RT Book, Section
A1 Hanania, Nicola A.
A1 Zimmerman, Janice L.
A2 Hall, Jesse B.
A2 Schmidt, Gregory A.
A2 Wood, Lawrence D.H.
SR Print(0)
ID 2282615
T1 Chapter 110. Hypothermia
T2 Principles of Critical Care, 3e
YR 2005
FD 2005
PB The McGraw-Hill Companies
PP New York, NY
SN 9780071416405
LK accessmedicine.mhmedical.com/content.aspx?aid=2282615
RD 2019/06/17
AB Accidental  hypothermia  results  from  the  unintentional  decrease  in  core  body  temperature  to  lower  than  35°C  (95°F)  and  can  be  classified  as  mild  (32.2°C  to  35°C,  or  90°F  to  95°F),  moderate  (28°C  to  32.2°C,  82°F  to  90°F),  or  severe  (<28°C,  82°F).Although  hypothermia  from  environmental  exposure  is  very  common,  several  medical  conditions  may  also  predispose  to  hypothermia  necessitating  hospitalization  and  admission  to  the  intensive  care  unit.Individuals  at  highest  risk  for  hypothermia  include  the  homeless,  the  mentally  ill,  trauma  victims,  outdoor  workers,  those  at  the  extremes  of  age,  those  with  serious  underlying  medical  conditions,  and  those  with  ethanol  or  drug  intoxication.Several  organ  systems  are  affected  by  hypothermia:  clinical  manifestations  depend  on  the  underlying  cause  and  core  body  temperature.  Below  30°C  (86°F),  shivering  ceases,  level  of  consciousness  progressively  declines,  and  cardiac  arrhythmias  become  more  common.In  the  initial  stages,  wet  clothing  should  be  removed  promptly,  continued  heat  loss  must  be  prevented,  and  the  underlying  illness  should  be  identified  and  treated.Rewarming  is  the  primary  treatment  for  moderate  to  severe  hypothermia.  For  patients  with  a  core  body  temperature  above  32°C  (90°F),  passive  and  active  external  rewarming  and  supportive  therapies  are  preferred;  for  patients  with  lower  temperatures  and  those  with  hemodynamic  instability,  active  core  rewarming  using  body  cavity  lavage  or  extracorporeal  blood  warming  may  be  considered.In  addition  to  rewarming,  all  patients  with  hypothermia  need  continuous  monitoring  of  cardiac  status,  intensive  fluid  resuscitation,  and  circulatory  support.