Hypothermia

Question 1

What signs might you see with hypothermia? (10)

Answer 1

Shivering (but also no shivering if <35 degrees)
Confusion
Agitation
Reduced GCS
Coma (leads to loss of brainstem reflexes)
Muscle stiffness
Depressed reflexes
Hypotension
Bradycardia
Arrhythmia

Question 2

What might you see on the ECG of a hypothermic patient?

Answer 2

J waves (convex deflections at the junction of QRS complex and ST segment)

Question 3

What is hypothermia?

Answer 3

Drop in core (rectal) temperature to below 35 degrees.

Question 4

A drop to what core temperature is frequently fatal?

Answer 4

28 degrees

Question 5

Why are the elderly prone to hypothermia?

Answer 5

They can’t feel temperature

Question 6

Which two groups of people are particularly prone to hypothermia?

Answer 6

Very young and very old

Question 7

When is hypothermia a medical emergency?

Answer 7

Below 32 degrees, at this point there is altered consciousness

Question 8

What tests should be sent off if hypothermia is suspected?

Answer 8

ABG
FBC, U&E, thyroid function test, blood glucose, blood cultures
ECG, CXR

Question 9

Why should you send off thyroid function tests?

Answer 9

Hypothyroidism can be a cause of hypothermia

Question 10

When should you passively warm a patient (e.g. in a warm room), when should you actively externally warm a patient (e.g. with heat pads), and when should you actively internally warm a patient (e.g. with humidified and warmed oxygen, lavage with warm fluids)?

Answer 10

Passive - core temp > 32

Active external - core temp

Question 11

When actively warming a patient, in what order should you approach the body? Why?

Answer 11

Heat trunk, and then extremities

To minimise peripheral vasodilatation