Hypothermia is a medical emergency that occurs when your body loses heat faster than it can produce heat, causing a dangerously low body temperature. Normal body temperature is around 98.6 F (37 C). Hypothermia (hi-poe-THUR-me-uh) occurs as your body temperature falls below 95 F (35 C).
Defined as a core temperature <35 (measured via rectal or IDC probe).
· Increased basal metabolic rate
· Amnesia, dysarthria, ataxia, apathy
· Respiratory stimulation
· Normal BP
· Cessation of shivering
· AF & dysrhythmias
· Heart rate declines
· Insulin ineffective
· Gradual loss of consciousness.
.Absent reflexes & voluntary movements
.Major acid-base disturbances
.Risk of developing pulmonary oedema
Results in multiorgan failure 9renal failure & pancreatitis are common.
Shivering stops at 30.
Tachycardia is followed by bradycardia & hypotension. Arrhythmias are common & often refractory to treatment.
Asystole & VT occur spontaneously below 25.
Respiratory stimulation is followed by depression.
· Cold water emersion
· Dermatological conditions (burns, erythroderma)
· Vasodilating drugs (Especially alcohol)
· Elderly & neonates
· Endocrine failure
· Immobility & inactivity
· CNS disfunction (drugs, trauma, acidosis, anoxia).
· ABC’s as indicated
· Remove wet clothing
· Handle gently (rough handling causes dysrhythmias!).
· IV access
· FBC, U&E’s, sugars, CK, Amylase/ lipase, Coagulation studies, venous gases
· ECG (bradycardias, dysrhythmias & Osbourne waves- ST elevation in II & V6)
Start warmed IV fluids (insulate lines), consider warmed humidified oxygen
Keep in a warm environment with warm clothing, space blankets
“Bair Hugger” should be used if <32 with aim to rewarm at 1-2/hr
· Bradycardia & AF are common & usually revert with rewarming
· Other atria & transient ventricular arrhythmias should be ignored
· VF- defibrillation ineffective if <30,
CPR- CPR is difficult because of chest & myocardial compliance, DON’T COMMENCE if other lethal injuries are present.