Hypothermia

Question 1

How should hypotension be managed in patients with active rewarming?

Answer 1

Having warmed IV fluids

Question 2

What happens in the body during active rewarming?

Answer 2

Vasodilation which the results in hypotension

Question 3

How much should a patients temperature rise per hour to reduce haemodynamic instability?

Answer 3

No more than 0.5 degrees

Question 4

What are external rewarming techniques?

Answer 4

Remove wet clothing
Supply warm blankets
Forced warm air system
Heating blankets

Question 5

What are core rewarming techniques?

Answer 5

IV fluids
Warm ventilator gases
Gastric or bladder lavage
Peritoneal lavage
Pleural or pericardial lavage
Endovascular rewarming
Extracorporeal rewarming

Question 6

At what core temperature should resuscitation be continued to, especially if it can’t be raised further despite active measures?

Answer 6

32 Degrees

Question 7

Should the dose interval for resuscitation drugs be doubled or halved between temps of 30-35 degrees?

Answer 7

Doubled

Question 8

How should arrhythmias, such as VF, be treated in a hypothermic (below 30 degrees) patients?

Answer 8

Defibrillation should be limited to 3 shocks and inotropic or anti arrhythmia drugs should not be given. If the 3 shocks are unsuccessful the patient should be rewarded to above 30 degrees where further defibrillation should be attempted

Question 9

What are common at temps below 30 degrees?

Answer 9

Arrhythmias and some may be refractory at these temps