Cooling blanket, shivering, & Magsulfate

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    what's the percentage of your patients actually shiver when used cooling vest? i've had my first one this week, and it's new to our unit. good thing there was an easy to follow protocol. is there a supported evidence or harm about the use of magnesium for shivering patients?
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  3. 10 Comments so far...

  4. 0
    Was the cooling blanket being used for fever or for post cardiac arrest hypothermia? I have never used magnesium for shivering patients. If we are using a cooling blanket for post cardiac arrest hypothermia, we generally sedate and paralyze the patient to prevent shivering.
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    Magsulfate was used for my patient who is on a cooling blanket after a traumatic brain injury. The shivering was not alleviated by Demerol and sedation, so MagSulfate is the next step. It's relatively new in our unit. I wonder if other neuro units have utilized this protocol. Thank!
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    Wow. We normally use the magnesium drip for the SAH to dilate the vessels and prevent vasospasms. For shivering we paralyze or sedate. We also give Buspar (Buspirone) for shivering. I didnt know MagSo4 had an effect on shivering?
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    Quote from jellybeanmead
    Wow. We normally use the magnesium drip for the SAH to dilate the vessels and prevent vasospasms. For shivering we paralyze or sedate. We also give Buspar (Buspirone) for shivering. I didnt know MagSo4 had an effect on shivering?
    wow mag gtts for vasospasm? this is interesting. Do you triple H? We give nimodipine q2-q4h and triple H....we also use sedation for shivering, demerol is no longer used at my facility.
  8. 0
    Quote from jensfbay
    Magsulfate was used for my patient who is on a cooling blanket after a traumatic brain injury. The shivering was not alleviated by Demerol and sedation, so MagSulfate is the next step. It's relatively new in our unit. I wonder if other neuro units have utilized this protocol. Thank!
    I don't know that I have ever had a pt shiver over sedation and demerol...geez
  9. 0
    I think most of our patients that are on cooling blankets we just sedate them to stop the shivering.
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    I've used a shiver protocol before, first warm palms of hands and bottoms of feet, which stops a lot of shivering; demerol could be used, but only to an established maximum dose; buspar was used; sedation and paralytics were last steps.

    I've read that mag sulfate increases the cooling rate and increases the comfort level of the patient but I've never used it in the cooling process. I know giving a lot of mag or giving it too rapidly can make your patient warm to hot feeling. I've also read that mag sulfate reduces the shivering threshold for patients.

    I'm looking for a good protocol. Anyone have one that they work with?
  11. 0
    We do not use mag sulfate for that!
  12. 0
    if the patient is vented then I just turn up the propofol. I havent really ever used a cooling blanket on a pt who wasn't pretty sick and intubated...


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