In the face of the heat of the killers, ERs use body bags to save their lives
Thursday, July 22, 2021 (Kaiser News) – When a deadly heatwave last month scorched the Pacific Northwest, when emergency rooms in hospitals in a region not accustomed to triple-digit temperatures were overwhelming, doctors used a harsh but practical tool to save lives: ice and bags of the human body filled with water.
Officials at Seattle and Rentong (Washington) hospitals said more people could be found deadly heat stroke, and with poor cooling catheters and ice packs, they used the new treatment to quickly immerse and cool several elderly people.
Splashing patients with heat stroke in ice-filled body bags worked so well that climate change could become a treatment treatment in an increasingly changing world, said Alex St. Dr. John, emergency physician at UW Medicine’s Harborview Medical Center.
“I have a feeling we’re looking at more days of extreme heat in the future, and it’s likely to be more common,” he said.
Despite the macabre feel of body bags, it’s an inexpensive, convenient, and scalable way to treat patients in massive accidental accidents caused by excessive heat, said Dr. Grant Lipman, a professor of emergency medicine at Stanford University. It was a pioneering case study documenting the use of what doctors call “human footprint bags” for heat stroke.
“When people are sick, you have to cool them down quickly,” Lipman said.
Heat stroke is the most dangerous type of heat illness. One-third of hospitalized patients have a medical emergency that results in death. It occurs when the body warms up due to exertion at high temperatures or prolonged exposure to unrelieved heat. The body temperature rises to 104 degrees Fahrenheit or higher, which can damage the brain and other organs.
Heat stroke can be especially dangerous for children and the elderly because their bodies do not regulate their temperature well. Older people can also take medications that impair their ability to withstand high temperatures.
Typically, patients would be treated with strategically placed ice packs or misted with water and placed in front of giant fans. Some emergency workers immerse patients in large buckets of water or insert cooling catheters into large veins in the body.
In emergencies, however, equipment, ice, and time can be scarce.
San Juan treated nearly two dozen heat stroke patients on June 28, when it was the hottest time of the six-day heat wave, when Seattle temperatures hit a record 108 degrees. That said more than what he had seen in his decade as a doctor, including working in Arizona desert hospitals.
The Washington Valley University Medical Center in Renton also saw more than 70 patients with heat-related illnesses, including three who were treated using body bags, said emergency department director Cameron Buck.
“The large amount that came in very quickly taxed the system,” Buck said.
Overall, nearly 2,800 emergency medical visits were made from June 25 to June 30 in a region that includes Oregon, Washington, Idaho and Alaska, more than 1,000 on June 28 alone, according to the Centers for Disease Control and Prevention. State officials said at least 112 deaths in Washington and 115 deaths in Oregon have been linked to the heat wave.
San Juan saw a woman in her 70s who arrived at Harborview ER on June 28 confused and weak, with a body temperature of 104 degrees. A family member found the patient at home. San Juan said a colleague mentioned the body bag technique a few days earlier, so he tried it.
Treatment involves filling a body bag with water and an ice slit, inserting the patient inside and splashing the bag up to the armpits to allow access to medical equipment and close monitoring. The stand-alone bag keeps ice and water close to the patient’s skin.
A few minutes after entering the bag, the woman’s temperature dropped to 100.4 degrees, enough for San Juan to “get out of that danger zone.” They were taken out of the bag, dried and placed on a cart, allowing the body to acquire its own cooling capabilities. After being admitted to the hospital, he said he was completely healed.
The effects of climate change have led to warmer temperatures in more places (including warm areas with little use of air conditioning) using body bags as a logical solution to quickly treat heat illness, Lipman, who leads the Stanford Wilderness Medicine Fellowship, said. and provides global emergency assistance or GOES, which provides medical guidance for external passengers.
“Every hospital has body bags. Every hospital has ice machines, ”Lipman said.
Colleagues described the treatment of an 87-year-old woman who was found unconscious in a parking lot in a hot flash in the San Francisco Bay Area in another region she was not accustomed to experiencing high temperatures. It was July 2019, when it was named the hottest month on Earth. Using body bags filled with ice and water, doctors cooled the temperature from 104 degrees to 101.1 in 10 minutes. He, too, fully recovered.
Lipman said that immersing patients in cold water is the gold standard for treating athletes with heat stroke caused by exertion. It is the most effective method, as water carries heat from the body 25 times faster than air.
So far, the treatment of body bags has been studied mainly in younger and healthier people, and some doctors are concerned about the effects of cold water on older people and whether the technique can actually cause tremors that raise body temperature. Lipman acknowledged that more testing is needed, but said his experience “will outweigh the harms of shaking the benefits of cooling.”
And what about patients who may be horrified at the thought of getting into a body bag?
When they arrive and are treated very quickly because they are so sick, “they’re unlikely to know,” Lipman said, adding, “But you should ask.”
KHN (Kaiser Health News) is a national newsroom that produces in-depth health journalism. Along with policy review and survey, KHN is one of the three main operating programs of the KFF (Kaiser Family Foundation). KFF is a non-profit organization that provides information on health issues to the nation.