chapter 12 pt7

Question 1

aetiology of hyperthermia

Answer 1

malignant hyperthermia - rare disorder of skeletal muscle calcium homeostasis - characterised by muscle contracture and life threatening hyper metabolic crisis
usually genetically predisposed to halogenated anaesthetics andepolarising muscle relaxants

impaired ability to sweat

hyperthyroidism

medication use - anticholinergic , sympathomimetics , calcium channel blockers

obesity

alcohol

Question 2

what is hyperthermia ?

Answer 2

> 37.5

Question 3

diagnosis of heat stroke

Answer 3

severe hyperthermic >49 degrees of core body temp

neurological symptoms - confusion , seizure , coma

exposure to high environmental temp or recent strenuous physical exertion

tachycardia, tachypnea , hypotension ,

syncope , dizziness , thirst

Question 4

clinical conditions presenting with increased core temp?

Answer 4

drug toxicity
drug withdrawal syndrome
serotonin syndrome
sepsis
neuroleptic malignant syndrome

Question 5

management of hyperthermia ?

Answer 5

transferred cool environment and laid flat

core temp checked
rapid cooling is safe = rapid cooling is achieved through immersion in cold water

or

misting , fanning , cool IV fluids , extracorp circuits

no specific drug for cooling

Question 6

complication of post resus hyperthermia ?

Answer 6

patient should be carefully monitored as relapse occurs in 25 percent of patients within 72h

Question 7

what to be considerate when doing resus in obese pt ?

Answer 7

manual ventilation with bag mask should be minimised
and should be performed by experienced staff using two person technique in order tp avoid gastric inflation

if supraglottiv airway is inserted then leaks may occur necessitating s tankard 30:2 compression ventilation ratio

experienced person should intubate trachea so that period of bag was ventilation is minimised