Accidental hypothermia SOP Flashcards
Outline the contents of the accidental hypothermia SOP
- Covers assessment and management of patients with accidental hypothermia
- Applies to patient with primary hypothermia moderate/severe or who are in arrest
- Patients not in arrest
- Patients in arrest
- Post ROSC Care
- Measurement of temp
Describe the approach to managing patients with hypothermia who are NOT in arrest
Remove wet clothes
Prevent further heat loss - blankets, warmer, blizzard
Minimise movement and invasive interventions
Consider a hospital that can do extracorporeal rewarming if: cardiac instability, temp <28, persistent hypotension
Describe the approach to managing patient with hypothermia who are in cardiac arrest
Prepare for prolonged resus - LUCAS and vent
Consider USS for cardiac activity
Remember ALS modifications
- shock VF 3 times then withhold until temp >30
- No adrenaline until temp >30
- Double interval between 30 and 35
Warm your fluids
Go to a centre with rewarming
TCC can assist with triage decisions and calling ahead
In what circumstances would you withhold resuscitation efforts in the context of hypothermia
Lethal injury/illness
Prolong asphyxia
Chest is incompressible
Describe the post-resus care of the patient with hypothermia
Prevent further heat loss - aim for 32 degrees
Move with care
Record 12-lead
Triage to extracorporeal re-warming centre
If temp sustained >32 could go to local ED
Define the temperature definitions of hypothermia
Mild 32-35
Moderate 28-32
Severe <28
At what core temperature does shivering cease?
32
At what core temperature do J-waves appear?
31
At what core temperature does susceptibility to VF increase?
28
At what core temperature does loss of voluntary movement occur?
27
At what core temperature does asystole occur?
19
