I’ve been watching the British series 24 Hours in A&E. Each episode (documentary) shows 24 hours in the ER department of King’s College Hospital in London. I love it - it’s very interesting.
I have noticed that quite often, when a patient is brought in by the EMTs they are wrapped in bubble wrap. As the doctors are working on the patient, there are voluminous amounts of bubble wrap hanging off the gurney. I have never seen or heard of this before. Is it a common thing? Why is it used? Is it used in the US also? Are the ambulances equipped with giant rolls of bubble wrap?
For the second successive year, family-run Sussex Transport will provide a year’s supply of the life-saving plastic sheeting which is used to keep each patient warm on their journey to hospital.
Air Ambulance Head of Corporate Relations Cheryl Johnson said: “It has been discovered that traumatised patients, even in very hot environments, lose their body heat rapidly.
“When this happens blood clotting takes longer and Bubble Wrap provides the most effective means of preserving body heat. It can therefore make the difference between bleeding to death and survival.”
I’ve never seen it used. And I wouldn’t think England sees an enormous volume of hypothermia patients compared to Canada. It would take time to apply that could be spent on other things. In most cases it would need to be removed to visualize limbs, and this might require moving them and be potentially painful.
However, were the ambulance engaging in a side hustle…
One link refers to air ambulances. This could be a different matter. Maybe landing is hard on broken limbs. Even then I see few routine uses but have much less experience here.
I think from the “It has been discovered that traumatised patients, even in very hot environments, lose their body heat rapidly” line, I suspect they’re talking about shock, not the usual sort of hypothermia.
Shock means that organs aren’t being perfused with oxygen. People get cold, but blankets are quick to apply and easy to sterilize. Sometimes BairHuggers, warm IV fluids, warm catheter flushes, etc. are applied but the priority is to get them to a higher level of care quickly. Remember, cold is often protective for some conditions like heart attack or neurological injury and rewarming can cause other damage if it is not gradually done.
I’m not saying it could not have some uses. But I don’t think it is commonly used, haven’t seen it despite thousands of hours travelling in the back of land ambulances, and would not think it greatly helpful for most prehospital treatments. I’m not saying it couldn’t reduce discomfort or vibration during flying or help with specific things.
For shock itself, a number of garments developed for military use on the field, such as Mast Trousers, have not been proven very effective.
That’s a good observation. In the show, I see the patient being wheeled into the ER from the ambulance and they are wrapped like a mummy in bubble wrap. They never show how the docs get it all off. The next thing I see is the patient lying on the gurney with yards of bubble wrap draped down to the floor or some of it sticking up. It looks to me that it’s in the way. I can’t imagine that they unroll the patient, they must have to cut it. But like you say it could be pretty painful having it removed. I’d like to see how the EMTs even get it wrapped around the patient.
It might be different if the air ambulance is transferring patients between hospitals in some specific case where research has shown it helps. It sounds more like a research experiment to me. In this case, the patient has been presumably stabilized, given pain medicines and possibly intubated. No doubt you can cut plastic off. But this takes time and still needs movement, and time is at a premium. You’d need proven benefit to want to do it.
Maybe adding padding to a spinal board makes it more comfortable, but that was never the point of them. The thing about emergencies is they tend to like tried and true stuff, some of which is older, because it is thought to work and due to litigation concerns.
If someone breaks their leg, the first order of business is to check the distal pulses, assess the nerve roots (reflexes, motor, sensory), see if there is an open wound (gashes exposing bone are easily infected so open fractures generally involve orthopaedics and an O.R), often pull on anything displaced (usually, not always, after imaging, not necessarily prehospital)… how do you do that through padding? It’s not like a broken leg is banging around on a traditional stretcher…
Paramedics will usually reset the bone before removing the patient and they carry the required equipment. Once reset, the leg will be secured in a vacuum splint and then put on a board, before being transferred to a helicopter.
Bubble wrap is used as insulation rather than padding. “Traumatised patients lose their body heat rapidly and bubble wrap provides a practical and disposable means of preserving body heat. It is most often used when the casualties are hill climbers or walkers.
Some of the medical staff who crew the helicopters served in Afghanistan where the material’s effectiveness as an insulator was amply demonstrated.
As an aside > If you really want to have fun with bubble wrap, lay it on the floor and drive a forklift truck over it. It sounds like a machine gun.
