Explore the critical issue of hypothermia in trauma care, where even healthy patients cool rapidly! Learn about the four mechanisms of heat loss and practical strategies to counter them in the field. Discover common pitfalls that can exacerbate cooling, such as wet clothing and unheated ventilation. Hear real-world experiences from deployments that emphasize the importance of keeping patients warm. Additionally, find out about effective team-based interventions and the trade-offs between cold blood resuscitation and hypothermia management.
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Primary Mechanisms Of Heat Loss
The four main heat-loss mechanisms are radiation, convection, conduction, and evaporation.
Radiation accounts for 40–60% of heat loss and is driven by ambient surface temperatures to the fourth power.
volunteer_activism ADVICE
Raise Ambient Temp And Cover The Head
Keep the ambient temperature high and cover as much of the patient as possible, including the head.
Use fluid warming and underbody warming to reduce the anesthesia-induced redistribution dip.
volunteer_activism ADVICE
Use Small Structures To Trap Heat
If you can't heat the whole area, get the patient into a small insulated structure like a tent or inflatable shelter.
Trapping team and patient body heat inside the structure can raise ambient temperature dramatically.
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In this essential episode of the Prolonged Field Care (PFC) Podcast, host Dennis sits down with CRNA Kevin to dive deep into one of the most overlooked yet critical issues in trauma care: Hypothermia prevention and management. Even in warm environments, trauma patients can rapidly become hypothermic—leading to coagulopathy, increased bleeding, wound infections, and worse outcomes. Dennis and Kevin break down the science, real-world lessons from deployments, and practical strategies for austere and prolonged field care settings.
Whether you're a medic, provider, or anyone involved in combat casualty care, this episode will change how you approach keeping patients warm under fire or in remote locations.
Episode Highlights:
The four main mechanisms of heat loss: radiation (40-60% of total loss), convection, conduction, and evaporation—and how to counter each one effectively.
Why even healthy patients cool rapidly under anesthesia, and why trauma patients in the field are at much higher risk.
Practical tips for austere environments: using tents, inflatable structures, insulation from the ground, wool blankets, and body heat to raise ambient temperature.
Common mistakes that actively cool patients: wet clothing, cold airways (LMAs/ventilation), uncovered exposure, and cold blood/fluid administration.
Best bang-for-buck interventions: covering the head, minimizing exposure, drying the patient, using HME filters, and insulating from the ground.
Real deployed experiences: keeping trauma bays warm, pre-warming gear, using camping pads on litters, and limitations of Ready-Heat and HPMKs at altitude or in extreme cold.
Prolonged Field Care Podcast