{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:13:21Z","timestamp":1777853601910,"version":"3.51.4"},"reference-count":9,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2017,9,21]],"date-time":"2017-09-21T00:00:00Z","timestamp":1505952000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Intensive Care Med"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec>\n                    <jats:title>Rationale:<\/jats:title>\n                    <jats:p>Despite guidelines advising passive rewarming for mild accidental hypothermia (AH), patients are frequently admitted to intensive care unit (ICU) for active rewarming using a forced-air warming device. We implemented a new policy at our institution aimed at safely reducing ICU admissions for AH. We analyzed our practice pre- and post-policy intervention and compared our experiences with acute care hospitals in Connecticut.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective chart review was performed on 203 participants with AH identified by primary and secondary discharge codes. Our new policy recommended passive rewarming on the medical floors for mild hypothermia (&gt;32\u00b0C) and ICU admission for moderate hypothermia (&lt;32\u00b0C). Practices of other Connecticut hospitals were obtained by surveying ICU nurse managers and medical directors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Over a 3-year period, prior to rewarming policy change, 64% (n = 92) of patients with AH were admitted to ICU, with a mean ICU length of stay (LOS [SD]) of 2.75 (2.2) days. After the policy change, over a 3-year period, 15% (n = 9) were admitted to ICU ( P &lt; .001), with an ICU LOS of 2.11 (0.9) days ( P = 0.005). In both groups with AH, altered mental status, infection, and acute alcohol intoxication were the most common diagnoses at presentation. Alcohol intoxication was more prevalent in the post-policy intervention group, pre 17% versus post 46% ( P &lt; .001). No complications such as dermal burns or cardiac arrhythmias were noted with forced-air warming device use during either time period. Among the 29 hospitals surveyed, 20 used active rewarming in ICU or intermediate care units and 9 cared for patients on telemetry units. Most hospitals used active external rewarming for core body temperature of &lt;35\u00b0C; however, 37% of hospitals performed active rewarming at temperatures &gt;35\u00b0Cor lacked a policy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Reserving forced-air warming devices for the treatment of moderate-to-severe hypothermia (&lt;32\u00b0C) significantly reduced ICU admissions for AH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0885066617731337","type":"journal-article","created":{"date-parts":[[2017,9,21]],"date-time":"2017-09-21T04:30:34Z","timestamp":1505968234000},"page":"91-94","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["A Guideline-Based Policy to Decrease Intensive Care Unit Admission Rates for Accidental Hypothermia"],"prefix":"10.1177","volume":"35","author":[{"given":"Herman R.","family":"Sequeira","sequence":"first","affiliation":[{"name":"Section of Pulmonary and Critical Care Medicine, Norwalk Hospital, Norwalk, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hesham E.","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Section of Pulmonary and Critical Care Medicine, West Virginia University, Charleston, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neal","family":"Hakimi","sequence":"additional","affiliation":[{"name":"Section of Pulmonary and Critical Care Medicine, Northwell LIJ Forest Hills, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorothy B.","family":"Wakefield","sequence":"additional","affiliation":[{"name":"Center on Aging, UCONN Health, Farmington, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Fine","sequence":"additional","affiliation":[{"name":"Section of Pulmonary and Critical Care Medicine, Norwalk Hospital, Norwalk, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,9,21]]},"reference":[{"key":"bibr1-0885066617731337","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1114208"},{"key":"bibr2-0885066617731337","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2015.07.017"},{"issue":"7","key":"bibr3-0885066617731337","first-page":"733","volume":"71","author":"Giesbrecht GG","year":"2000","journal-title":"Aviat Sp Environ Med"},{"key":"bibr4-0885066617731337","doi-asserted-by":"crossref","unstructured":"Danzl D, Pozos R. Accidental hypothermia. N Engl J Med. 1994. http:\/\/www.nejm.org\/doi\/pdf\/10.1056\/NEJM199412293312607.","DOI":"10.1056\/NEJM199412293312607"},{"key":"bibr5-0885066617731337","unstructured":"Schubert A. Side effects of mild hypothermia. J Neurosurg Anesthesiol. 1995. http:\/\/journals.lww.com\/jnsa\/Abstract\/1995\/04000\/Side_Effects_of_Mild_Hypothermia.21.aspx."},{"key":"bibr6-0885066617731337","first-page":"116","volume-title":"Wilderness medicine","volume":"2012","author":"Danzl DF","edition":"6"},{"key":"bibr7-0885066617731337","doi-asserted-by":"crossref","unstructured":"Pirnes J, Ala-Kokko T. Accidental hypothermia: factors related to long-term hospitalization. A retrospective study from northern Finland. Intern Emerg Med. 2016. http:\/\/link.springer.com\/article\/10.1007\/s11739-016-1547-y.","DOI":"10.1007\/s11739-016-1547-y"},{"key":"bibr8-0885066617731337","unstructured":"Albiin N, Eriksson A. Fatal accidental hypothermia and alcohol. Alcohol Alcohol. 1984. http:\/\/alcalc.oxfordjournals.org\/content\/19\/1\/13.short."},{"key":"bibr9-0885066617731337","doi-asserted-by":"crossref","unstructured":"Uzun G, Mutluoglu M, Evinc R, Ozdemir Y, Sen H. Severe burn injury associated with misuse of forced-air warming device. J Anesth. 2010. http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00540-010-1031-1.pdf.","DOI":"10.1007\/s00540-010-1031-1"}],"container-title":["Journal of Intensive Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0885066617731337","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0885066617731337","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0885066617731337","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:54:57Z","timestamp":1777503297000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0885066617731337"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9,21]]},"references-count":9,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,1]]}},"alternative-id":["10.1177\/0885066617731337"],"URL":"https:\/\/doi.org\/10.1177\/0885066617731337","relation":{},"ISSN":["0885-0666","1525-1489"],"issn-type":[{"value":"0885-0666","type":"print"},{"value":"1525-1489","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,9,21]]}}}