Hypothermia and Heat injuries Flashcards
Hypothermia def
core temp less than 35 degrees
Severity of hypothermia
Mild <35 degrees
Moderate <32 degrees
Severe <30 degrees
Swiss staging of accidental hypothermia sx
Stage 1 conscious shivering
Stage 2 Impaired consciousness, not shivering
Stage 3 Unconcious and nit shivering, vital signs present
Stage 4 no vital signs
Swiss staging of accidental hypothermia temperatures
Stage 1 32>
Stage 2 <32
Stage 3 <28
Stage 4 <24
Stage 1 hypothermia management
Warm environment and clothing
Warm drink
Activity
Stage 2 hypothermia mx
Cardiac monitoring
Minimal movement to avoid arrhythmias
Horizontal position and immobilization
Full body insulation
Active external rewarming
Stage 3 hypothermia mx
Stage 2 +
ECHMO or CPB with cardiac instability pts
Stage 4 hypothermia mx
Stage 2, and 3
Plus CPR
Hypothermia ECG changes
J waves
Different methods of rewarming
Pronouncing death in hypothermia
Only after full attempts at rewarming (exceptions: K >10mmol, anoxic while still normothermic, fatal wound eg transcerebral gunshot )
Temperature of heat exhaustion vs heat stroke
Heat exhaustion <39
Heat stroke >40
Sx of heat exhaustion
headache
N+V
Dizziness
Myalgia
Low BP
Syncope
Sx of heat stroke
Heat exhaustion +
mental confusion, irritability, disorientation, seizure, coma
Two types of heat stroke
Nonexertional (classic)
Exertional
Pt cohort for classical heat stroke
Young children
Elderly
Exertional heat stroke pt cohort
Healthy young people doing exercise in the heat
When does sweating start
When ambient temperature exceeds 37 degrees
Changes to cardiac output to peripheries with high temperature
raises from 5% to 20% trying to lose heat through skin
What happens when normal physiological response fails to dissipate heat
The core body temp steadily rises until gets to 41-42 degrees (critical maximal temperature)
Mx of hyperthermia
Rapid cooling to reduce core temp below 39 degrees
Methods of rapid cooling prehospital
Water spray and airflow over patient
Ice packs to groin, neck, axilla
Contraindication to immersion in ice-cold water to treat hyperthermia
Do not use in elderly as increases mortality
