Environmental Medicine Flashcards
In hypothermic patient in asystole, what temperature do you have to re-warm up to before calling it?
32 degrees
What are the 2 categories of hypothermia?
Primary - Patient became hypothermic first
Secondary - Medical condition or something happened first then pt became hypothermic.
Distinguishing is important because in the first case if they are in arrest, there is a better chance of recovery. If the patient died first (ie. drowning, MI) then became hypothermic, survival is dismal.
At what temperature does cardiac arrest and arrhythmias become more prevalent?
32 degrees and risk substantially increases below 28 degrees
If Central line access is required in a hypothermic patient, what needs to be considered?
Go femoral as guidewire can precipitate arrythmias due to the agitated/fragile nature of the heart.
What is the best way to measure core temperature in hypothermic pt?
Esophageal probe.
- there have been discrepancies with rectal and core temps.
Why is hypothermia neuro-protective in a sense?
The brain has less oxygen and metabolic requirements when hypothermic and this is protective to damage.
How is potassium prognostic in hypothermia?
> 12 mmol/L CPR should be stopped. There has been no adult survivors with K >6.4
- there was one case of K 11.8 in a 13 month old child.
At what low temperature does critical coagulopathy occur?
34 degrees
In an avalanche victim typically how fast does the body cool?
9 degrees/hour
- typically good survival if burial time less than 35 minutes
