Hypothermia
From Anvita Health Wiki
Contents |
Introduction
- A core temperature < 35 degrees C (95 degrees F).
Etiology
- environmental exposure
- drugs
- hypothalamic dysfunction
- spinal cord transection (T1 of above)
- skin disorders
- general debilitation
- episodic spontaneous hypothermia with hyperhidrosis
- sepsis
- uremia
Clinical-manifestations
- mild hypotherma (32-35 C or 89.6-95 F)
- shivering
- delirium
- normal pulse & blood pressure
- below 32 C (89.6 F)
- shivering ceases
- metabolism slows
- multiple organ system dysfunction occurs
- pulse, blood pressure & respirations decline
- consciousness progressively declines
- below 30 C (86 F)
- comatose
- pupils are fixed & dilated
- reflexes are absent
- hypotension
- pulse & respirations are barely detectable or absent
Laboratory
-
- elevated hematocrit from hemoconcentration
- leukopenia
- thrombocytopenia Electrocardiogram ( EKG):
- atrial fibrillation
- slurring of J wave ( J point)
- Osborne wave < 29 C
Management
- responsive patients
- warming with blankets
- warm, humidified air
- warm intravenous fluids
- unresponsive patients (< 32 degrees C)
- active core warming with gastric, colonic or peritoneal lavage
- hemodialysis ( core temperature < 28 C)
- patients should not be pronounced dead until they have been warmed to a core temperature of > 32 C (> 89.6 F)
More General Terms
Additional Terms
References
- Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
- Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 98
- Hypothermia: NIH Institute and Center Resources [1]
