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Using Esophageal Temperature Management to Treat Severe Heat Stroke: A Case Report

BACKGROUND: Exertional heat stroke (EHS) is defined by a core body temperature that exceeds 40°C with associated central nervous system dysfunction, skeletal muscle injury, and multiple organ damage. The most important initial focus of treatment involves reduction of patient temperature. First appro...

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Autores principales: Martin, Katherine Riley, Naiman, Melissa, Espinoza, Maurice
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6948806/
https://www.ncbi.nlm.nih.gov/pubmed/31842028
http://dx.doi.org/10.1097/JNN.0000000000000488
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author Martin, Katherine Riley
Naiman, Melissa
Espinoza, Maurice
author_facet Martin, Katherine Riley
Naiman, Melissa
Espinoza, Maurice
author_sort Martin, Katherine Riley
collection PubMed
description BACKGROUND: Exertional heat stroke (EHS) is defined by a core body temperature that exceeds 40°C with associated central nervous system dysfunction, skeletal muscle injury, and multiple organ damage. The most important initial focus of treatment involves reduction of patient temperature. First approaches to achieve temperature reduction often include ice packs, water blankets, and cold intravenous fluid administration. When these measures fail, more advanced temperature management methods may be deployed but often require surgical expertise. Esophageal temperature management (ETM) has recently emerged as a new temperature management modality in which an esophageal heat transfer device replaces the standard orogastric tube routinely placed after endotracheal intubation and adds a temperature modulation capability. The objective of this case study is to report the first known use of ETM driven by bedside nursing staff in the treatment of EHS. METHOD: An ETM device was placed after endotracheal intubation in a 28-year-old man experiencing EHS over a 5-day course of treatment. RESULTS: Because the ETM device was left in place, when the patient experienced episodes of increasing temperature as high as 39.1°C, which required active cooling, nursing staff were able to immediately adjust the external heat exchange unit settings to achieve aggressive cooling at bedside. CONCLUSION: This nurse-driven technology offers a new means to rapidly deploy cooling to critically ill patients without needing to implement advanced surgical approaches or obstruct access to the patient, freeing the provider to continue optimal care in high-morbidity conditions.
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spelling pubmed-69488062020-02-04 Using Esophageal Temperature Management to Treat Severe Heat Stroke: A Case Report Martin, Katherine Riley Naiman, Melissa Espinoza, Maurice J Neurosci Nurs Case Study BACKGROUND: Exertional heat stroke (EHS) is defined by a core body temperature that exceeds 40°C with associated central nervous system dysfunction, skeletal muscle injury, and multiple organ damage. The most important initial focus of treatment involves reduction of patient temperature. First approaches to achieve temperature reduction often include ice packs, water blankets, and cold intravenous fluid administration. When these measures fail, more advanced temperature management methods may be deployed but often require surgical expertise. Esophageal temperature management (ETM) has recently emerged as a new temperature management modality in which an esophageal heat transfer device replaces the standard orogastric tube routinely placed after endotracheal intubation and adds a temperature modulation capability. The objective of this case study is to report the first known use of ETM driven by bedside nursing staff in the treatment of EHS. METHOD: An ETM device was placed after endotracheal intubation in a 28-year-old man experiencing EHS over a 5-day course of treatment. RESULTS: Because the ETM device was left in place, when the patient experienced episodes of increasing temperature as high as 39.1°C, which required active cooling, nursing staff were able to immediately adjust the external heat exchange unit settings to achieve aggressive cooling at bedside. CONCLUSION: This nurse-driven technology offers a new means to rapidly deploy cooling to critically ill patients without needing to implement advanced surgical approaches or obstruct access to the patient, freeing the provider to continue optimal care in high-morbidity conditions. Lippincott Williams & Wilkins 2020-02 2019-12-13 /pmc/articles/PMC6948806/ /pubmed/31842028 http://dx.doi.org/10.1097/JNN.0000000000000488 Text en Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Association of Neuroscience Nurses. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in anyway or used commercially without permission from the journal.
spellingShingle Case Study
Martin, Katherine Riley
Naiman, Melissa
Espinoza, Maurice
Using Esophageal Temperature Management to Treat Severe Heat Stroke: A Case Report
title Using Esophageal Temperature Management to Treat Severe Heat Stroke: A Case Report
title_full Using Esophageal Temperature Management to Treat Severe Heat Stroke: A Case Report
title_fullStr Using Esophageal Temperature Management to Treat Severe Heat Stroke: A Case Report
title_full_unstemmed Using Esophageal Temperature Management to Treat Severe Heat Stroke: A Case Report
title_short Using Esophageal Temperature Management to Treat Severe Heat Stroke: A Case Report
title_sort using esophageal temperature management to treat severe heat stroke: a case report
topic Case Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6948806/
https://www.ncbi.nlm.nih.gov/pubmed/31842028
http://dx.doi.org/10.1097/JNN.0000000000000488
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