Cooling mattress
OVERVIEW
- mattress used for therapeutic active cooling
USES
Indications:
- hyperthermia
- post cardiac arrest
DESCRIPTION
- Depending on the device the blanket may be placed under the patient whilst others are placed over
- Usualy work by pumping cooled air or water through channels in a blanket
- Hoses allow attachment to a console supplying water/air and a means of cooling
- Flow designs ensure even heat transfer
- Gels and electric systems may be used
- Composed of various plastics; urethane is easily cleaned, non-porous, and difficult to puncture
- Automatic temperature feedback controls are typically used
METHOD OF USE
- Core temperature monitoring needed
- Sedation+/- neuromuscular blockade often required
- Other requirements vary with devices (e.g. minimal patient covering, a dry sheet, or a wet sheet with recurrent patient spraying)
- Devices may be combined to achieve efficient cooling and minimise side effects such as pressure areas
COMPLICATIONS
Hypothermia-related:
- Bradyarrhythmias
- Coagulopathy
- Hyperglycaemia
- Infection
- ileus
- hypotension on rewarming
Device-related:
- Skin hypoperfusion and pressure areas
OTHER INFORMATION
Contraindications
- hypothermia on admission
- haemodynamically unstable post arrest
- pre-existing coagulopathy or terminal disease
Intravascular devices
- more efficient temperature control
- more rapid cooling/heating
- expensive
- more invasive
Some devices can be used to cool and heat
Critical Care
Compendium
Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.
After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.
He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
His one great achievement is being the father of three amazing children.
On Twitter, he is @precordialthump.
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