Body Warmers in Burn Patients: Safety Considerations
Body warmers should not be used directly on burn wounds due to the risk of further tissue damage, but may be used with caution to prevent hypothermia in burn patients when following specific safety protocols.
Risk Assessment for Body Warmer Use
- Burn patients are at high risk for both hypothermia and tissue damage from external heat sources 1
- When using any rewarming devices, first aid providers should follow manufacturer's instructions, place insulation between the heat source and skin, and frequently monitor for burns and pressure injury 1
- External cooling devices (e.g., Water-Jel dressings) should not be used for prolonged periods to limit the risk of hypothermia in burn patients 1
Safe Use of Body Warmers Based on Burn Severity
For Limited Burns (<20% TBSA in adults, <10% in children):
- Initial management should focus on cooling the burn with clean running water for 5-20 minutes to limit tissue damage 2, 3
- After appropriate cooling, burns should be covered with appropriate dressings to protect the wound from external contamination and limit heat loss 1
- Body warmers may be used to prevent hypothermia but must never be placed directly on burned tissue 1
For Extensive Burns (>20% TBSA in adults, >10% in children):
- Patients with extensive burns are at significant risk for hypothermia due to impaired thermoregulation and increased evaporative heat loss 4, 5
- Maintaining normothermia is critical as hypothermia is associated with increased mortality in severely burned patients 5
- Body warmers should only be used with extreme caution, ensuring proper insulation and monitoring 1
Proper Technique for Using Body Warmers
- Always place insulation (e.g., cloth) between the body warmer and the patient's skin 1
- Never place body warmers directly on burn wounds 1
- Monitor skin frequently for signs of impending burn injury (e.g., redness) 1
- Chemical warmers should not be placed directly on frostbitten or burned tissue because they can reach temperatures that can cause burns 1
Environmental Temperature Management
- Increasing ambient room temperature (75-95°F) is often preferred over direct body warmers for burn patients 6
- Burn centers commonly target a core temperature between 36-38°C in patients 6
- Maintaining normothermia helps mitigate the hypermetabolic response seen in burn patients 4, 7
Common Pitfalls to Avoid
- Avoid placing any heat source directly on burned tissue, as this can cause further damage 1
- Do not use body-to-body rewarming for active rewarming as it is less effective than other active rewarming techniques 1
- Avoid prolonged exposure of burn wounds during dressing changes to prevent hypothermia 1
- Be aware that burn patients have impaired thermoregulation and may not sense when a body warmer is too hot 4, 5
When to Seek Medical Attention
- Seek immediate medical care for burns that involve the face, hands, feet, or genitals 2, 3
- Seek immediate medical care for partial-thickness burns covering >10% body surface area (>5% in children) 2, 8
- Seek immediate medical care for all full-thickness (third-degree) burns 2, 3
- Seek immediate medical care if hypothermia is suspected (decreased level of responsiveness, mumbling speech, confusion) 1