Hyper and Hypo Thermia Flashcards
past what age does thirst sensation decline?
50
a core temp over what is hyperthermia?
105 F
list some complications of heat stroke
Myocardial damage
renal failure
seizures
hepatocelullar necrosis
with early hyperthermia will you sweat?
Yes but not with late
Why do elderly have difficulty with temp regulation?
Loss of diurnal variation (rise)
Diminished sweating
Abnormal vasoconstrictor response
What is hypothermia?
Core temp < 35C or < 95F
increased heat loss with decreased heat production
Early signs of hypothermia
Fatigue, weakness, slowed gait, cool skin, shivering
Moderate signs of hypothermia
Cold skin, cyanotic, bradycardia, arrhythmia, hypotensive, hypo-reflexive, slowed pupillary rxn
Severe signs of hypothermia
Areflexia, fixed pupils, apneic, non-responsive, v. fib
What is a key finding of hypothermia?
J wave (Osborne wave) follows the QRS complex
Other labs that treat hypothermia
CMP, BUN, creatinine, clotting factors, CBC, urine/serum toxicity screens, thyroid, cardiac enzymes
Treatment of hypothermia
Warm IV fluids, warm core before limbs, anticipatory monitoring
What are anticipatory monitoring in hypothermia?
Metabolic acidosis
Cardiac decompensation/arrhythmias
Hyperkalemia, hypoglycemia
Renal failure
What is numb, swollen, erythematous area?
Frostnip (non-freezing)
Distal extremities & exposed skin
Cold, hard, white & numb; dry vs. wet gangrene
Frostbite
pale, edematous, clammy, cold, numb foot/feet
Immersion foot (non-freezing)
How do you treat frostnip, immersion foot, frostbite?
Rewarm
Wound care in frostbite
What is passive treatment for hypothermia and what temp should it be done at?
> 32 C or 89.6 F, evidence shivering
Remove wet clothes and from cold env’t
Warm fluids, heated blankets
What is active treatment for hypothermia and what temp should it be done at?
< 89.6F (also cardiac instability,toxin, trauma, or co-morbidity)
Heated and humidified O2
Warmed IV infusion (Lavage or ECR)
How to prevent hypothermia?
Warm layered clothing Wind protection & moisture wicking Foot wear allows for circulation Head covering Community outreach
What is hyperthermia?
Core temp > 40.6C or >105F
increased heat input with decreased heat output
Dizzy s/p exercise/exertion in hot weather
Pale & sweaty, moist & cool skin, HR increased, core temp normal
Heat syncope
Treatment for heat syncope and heat fatigue
rest, oral rehydration, cooler & less humid environment
Weakness, dizzy, HA, malaise, NAUSEA, syncope with prolonged standing in heat
PE: appear tired, sweaty, tachycardia, MS INTACT, NORMAL TEMP or < 40C or < 104F
Heat exhaustion
d/t exposure to elevated ambient temp or overexertion
Pale & sweaty, moist & cool skin, HR increased, core temp normal
Heat fatigue
Muscle cramps in legs due to exertion in hot weather, core temp normal
Heat cramps
How do you treat heat cramps?
Rx: cool environment, oral rehydration, IV NS, rest
How do you treat heat exhaustion?
Rx: Remove to cool environment, rest, supine, IV fluids/electrolyte replacement
hypoglycemia, coronary syndrome/MI, sepsis should be ruled out for what problem?
Heat exhaustion
Weakness, HA, malaise, CONFUSED, delirious
PE: skin hot & dry, supine tachycardia, tachypnea, ALTERED MENTAL STATUS, T > 40 C or > 104 F
Heat stroke
What are some causes of heat stroke?
Thermoregulatory dysfunction, heat wave exposure (2-3 days exposure)
CBC, clotting factors, electrolytes, BUN, creatinine, LFT, monitor urine output, core temp via rectal or esophageal probe
What are these labs for?
Heat stroke
What is treatment for heat stroke?
Admit & ID underlying cause
Ddx: sepsis, meningitis, CVA, meds/drugs, thyroid storm, malignant hyperthermia, neuroleptic malignant syndrome (from antipsychotics), serotonin syndrome (SSRIs)
Manage shivering/prevent seizures
Anticipatory monitoring
What is prescription for heat stroke?
Rapid cooling (continually wet & fan the skin; Add ice packs (groin & axilla))
IV hydration NS
PRN sedation to prevent agitation, seizures
Prevent aspiration if vomiting
DIC: platelets & fresh frozen plasma
Prevention of hyperthermia
Access to air conditioning in excessively hot weather Avoid exertion Maintain hydration Loose fitting/ventilating clothing Community outreach
