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Facing Killer Heat, ERs Use Body Bags to Save Lives

By JoNel Aleccia, Kaiser Overall health News

Thursday, July 22, 2021 (Kaiser News) — As a lethal warmth wave scorched the Pacific Northwest previous thirty day period, too much to handle clinic unexpected emergency rooms in a area unaccustomed to triple-digit temperatures, medical doctors resorted to a grim but simple tool to preserve life: human physique bags filled with ice and h2o.

Officials at hospitals in Seattle and Renton, Washington, stated that as much more folks arrived enduring likely lethal heatstroke, and with cooling catheters and even ice packs in short supply, they employed the novel treatment method to rapidly immerse and cool many aged folks.

Zipping heatstroke individuals into ice-filled physique bags worked so well it could turn out to be a go-to treatment method in a earth increasingly altered by local climate modify, stated Dr. Alex St. John, an unexpected emergency medical doctor at UW Medicine’s Harborview Health-related Middle.

“I have a emotion that we’re wanting at quite a few much more times of extreme warmth in the foreseeable future, and this is possible to turn out to be much more widespread,” he stated.

In spite of the macabre connotation of physique bags, using them is a inexpensive, easy and scalable way to address individuals in mass casualty emergencies caused by too much warmth, stated Dr. Grant Lipman, a Stanford University professor of unexpected emergency medicine. He co-authored a groundbreaking scenario study documenting the use for heatstroke of what medical doctors simply call “human stays pouches.”

“When folks are this unwell, you have obtained to cool them down rapidly,” Lipman stated.

Heatstroke is the most perilous type of warmth disease, a healthcare unexpected emergency that potential customers to death in up to a third of hospitalized individuals. It takes place when the physique overheats, both simply because of exertion in high temperatures or simply because of prolonged exposure to warmth with no reduction. The main physique temperature rises to 104 levels Fahrenheit or larger, which can harm the brain and other organs.

Heatstroke can be specially perilous for small children and more mature folks, whose bodies really don’t control temperature well. Also, aged folks may perhaps choose medicines that impair their skill to tolerate high temperatures.

Patients usually would be handled with strategically placed ice packs or misted with h2o and placed in entrance of enormous enthusiasts. Some unexpected emergency room staffers immerse individuals in big tubs of h2o or insert cooling catheters into the body’s big veins.

All through emergencies, even so, tools, ice and time may perhaps all be in short supply.

St. John handled nearly two dozen heatstroke individuals on June 28, the hottest time period of a six-working day warmth wave, when temperatures in Seattle shot up to a record-breaking 108 levels. That was much more than he’d found at 1 time in his 10 years as a doctor, together with doing work in hospitals in the Arizona desert, he stated.

Equally, the University of Washington Valley Health-related Middle in Renton observed much more than 70 individuals with warmth-connected health problems, together with a few who were handled using physique bags, stated unexpected emergency section director Dr. Cameron Buck.

“The big amount who came in extremely rapidly taxed the technique,” Buck stated.

All round, nearly 2,800 unexpected emergency section visits for warmth disease were logged from June 25 via June 30 in a area that includes Oregon, Washington, Idaho and Alaska, together with much more than 1,000 on June 28 alone, according to the Centers for Condition Regulate and Prevention. At minimum 112 fatalities in Washington and 115 fatalities in Oregon have been joined to the warmth wave, state officials stated.

Amid the sickest individuals St. John observed was a lady in her 70s who arrived at the Harborview ER on June 28 baffled and weak, with a main physique temperature of 104 levels. A spouse and children member experienced learned her sick at residence. St. John stated a colleague experienced outlined the physique bag system just times before, so he gave it a check out.

The treatment method requires filling a physique bag with a slurry of h2o and ice, putting the affected person within and zipping the bag just up to the armpits to permit accessibility for healthcare tools and shut checking. The self-contained bag keeps the ice and h2o shut to the patient’s pores and skin.

In just many minutes of becoming placed into the bag, the woman’s temperature dropped to one hundred.four levels, just more than enough to “get her out of that hazard zone,” St. John stated. She was taken out from the bag, dried off and placed on a gurney, letting her body’s all-natural cooling skills to choose over. After becoming admitted to the clinic, she recovered totally, he stated.

As the effects of local climate modify lead to hotter temperatures in much more spots — together with traditionally temperate zones in which air conditioning isn’t in huge use — using physique bags to fast address warmth disease is a logical alternative, stated Lipman, who directs Stanford’s Wilderness Medicine Fellowship and operates World Outdoor Crisis Support, or GOES, which delivers healthcare advice for outdoor tourists.

“Every clinic has physique bags. Each individual clinic has ice machines,” Lipman stated.

He and colleagues described the treatment method of an 87-yr-previous lady with most cancers who was located unconscious in a parking large amount in the course of a warmth wave in the San Francisco Bay Location, yet another area not accustomed to sustained high temperatures. It was July 2019, which was then designated the hottest thirty day period recorded on Earth. Making use of the ice-and-h2o-filled physique bags, medical doctors cooled her temperature from 104 levels to one hundred and one.1 within 10 minutes. She, far too, totally recovered.

Immersing individuals in chilly h2o has long been the gold conventional for treating athletes with heatstroke caused by exertion, Lipman stated. It’s the most economical approach, simply because h2o conducts warmth absent from the physique about 25 instances quicker than air.

For now, the physique bag treatment method has been researched generally in more youthful, much healthier folks, and some medical doctors be concerned about the effects of chilly h2o on more mature folks and whether or not the system may well induce shivering that truly raises physique temperature. Lipman agrees more study is desired but stated his encounter has located “the cooling positive aspects will outweigh any hurt of shivering.”

And what about individuals who may well shudder at the thought of becoming zipped into a physique bag?

Due to the fact they are normally so sick when they arrive and get handled so rapidly, it is “unlikely they are aware,” Lipman stated, adding: “But you’d require to ask them.”

KHN (Kaiser Overall health News) is a nationwide newsroom that provides in-depth journalism about overall health challenges. Jointly with Coverage Assessment and Polling, KHN is 1 of the a few key operating courses at KFF (Kaiser Household Basis). KFF is an endowed nonprofit group supplying info on overall health challenges to the nation.