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We have increasingly noted that patients with traumatic injuries attended by the paramedic response unit of the Durban University of Technology, South Africa are hypothermic. Daytime winter temperatures in Kwa-Zulu Natal remain warm, but nightly coastal temperatures drop to 4°C and as low as freezing inland.
An elderly man had been involved in a motor vehicle accident while being transferred to hospital by his family following an abdominal gunshot wound. Examination revealed: A, airway clear; B, respiratory rate 22/min; C, pulse >100/min and systolic BP 90 mm Hg; D, Glasgow Coma Score 15; E, temperature 34.1°C (tympanic). We minimised further exposure by positioning the response unit to act as a wind break and wrapping the patient in a space blanket while active rewarming was instigated with the application of a heating pad (DM EMG Diemme International, Italy). Warmed intravenous fluids were commenced at a keep open rate (as a radial pulse was palpable) while awaiting the …