FN: Hypothermia Flashcards Preview

Final Notes > FN: Hypothermia > Flashcards

Flashcards in FN: Hypothermia Deck (11):
1

Definition

Core (rectal) temperature

2

Pathophysiology 4 wats to loose heat

1. Radiation: 60% - infra-red emissions
2. Conduction 15%: primary menas in cold water immersion
3. Convection: 15% removes warmed air from around the body e.g. windy conditions
4. Evaporation 10% - removal of warmed water, increased in dry, windy environments

3

Aetiological classification

Primary: envirnmental exposure
Secondary: change in temperature set-pont e.g. age-related, hypothyroidism, autonomic neuropathy

4

Presentation mild

32.2-35 degrees
- shivering
- tachycardic
- vasoconstriction
- apathy

5

Presentaiton moderate

28-32.2 degrees
- dysrhythmia, bradycardia, hypotension
- J waves
- reduced reflexes, dilated pupils, reduced GCS

6

Presentaiton severe

VT-VF- Cardiogenic shock
- Apnoea
- Non-reactive pupils
- Coagulopathy
- Oliguria
- Pulmonary oedema

7

Investigations

1. Rectal/ear temperature
2. FBC, U+E, glucose
3. TFTs, blood gas
4. ECG

8

ECG changes in hypothermia

J waves: between QRS and T wave
Arrhythmias

9

Management

- Cardiac monitor
- Warm IVI 0.9% NS
- Urinary catheter
- Consider Abx for prevention of pneumonia - routine if temp 65yrs

10

Slowly rewarming process

- reheating too quickly: peripheral vasodilatation and shock
- Aim for 0.5 degrees/hr
- Passive external: blankets, warm drinks
- Active external: warm water or warmed air
Active external: mediastinal lavage and CPB - severe hypothermia only

11

Complications

Arrhythmias
Pneumonia
Coagulopathy
Acute renal failure

Decks in Final Notes Class (196):