FIELD “TRICKS OF THE TRADE” + ANECDOTAL “TROUBLE SHOOTING”

- Use RHB/active rewarming systems in maritime environment.
- On scene materials/clean trash bags or saran wrap may be helpful improvised insulation materials.
- Vehicle heating systems may help direct hot air to a patient in a field expedient Bair Hugger in certain platforms. This requires prior coordination and setup and is a non-standard equipment load.
- Use of thermal heat packs (crush packs, Ready Heat 1 Panel Blanket, MRE heater, even Foley bag in extremis) or body heat for fluid pre-warming (of most utility in Ruck-Truck-House phases when fluid warmers might be in short supply) Note: Do not place directly on skin to prevent thermal injury to patient.
- Expect issues with finger pulse-ox devices. If value shown does not correlate to patient presentation, remember to treat the patient, not the device. Taping heat pack over hand, but not in direct contact with the skin and device, may aid in accuracy/operation.
- In extreme cold weather (below -20°F), exhalation gas from intubated patients may cause ice to instantly form in the ET tube and vent tubing. Care should be taken to insulate all interventions while exposed to these conditions.