Chpt 9 Care of Pt's w Environmental Emergencies HYPOTHERMIA

Question 1

What is Hypothermia?

Answer 1

is a core body temperature less than 95° F, or 35° C. An environmental temperature below 82° F (28° C) can produce impaired thermoregulation and hypothermia in any susceptible person, especially older adults.

Core temperature <86º F (30º C) is potentially life threatening.

Question 2

What is Mild hypothermia?

Answer 2

93.2 to 96.8 , manifested by shivering, dysarthria, muscular incoordination, impaired cognitive abilities, and cold diuresis
Lethargy, 
Confusion
Irrational behavior
Minor heart rate changes
Slurred Speech
decreased muscle coordination
Diuresis- shutting of blood to another organ.

Question 3

If Patient Dead from Hypothermia, what to do?

Answer 3

Warm patient to at least 90º F (32.2º C) before pronouncing dead Cause of death—refractory ventricular fibrillation.

Death may occur at 88F or below 83

Question 4

What Interventions/treatments are done for Hypothermia?

Answer 4

Manage and maintain ABCs
Rewarm patient
Correct dehydration and acidosis
Treat cardiac dysrhythmias

Question 5

What is Mild hypothermia: passive external rewarming?

First aid pre-hospital care

Answer 5

Passive external rewarming: move patient to warm, dry place; remove damp clothing; place warm blankets on patient

Question 6

What is Mild hypothermia: active external rewarming?

First aid pre-hospital care

Answer 6

Active external rewarming: body-to-body contact, fluid- or air-filled warming blankets, radiant heat lamps.

If hearing blanket is used then monitor pt’s skin q15-30 mins.

Drink warm high-carbonated liquids
Avoid ETOH and Caffeine, b/c peripheral vasodilators and will worsen effects of dehydration and hypothermia

Question 7

What are Hospital Care Methods to manage Moderate/ Severe Hypothermia?

Answer 7

1. Position the pt supine = prevents orthostatic changes in BP from cardiovascular instability
2. Administer drugs with caution/ spaced longer= metabolism is unpredictable when PT is cold, so when warmed, can lead to drug toxicity.
3. Withhold IV drugs, EXCEPT Vasopressor- which increases BP by constricting blood vessels, Till core temp is 86* or higher. Is used o manage shock, Hypotension, and PT’s in OR.
4. Pt’s in Ventricular Fib, 1 defibrillation attempt is appropriate. Defibrillation maybe ineffective oil core temp is 86*

Question 8

What is Moderate to severe hypothermia: active core rewarming 3 methods?

Answer 8

Use of heated, humidified oxygen
Warmed IV fluids
Peritoneal, gastric, or colonic lavage with warmed fluids

Question 9

What is After-drop? a risk of rewarming

Answer 9

a further drop in core temperature, once Pt is removed from cold environment, caused by cold blood from periphery to the central circulation.

PT’S TRUNK SHOULD BE ACTIVELY REWARMED B4 EXTREMITIES.

Question 10

Rewarming should be discontinued once core temp is?

Answer 10

95º F (35º C)

Question 11

What is the fastest core rewarming Technique?

Answer 11

Cardiopulmonary bypass

Question 12

What are early signs of complications after rewarming?

Answer 12

metabolic abnormalities
ARDS Acute respiratory distress syndrome
acute renal failure
pneumonia

Question 13

What temp should rewarming be discontinued?

Answer 13

95F ( 35C)