Environmental: hypothermia Flashcards Preview

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Flashcards in Environmental: hypothermia Deck (18)
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1
Q

Shivering

A

Increases metabolic requirements of O2 (MRO2) up to 600%
Limited by available glycogen stores
Ceases at 32 degrees C

2
Q

Metabolic response to hypothermia

A

Initial increase to produce heat

- decreases by half q drop in core temp of 10 degrees C

3
Q

BGL response to hypothermia

A
  • Will decrease with mild chronic hypothermia

- sever hypothermia inhibits insulin thus BGls spike

4
Q

Respiratory reactions to hypothermia

A
  • Respiratory minute volume decreases

- rate becomes inadequate to blow off CO2 = respiratory acidosis

5
Q

Cardiovascular considerations with hypothermia

A

CO decreases, increased SVR, capillary leakage

-pt becomes hypovolemic

6
Q

Hypothermia metabolic considerations

A

O2 demand is very high due to shivering,
-increases SVR, decrease CO/RR/Ve decrease O2 to muscles
=anaerobic metabolism / acidosis

7
Q

Enzymatic and medication considerations with hypothermia

A

Enzymatic function decreases = decrease clotting factors

  • enzymes no longer process drugs in liver
  • medication bio transformation decreases
8
Q

Hypothermia mild stage

A

> 32-34 degrees C

-increased BMR, CO, HR begins to fall at 32 degrees

9
Q

Hypothermia moderate stage

A

29-32 degrees Celsius

  • no more attempts to preserve or produce heat
  • LOC and SVR fall, acidosis, hyperglycemia, CO falls
10
Q

Hypothermia severe stage

A
28 degrees C or less. 
Poikilothermic stage. 
-hypotension, ECG changes
-PT, aPTT increase by 50%
-platelets decrease by 40%
11
Q

Hypothermia EKG changes

A

Prolonged PR, QRS and QT intervals.
VF risk highest at 22 degrees C
Osborne waves evident at 25 degrees C

12
Q

Poikilothermic

A

Animal kingdom: Animals who assume environmental temps.

13
Q

Hypothermia intubation consideration

A

Can induce VF

14
Q

When to start CPR

A

VF or asystole only

Not with PEA

15
Q

Hypothermia medication considerations

A

Do not administer if less than 30 degrees C

Enzymatic retardation at 33 degrees C

16
Q

Rewarming: Afterdrop

A

Warming increases CO

  • cold stagnant blood from periphery enters core
  • acidotic blood, watch for arrhythmias
17
Q

Active internal rewarming

A

IVF, hemodialysis, gastric lavage, rectal lavage, ECMO

18
Q

Body’s response to cold

A

Peripheral vasoconstriction, skeletal muscle vasodilation, increased cardiac output and, shivering