Even on the sweltering afternoons of a Texas summer, hypothermia can pose a threat to trauma victims. That's a function of both injury severity and environmental factors (for instance, being hurt in a briskly cooled building), and optimal patient management requires limiting that heat loss.
That need was on the minds of Harris County emergency leaders when they became the first in Texas to carry fresh plasma and packed red blood cells to transfuse patients in the field.
"We know trauma patients need to stay warm and we need to watch for hypothermia," says Eric Bank, assistant chief of EMS for Harris County Emergency Services District 48 in the Houston area. "People look at me like I'm crazy when I say that, because we're in southeast Texas, where it's 75 degrees in February. But with air-conditioned environments and their loss of blood volume, we have to keep them warm, which means being able to warm the blood before we give it."
For that they chose the buddy lite AC from Belmont Instrument Corp. The buddy lite is a portable blood and fluid warmer originally developed for the military. The military is still its biggest user, but the device's rugged construction, light weight (1.6 lbs.) and compact size well-suit it for EMS work too, in both the air and now the field.
"It's very simple to use--there aren't a whole lot of controls to it," says Bank. "The system is easy to prime and easy to transfer over. Neither the device itself nor the extension set is overly heavy. It's very safe; it's not going to overheat the fluid, and because it's sealed, there's not a big chance of cross-contamination."
Additional features include close-to-patient warming (with less than six inches of tubing between the heater and cannulation site, cool-down is reduced) and automatic air removal (the buddy lite disposable has a microporous membrane that vents air through the side while allowing fluid through).
Texas responders envisioned using the buddy lite and field transfusions primarily on trauma patients. Instead a number of medical patients have benefited from the advance as well.
"Going back and looking at the numbers, it's been probably 4-to-1 medical to trauma patients," says Bank. "That's been an unexpected benefit."