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A Hypothermia Treatment Technology Web Site. |
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Alaskan Protocol|
An article written for the local Comox BC paper and also the Dolphin, the CCGA Pacific magazine.
Thanks to the kind donations of the Comox Valley United Way and the Cape Lazo Squadron of the Canadian Power and Sail Squadrons, the Comox Valley Marine Rescue Society has been able to purchase a new Res-Q-Air HT 1000 warm/ moist air hypothermia machine. The Comox Valley Marine Rescue Society is Canadian Coast Guard Auxiliary-Pacific Region Unit 60's (Comox) parent body. This machine was on board rescue vessel Bruce Brown II on Saturday 17 th May 2008 when the crew was tasked out on a rescue mission. The Res-Q-Air HT1000 treats a hypothermic patient by gradually warming them up from the “inside out”. The patient breathes in warm moist air (or oxygen) into their lungs and so the warm air gradually raises their core body temperature and any incoming cold blood from the patient's arms and legs.
Part of the standard procedure when you are on “duty crew” is to attend a two hour training session, normally some time over the weekend. This is in
addition to monthly and annual training. The topic for last Saturday's session was training on the new Res-Q-Air hypothermia machine. Our crew member
Mike Rutledge, who is an experienced paramedic, gave a very thorough briefing and demonstration on the machine. During this demonstration one of the
crew members was used as a "victim" with the latter breathing the warmed, moistened air from the machine, while the trainees watched and checked the
inhaled air temperature.
Four hours later the duty crew was called out (level 3 - Mayday - life in danger) to a small boat reported to be taking on water close to the rocks
near the Kingfisher Hotel; this is about 3 miles South of Comox Marina. When we got to the scene of the incident the lady crew member of the small boat
was in the water (wearing a life jacket) clinging to the side of the boat with the gentleman standing on the fore deck. We first got the lady out of
the water and on board our vessel, the Bruce Brown II, and then assisted the gentleman on board. We then took their boat in tow back to the Comox
Marina. It turned out that their boat's main motor and also the kicker motor had failed possibly due to fuel contamination or other mechanical failure;
it was their first trip out this year. Their boat was close to the shore and had been taking on water due to wave action rather than a damaged hull
but the crew had been forced to bail water out. The gentleman was hypothermic because he had spent an hour in the water prior to our arrival (and was
still in his wet clothing). He had been swimming with the boat trying to keep it clear of the rocks. Just before we arrived he had changed places with
his wife which is why she was in the water when we got there. She had been in the water for about half an hour at that time. What a way to spend their
anniversary! Our paramedic crew member judged that they were both hypothermic but the gentleman was worse as he was visibly shaking and looked a bit
blue and was cold to the touch. So they were both wrapped in blankets and the gentleman was treatment with the new Res-Q-Air hypothermia machine. By
the time that we had arrived back at the dock the he could feel his toes and was feeling and looking much better and declined an ambulance to the
hospital.
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“Frankly I'm still amazed at how the Res-Q-Air treatment went last week” says Mike Rutledge in his report of the tasking. “I've seen a lot of cold people and never seen anyone recover so quickly. The patient mentioned at one point how he could feel the warmth circulating into the lower legs and feet that he initially couldn't even feel. I've never heard anyone describe this before. Based on previous experience with people like him, I had every expectation (despite his protests) that we would be transferring him to an ambulance for assessment at St. Joseph's in Comox. He was very pale and cold to the touch everywhere except the sides of his chest. His radial pulse was initially a bit irregular and that had me concerned, however it resolved early in the rewarming. In chatting with the paramedics at work, everyone one is impressed with how rapidly things turned around for the patient. My experience with hot packs and blankets alone is that the shivering might stop but the patient would still be very cold and would head off for a long hot soak in the tub to get warm again. These folks often say that they feel cold for a day or so after the event. To see this fellow regain his color, warm right up, walk off the Bruce Brown II and trailer the boat we towed was unexpected to say the least!”
Fair winds and safe boating.
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Hi Christine
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" Dear Robert: We used your RES-Q-AIR unit on a severely hypothermic patient. My patient was a twenty-five year old male who had been treading water in Georgia Strait for three and a half to four hours before being recovered. I am pleased to report that the RES-Q-AIR unit was extremely effective in stabilizing this patient. The patient's colour, mental state and pulse all showed a marked improvement after twenty minutes of inhalation therapy. Thank you for supplying us with this most valuable piece of equipment. Sincerely, J P. Rescue Specialist, Canadian Coast Guard."
