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Flashcards in Environmental Protocols Deck (12):
1

Hypothermic arrest management in adults.

Severe hypothermia is suspected (<30C)

If VF or pVT, defibrillate (one shock max) with 200J. No drugs.

Ensure advanced airway established prior to transport if rhythm is asystole or VF. Otherwise only establish an advanced airway if BVM ventilations are not adequate.

Remove wet clothing and warm pt with blankets.

Transport to SBGH.

2

How long to assess pulse in unresponsive hypothermic patient.

30 seconds.

3

How long to assess respirations in unresponsive hypothermic patient.

30 seconds.

4

Typical progression of rhythm changes in hypothermic patient.

The corresponding rhythm changes that typically occur in hypothermia is a progression from sinus bradycardia to atrial fibrillation to VF and finally asystole.

5

Procedure for IO initiation in hypothermic patient.

IO access is not to be attempted.

6

Handling hypothermic patients.

In patients with severe hypothermia, VF may be precipitated by rough handling, CPR, intubation or intraosseous (IO)
insertion. The resultant fibrillation is usually refractory to treatment with drugs or defibrillation until core rewarming is
accomplished. Therefore, attempts at converting VF in the field should be of short duration and transport to hospital
expedited. IO access is not to be attempted.

7

Hypothermic arrest management in adolescents.

Severe hypothermia is suspected (<30C)

If VF or pVT, defibrillate (one shock max) with 4J/kg. No drugs.

Ensure advanced airway established prior to transport if rhythm is asystole or VF. Otherwise only establish an advanced airway if BVM ventilations are not adequate.

Remove wet clothing and warm pt with blankets.

Transport to Children's (if no ICP/ACP/MS on scene, transport to closest hospital).

8

Hypothermic cardiac arrest management in pediatrics.

Severe hypothermia is suspected (<30C)

If VF or pVT, defibrillate (one shock max) with 4J/kg. No drugs.

Ensure advanced airway established prior to transport if rhythm is asystole or VF. Otherwise only establish an advanced airway if BVM ventilations are not adequate.

Remove wet clothing and warm pt with blankets.

Transport to Children's.

9

When to establish IV in hypothermic cardiac arrest.

En route.

10

Ventilation rate in hypothermic cardiac arrest with advanced airway (adults & adolescents)

Patients with severe hypothermia (core temperature below 30 degrees Celsius) have lowered metabolic requirements and
should be ventilated at 8 - 10 breaths per minute.

11

Ventilation rate in hypothermic cardiac arrest with advanced airway (pediatrics)

Patients with severe hypothermia (core temperature below 30 degrees Celsius) have lowered metabolic requirements and
should be ventilated at 10 breaths per minute.

12

Cooling a hyperthermic patient.

Some examples of cooling techniques are : direct cool air on the patient, remove unnecessary clothing from the patient, remove patient from environment, cold packs, etc.