What is the PICOT question?
How does using of passive warming device (I) over the course of two hours (T) compared to use of current warming techniques (C) can help nurses to prevent hypothermia and the subsequent metabolic consequences that make up Triad of Death (O) when caring for the adult trauma patient (P)?
Definition of each element
P– (Patient, population, or problem): trauma patients in the emergency department with temperature not less than 35.5C
I– (Intervention): using of passive warming device (a battery operated warming blanket in conjunction with other available methods to prevent heat loss)
C– (Comparison with other treatment/current practice): using of current warming techniques (warmed blankets, warmed fluids, ambient room temperature)
O– (Desired outcome): an increase in core temp of at least 0.55C for every half hour of warming (primary) and have reduced rates of shivering or thermal discomfort (secondary)
T– (Time Frame): two hours
What is the practice issue/problem? What is the scope of the issue? What is the need for change?
Hypothermia therapy is recognized to be effective when applying to trauma patients with serious injuries leading to decrease of mortality cases. It is mostly used to prevent neurological injury and provide protection for patients with traumatic brain injury, stroke, and many other disorders. Monitoring of temperature in such patients is one of the basic techniques. Passive warming devices are believed to improve the effectiveness of keeping a patient warm after getting a serious injury because such traumas cause intensive heat loss. Still, there are no evidence-based approaches in managing trauma patients with hypothermia.
What is the practice area?
- Clinical
- Education
How was the practice issue identified?
- Safety/risk management concerns
- Unsatisfactory patient outcomes
- Clinical practice issue is a concern
What evidence must be gathered?
To study this issue properly, a research on the recent trends in hypothermia therapy should be made to understand the standpoint of other researchers and experts. A literature review of the relevant scholarly works is advisable to make. The guidelines regarding preferred and recommended warming techniques of the seriously injured patients should be checked as well. A financial analysis should be conducted to prove cost-effectiveness of the suggested technique, as well as a clinical expertise should be included to prove the decreasing of mortality after using passive warming devices for trauma patients.
- Literature search
- Guidelines
- Expert Opinion
- Clinical Expertise
- Financial Analysis
Search terms/How to narrow the search?
The key terms to narrow the search are: hypothermia therapy, serious injuries, intensive heat loss, traumatic brain injury, passive warming devices.
It is advisable to use various databases, search for scholarly and peer-reviewed articles less than five years old, keep the words of a searching phrase together by using quotation marks, and use the relevant key terms listed above.