Any kid who has ever drank a Slurpee too fast on a warm day, and found themselves shivering and chilled, knows that cold fluids can be remarkably effective at cooling the human body. I had this leason reinforced while I was working as a consultant for a bio-tech company. 
The company was looking for methods to induce and maintain therapeutic hypothermia.
I can disclose much about the different methods and results that the engineering team experimented with, but I will tell you this, if you want to drop someones core temperature fast, nothing is quite as effective as a quick, two litter bolus of cold saline. This is why most therapeutic hypothermia protocols begin by inducing hypothermia, not with some fancy cooling blanket or external cooling device, but an infusion of 37 degree saline.
With that thought in mind, how important should it be to keep the saline we infuse into our patients whom we want to keep warm at something close to body temperature? I hadn’t really given the question much thought until I got an email from Scott.
Scott’s one of those SWAT medic types. He works with his local SWAT team to provide on site medical interventions if the need arises. Scott had an interesting experience with an accidental infusion of ice cold saline. I’ll let Scott take it from here:
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In our last post we looked at some of the causes of hypothermia, both typical and atypical. Then we talked a bit about the recognition of the
hypothermia progression and what patients might look, feel and act like as they progress through their hypothermic condition.
Now let’s look at some of the guidelines for treating our hypothermia victims.
On the surface, treating hypothermia might seem deceptively simple. The treatment of mild hypothermia often is simple. Bring them in, stop the cooling and rewarm them. But as we progress into moderate and severe hypothermia, things get more complicated. Here are 12 guidelines to consider when the patient is more than just a little chilled.
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Treatment Guidelines For The Burn Patient
You’ve taken an educated guess on burn depth, calculated the burn area and classified the burns severity. With those priorities out of the way we can start treating the victim. (Yes, I’m taking some creative literary licence here, since assessment and treatment tend to occur in tandem.)
There are things we tend to do well and things we tend to do poorly in prehospital burn management. Here are some “do and don’t” type guidelines to direct your burn treatment.
Always consider the possibility of non - accidental trauma in pediatric burns.
Do:
Assess the heck out of the Airway.
- Inhalation burns are easy to miss if you’re not paying attention. Burn victims have a tendency to gasp when they are burned. You need to look really close at that airway. Shine a light on the patients facial hairs (yes women have them also) and look for singed or missing patches. Look up their nose and in their mouth for evidence of burns.
- Listen to the lungs and auscultate over the trachea. Reassess frequently. Only time will tell for certain if there is damage to the lower airway or lungs. Until then, you need to reassess frequently and don’t get caught behind the eight ball trying to manage an airway that goes down hill due to unrecognized burns.
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