Hypothermia

Question 1

Hypothermia dx

Answer 1

Core temp <35 c

Question 2

Causes of hypothermia

Answer 2

Exposure
Impairment of thermoregulatory reflexes
Decreased heat production
Increased heat loss

Question 3

Exposure cause of hypoT

Answer 3

ambient temp <15.5 c ( our house is normally around 10 c)

Question 4

Impairment of thermoregulatory reflexes eg

Answer 4

Decreased:

• shivering
• basal metabolic rate
• perception of cold
• vasoconstriction

Question 5

Endocrine conditions causing hypoT

Answer 5

hypothyroid
hypopituitary
Addisons

Question 6

Drugs causes of hypothermia

Answer 6

alcohol
barbiturates
neural depressants
CO poisoning

Question 7

Examples of neural depressants

Answer 7

phenothiazines

benzodiazepines

Question 8

How long does it take for hypoT to develop

Answer 8

24-48hrs but could be chronic

Question 9

Best way of measuring hypothermia

Answer 9

low reading rectal thermometer

Question 10

Rewarming methods

Answer 10

slow surface re-warming
rapid surface re-warming
rapid core-rewarming

Question 11

slow surface re-warming method description

Answer 11

• pt put in 25 c room covered with normal blankets

- monitor ECG, BP and core temp every 30mins

Question 12

Use of slow surface re-warming

Answer 12

haemodynamically stable

temp >31

Question 13

Rapid surface re-warming

Answer 13

• hot bath (41-45) or heat cradle or bair hugger blanket

Question 14

Problems with rapid surface re-warming

Answer 14

• could cause ventricular arrhythmias in elderly
• could cause vasodilation of the skin, heart has to work harder, pumping lactic acidotic blood around
• could lead to hypotension /cardiogenic shock

Question 15

Methods of rapid core re-warming

Answer 15

Warmed inhaled gas (42)
Warmed IV fluids (42)
Peritoneal lavage/dialysis (38-48)
Haemodialyisis or continues arteriovenous rewarming (CAVR)

Question 16

Where/when does core re-warming take place

Answer 16

ITU

when temp<28

Question 17

Prognosis of hypothermia

Answer 17

30-80% death rate