Hypothermia and Heat injuries

Question 1

Hypothermia def

Answer 1

core temp less than 35 degrees

Question 2

Severity of hypothermia

Answer 2

Mild <35 degrees

Moderate <32 degrees

Severe <30 degrees

Question 3

Swiss staging of accidental hypothermia sx

Answer 3

Stage 1 conscious shivering

Stage 2 Impaired consciousness, not shivering

Stage 3 Unconcious and nit shivering, vital signs present

Stage 4 no vital signs

Question 4

Swiss staging of accidental hypothermia temperatures

Answer 4

Stage 1 32>

Stage 2 <32

Stage 3 <28

Stage 4 <24

Question 5

Stage 1 hypothermia management

Answer 5

Warm environment and clothing

Warm drink

Activity

Question 6

Stage 2 hypothermia mx

Answer 6

Cardiac monitoring

Minimal movement to avoid arrhythmias

Horizontal position and immobilization

Full body insulation

Active external rewarming

Question 7

Stage 3 hypothermia mx

Answer 7

Stage 2 +

ECHMO or CPB with cardiac instability pts

Question 8

Stage 4 hypothermia mx

Answer 8

Stage 2, and 3

Plus CPR

Question 9

Hypothermia ECG changes

Answer 9

J waves

Question 10

Different methods of rewarming

Answer 10

Question 11

Pronouncing death in hypothermia

Answer 11

Only after full attempts at rewarming (exceptions: K >10mmol, anoxic while still normothermic, fatal wound eg transcerebral gunshot )

Question 12

Temperature of heat exhaustion vs heat stroke

Answer 12

Heat exhaustion <39

Heat stroke >40

Question 13

Sx of heat exhaustion

Answer 13

headache

N+V

Dizziness

Myalgia

Low BP

Syncope

Question 14

Sx of heat stroke

Answer 14

Heat exhaustion +

mental confusion, irritability, disorientation, seizure, coma

Question 15

Two types of heat stroke

Answer 15

Nonexertional (classic)

Exertional

Question 16

Pt cohort for classical heat stroke

Answer 16

Young children

Elderly

Question 17

Exertional heat stroke pt cohort

Answer 17

Healthy young people doing exercise in the heat

Question 18

When does sweating start

Answer 18

When ambient temperature exceeds 37 degrees

Question 19

Changes to cardiac output to peripheries with high temperature

Answer 19

raises from 5% to 20% trying to lose heat through skin

Question 20

What happens when normal physiological response fails to dissipate heat

Answer 20

The core body temp steadily rises until gets to 41-42 degrees (critical maximal temperature)

Question 21

Mx of hyperthermia

Answer 21

Rapid cooling to reduce core temp below 39 degrees

Question 22

Methods of rapid cooling prehospital

Answer 22

Water spray and airflow over patient

Ice packs to groin, neck, axilla

Question 23

Contraindication to immersion in ice-cold water to treat hyperthermia

Answer 23

Do not use in elderly as increases mortality