Side Note: Back in the late 70's when I was just a youngster in (back then) the "Inhalation Therapy Dept" in Portland Oregon there were several of us that were or had been involved in SAR and being in close proximity to Mt Hood where it was not uncommon for us to get hypothermic patients off the mountain. Being young, full of "can-do spirit" and interested in hypothermic resuscitation decided we were going to do something about it. There was a local Emergency Medicine/Cardiologist doc with some experience in Everest team medical management. We collaborated with him and developed a device called "Hot Oxygen Therapy" which consisted of a humidified, heated, closed-circle breathing circuit with a CO2 absorber and ability to add O2 into the circuit. We were able to monitor the circuit temperature and CO2 percentages and monitor the patients oxygen saturation level. The device was used via soft cushion mask held on via an anesthesia headset. (Today a Full Face CPAP mask would be perfect.) It was affectionately called the O2 Hotbox, was 10" square (footprint) and 14" tall.
With the help and contacts of Dr Bangs, we started using them, in transporting patients from the mountain to our facility in both air and ground transport. And it was working. The 304 Air Evac started carrying one on each of their aircraft (Huey's) and eventually we had 10 in local service, and had good results in each case with core temp resuscitations down into the low 80's. My recollection was that we did resuscitate a late 30"s female that was down to 75 core temp. I don't remember the lowest temp, or a lot of the other details. (Moving someone with that low a core temp has to be done very carefully because of the increased likelihood Ventricular Fibrillation due to clod shock syndrome). The initial warming could be done with the patient in the initially found position, before major moving.
The physiology was that inhaling warmed air (102 - 104 degrees) heated the core by having the warm air into the lungs and heating the blood thus warming the core. The warmed blood then perfused the body brain and periphery. It was faster than doing a peritoneal lavage with heated fluid, and less invasive so could be done in the field and during transport.
The US Coast Guard would not use them on their rescue craft due to the fact they could not be submerged or inverted 180 degrees, but they did have some on their helicopters for a while. We made about 200 IIRC and had them placed in Iceland, Norway, Montana, Idaho, and UK. Back then, it was easier to do that sort of thing. Now, there would be way too many lawyers in the way. I moved from Portland so lost track of what happened to the "HotBox" project before it ended.
So goes another "Back Then, Shoulda Woulda story.
Harvey
SleepyC :moon
