Environmental: hypothermia Flashcards Preview

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Flashcards in Environmental: hypothermia Deck (18):
1

Shivering

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

2

Metabolic response to hypothermia

Initial increase to produce heat
- decreases by half q drop in core temp of 10 degrees C

3

BGL response to hypothermia

-Will decrease with mild chronic hypothermia
-sever hypothermia inhibits insulin thus BGls spike

4

Respiratory reactions to hypothermia

-Respiratory minute volume decreases
-rate becomes inadequate to blow off CO2 = respiratory acidosis

5

Cardiovascular considerations with hypothermia

CO decreases, increased SVR, capillary leakage
-pt becomes hypovolemic

6

Hypothermia metabolic considerations

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

7

Enzymatic and medication considerations with hypothermia

Enzymatic function decreases = decrease clotting factors
-enzymes no longer process drugs in liver
-medication bio transformation decreases

8

Hypothermia mild stage

>32-34 degrees C
-increased BMR, CO, HR begins to fall at 32 degrees

9

Hypothermia moderate stage

29-32 degrees Celsius
-no more attempts to preserve or produce heat
-LOC and SVR fall, acidosis, hyperglycemia, CO falls

10

Hypothermia severe stage

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

11

Hypothermia EKG changes

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

12

Poikilothermic

Animal kingdom: Animals who assume environmental temps.

13

Hypothermia intubation consideration

Can induce VF

14

When to start CPR

VF or asystole only
Not with PEA

15

Hypothermia medication considerations

Do not administer if less than 30 degrees C
Enzymatic retardation at 33 degrees C

16

Rewarming: Afterdrop

Warming increases CO
-cold stagnant blood from periphery enters core
-acidotic blood, watch for arrhythmias

17

Active internal rewarming

IVF, hemodialysis, gastric lavage, rectal lavage, ECMO

18

Body's response to cold

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