional remedy to temporarily immerse and funky a number of aged other people.

Zipping heatstroke sufferers into ice-filled frame luggage labored so smartly it would turn into a go-to remedy in a global an increasing number of altered via local weather exchange, mentioned 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 mentioned.

Despite the macabre connotation of frame luggage, the usage of them is an inexpensive, handy and scalable method to deal with sufferers in mass casualty emergencies brought about via over the top warmth, mentioned Dr. Grant Lipman, a Stanford University professor of emergency drugs. He co-authored a pioneering case find out about 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 mentioned.

Heatstroke is probably the most unhealthy form of warmth sickness, a clinical emergency that ends up in loss of life in as much as a 3rd of hospitalized sufferers. It happens when the frame overheats, both on account of exertion in prime temperatures or on account of extended publicity to warmth without a reduction. The core frame temperature rises to 104 levels Fahrenheit or upper, which will harm the mind and different organs.

Heatstroke can also be specifically unhealthy for youngsters and older other people, whose our bodies do not keep an eye on temperature smartly. Also, aged other people would possibly take medicines that impair their talent to tolerate prime temperatures.

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

During emergencies, then again, apparatus, ice and time would possibly all be briefly provide.

St. John handled just about two dozen heatstroke sufferers on June 28, the most up to date duration of a six-day warmth wave, when temperatures in Seattle shot as much as a record-breaking 108 levels. That was once greater than he’d observed at one time in his decade as a health care provider, together with operating in hospitals within the Arizona wilderness, he mentioned.

Similarly, the University of Washington Valley Medical Center in Renton noticed greater than 70 sufferers with heat-related sicknesses, together with 3 who had been handled the usage of frame luggage, mentioned emergency division director Dr. Cameron Buck.

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

Overall, just about 2,800 emergency division visits for warmth sickness had been logged from June 25 thru June 30 in a area that incorporates Oregon, Washington, Idaho and Alaska, together with greater than 1,000 on June 28 on my own, consistent with the Centers for Disease Control and Prevention. At least 112 deaths in Washington and 115 deaths in Oregon had been connected to the warmth wave, state officers mentioned.

Among the sickest sufferers John noticed was once a girl in her 70s who arrived on the Harborview ER on June 28 puzzled and vulnerable, with a core frame temperature of 104 levels. A circle of relatives member had came upon her sick at house. St. John mentioned a colleague had discussed the frame bag method simply days previous, so he gave it a check out.

The remedy comes to filling a frame bag with a slurry of water and ice, placing the affected person inside of and zipping the bag simply as much as the armpits to permit get entry to for clinical apparatus and shut tracking. The self-contained bag helps to keep the ice and water with reference to the affected person’s pores and skin.

Within a number of mins 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 mentioned. She was once got rid of from the bag, dried off and put on a gurney, permitting her frame’s herbal cooling talents to take over. After being admitted to the health center, she recovered absolutely, he mentioned.

As the consequences of local weather exchange result in warmer temperatures in additional puts — together with traditionally temperate zones the place air-con is not in huge use — the usage of frame luggage to impulsively deal with warmth sickness is a logical resolution, mentioned Lipman, who directs Stanford’s Wilderness Medicine Fellowship and runs Global Outdoor Emergency Support, or GOES, which gives clinical steerage for outside vacationers.

“Every health center has frame luggage. Every health center has ice machines,” Lipman said.

He and colleagues described the treatment of an 87-year-old woman with cancer who was found unconscious in a parking lot during a heat wave in the San Francisco Bay Area, another region not accustomed to sustained high temperatures. It was July 2019, which was then designated the hottest month recorded on Earth. Using the ice-and-water-filled body bags, doctors cooled her temperature from 104 degrees to 101.1 within 10 minutes. She, too, fully recovered.

Immersing patients in cold water has long been the gold standard for treating athletes with heatstroke caused by exertion, Lipman said. It’s the most efficient method, because water conducts heat away from the body about 25 times faster than air.

For now, the body bag treatment has been studied mostly in younger, healthier people, and some doctors worry about the effects of cold water on older people and whether the technique might induce shivering that actually raises body temperature. Lipman agrees further study is needed but said his experience has found “the cooling advantages will outweigh any hurt of shivering.”

And what about patients who might shudder at the thought of being zipped into a body bag?

Because they’re generally so ill when they arrive and get treated so quickly, it’s “not going they are mindful,” Lipman said, adding: “But you’ll wish to ask them.”

KHN (Kaiser Health News) is a countrywide newsroom that produces in-depth journalism about well being problems. Together with Policy Analysis and Polling, KHN is without doubt one of the 3 primary working systems at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit group offering knowledge on well being problems to the country.


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