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Prehospital providers must be aware of the dangers hypothermia poses for their patients and treat it aggressively if it cannot be prevented. Hypothermia is defined as a core body temperature less than 95 degrees F (35 degrees C). [14]
The causes of hypothermia in trauma are multifactorial. One element not related to the trauma itself is heat loss through convection resulting from being exposed by prehospital providers in an attempt to identify and treat all of the patient's injuries. Another key contributing factor similar to this is the administration of room temperature IV fluids. It is also precipitated by the presence of acidosis. A study of combat casualties in Iraq in 2004 found that 91% of patients delivered to combat support hospitals were hypothermic.[5] Karim Brohi reported nearly 25% of trauma patients brought in to the emergency department were hypothermic upon delivery by prehospital personnel. [23] Preventing and controlling hypothermia in the trauma patient is crucial to ensuring their survival. Hypothermia is an independent contributor to mortality with trauma and is associated with a nearly 100% mortality rate in trauma when the patient's core temperature drops below 90 degrees F. [14]
Acidosis reduces efficiency in energy production, resulting in the inability to generate heat by shivering. This contributes to the lowering of the patient's core temperature and exacerbates the problems that the patient already faces secondary to the trauma.
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