"Robert Douwens Dear Robert: Your "RES-Q-AIR" rewarming system has now been field tested by myself on a patient suffering from severe hypothermia. On July 26, 1993 Mr. (name withheld) was recovered from the Strait of Georgia after EIGHT hours of immersion. Rewarming of Mr.(X) was aggressive and very successful. Mr.(X) was brought from critical to stable within 40 minutes. For ambulance transport to hospital internal rewarming was continued using the RES-Q-AIR portable unit (no internal rewarming unit was available on the ambulance). In the final analysis, the RES-Q-AIR system proves to be the best all around internal rewarming system I have used to date. I.K. Rescue Specialist, Canadian Coast Guard."
"July 1999 The Effectiveness of the Res-Q-Air Treatment Unit. According to Bruce Paterson a Rescue Specialist with the Canadian Coast Guard, the following observations were made while using the Res Q Air System (model HT 1000) in a case of severe hypothermia. The case involves a Chinese migrant who was rescued off the coast of British Columbia in 1999. After having jumped ship, he and others had hiked through dense bush for an unknown period of time, seeking some form of civilization. The man was discovered exhausted and thoroughly disorientated. He was given a floater jacket and transported to the Coast Guard vessel, Tanu. On board were two doctors contracted by immigration Canada and Canadian Coast Guard Rescue Specialists Harold Slornan and Bruce Paterson. Due to fear of disease, the physicians chose to isolate the migrants from the rest of the ship and treat them on deck where a tarp had been rigged up to offer some protection. The migrant had lost consciousness enroute to the Tanu and was now in critical condition. The physicians concluded the man was suffering from life threatening severe hypothermia and possible dehydration. They recommended IV fluids but had none available. Another Coast Guard vessel in the area was radioed for help in getting IV fluids. One of the doctors attempted to get a heart beat reading by trying to find a radial pulse, not being successful, he suggested CPR. However, one of the Rescue Specialists, who from experience knew to take a carotid pulse reading when dealing with a hypothermic patient, detected a heart beat. Now with a correct cardiac reading, they decided to immediately hook the patient up to the Res Q Air hypothermia treatment Unit. As is frequently the case, the physicians were neither familiar with the unit nor its use. They had to be instructed in the use of this equipment and use of the tympanic thermometer for core temperature readings. The patient's core temperature was 93.2 degrees F, pulse carotid 40 strong and regular, pupils were constricted but equal and reactive to light. Respiration's were 8 and shallow. After diagnosing the patient, the heat packs were applied to the body and the life saving warm moist air of the Res Q Air was administered. As the temperature of the Res Q Air Unit increased to operating temperature, so did the patient's core temperature and pulse. A core temperature reading was taken every 5 minutes. During the first 10 minutes of treatment, the patient suffered back arching convulsions every 30 or 40 seconds. As his core temperature and pulse increased, he relaxed. After about 35 minutes the IV fluid arrived. However, the physicians had great difficulty in getting the needle into the cold collapsed veins. The fluid was at ambient temperature (on a warm but misty day). After approximately one hour on the Res Q Air unit, the patient recovered consciousness. The interpreter asked him if he was thirsty or hungry and he was given a few sips of water and vegetable broth. His temperature was around 95.5. degrees F. About 5 minutes later, the patient lapsed into unconsciousness and it was thought that it was a result of "after-drop". However, the battery output to the Res Q Air unit was dropping and there was insufficient warm moist air to keep the patient stabilized. His temperature had dropped to 94.2 degrees F and his pulse slowed to 52. The battery was quickly hooked up to the charger, after a few minutes the Res Q Air reached it's normal operating temperature, and the patients core temperature reacted accordingly and he regained consciousness. (Note from Res-Q Products Inc.: After about two and a half hours of treatment, with a core temperature of 96.6 degrees F and pulse at 60, it was agreed to Medivac him. His pupils were equal and reactive and respiration's were at 12. We were told the next day, that the man was up and around and in good shape. According to Canadian Rescue Specialist Bruce Paterson: "the Res Q Air unit was very effective in saving this man's life!"
The Res-Q-Air is used extensively by Canadian Coast Guard and other rescue professionals and has saved many lives.
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