Tuesday, February 9, 2021

Accidental Hypothermia

Taming The SRU - By Katherine Connelly - February 09, 2021

Accidental hypothermia may occur as a result of environmental exposure or an underlying medical condition, and ranges in severity from mild to profound. The safety of responders is paramount during rescue of a hypothermic patient, and management priorities should include gentle handling with avoidance of rescue collapse, afterdrop, and ongoing heat loss. Patients with HT I can typically be treated in the field with self-rewarming, calories to support shivering, and external rewarming with hot packs or heated blankets. Stable HT II - III patients warrant hospital evaluation with active external rewarming as the mainstay of therapy. Extracorporeal rewarming should be strongly considered for HT II - III patients with hemodynamic instability, core temperature <28°C, or who fail to improve with less invasive measures. Resuscitation should be attempted for all patients in hypothermic cardiac arrest, with the exception of those who are frozen solid or have injuries obviously incompatible with life, as good neurologic survival is possible even with prolonged down times. VA-ECMO is the rewarming strategy of choice for patients in hypothermic arrest, and the HOPE score can be used to guide resuscitation decisions in such patients."