Hypothermia (Hyperthermia) Dr. Stella Yiu Staff Emergency Physician.
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Transcript of Hypothermia (Hyperthermia) Dr. Stella Yiu Staff Emergency Physician.
LMCC objectives
List clinical findings of hypothermia
Investigate
Initiate resuscitation for severe hypothermia
Effects
By Patrick J. Lynch, medical illustrator (Patrick J. Lynch, medical illustrator) [CC-BY-2.5 (http://creativecommons.org/licenses/by/2.5)], via Wikimedia Commons
Image credit: US public domain
EM Ottawa
Exposure
14Photo credit: Jonathan Snyder, U.S. Air Force, UNC - CFC – USFK, CC by
2.0, via Flickr creative commons
Impaired thermostat
Metabolic (Cirrhosis, uremia, DM, Hypothyroid)
CNS (stroke, trauma, MS, Parkinson)
Drugs (Barbituates, TCAs)
EM Ottawa
Mod (28-32C): Active external rewarm
23By Patrick J. Lynch, medical illustrator (Patrick J. Lynch, medical illustrator) [CC-BY-2.5 (http://creativecommons.org/licenses/by/2.5)], via Wikimedia Commons
Warm humidified Oxygen
Pleural space
By Patrick J. Lynch, medical illustrator (Patrick J. Lynch, medical illustrator) [CC-BY-2.5 (http://creativecommons.org/licenses/by/2.5)], via Wikimedia Commons
Bladder
By User:Lennert B [GFDL (http://www.gnu.org/copyleft/fdl.html), CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0/) or CC-BY-2.5
(http://creativecommons.org/licenses/by/2.5)], via Wikimedia Commons
Dialysis
By National Kidney and Urologic Diseases Information Clearinghouse, National Institute of Diabetes and Digestive
and Kidney Diseases, National Institutes of Health, USA [Public domain], via Wikimedia Commons
Photo credit: becre8tv, CC by 2.0, via Flickr Creative commons
Bypass
By Van Meurs, K, Lally, KP, Peek, G, Zwischenberger, Extracorporeal Life Support Organization, Ann Arbor 2005. [CC-BY-2.5
(http://creativecommons.org/licenses/by/2.5)], via Wikimedia Commons
MCQ 3: Patient is lethargic and bradycardic. Most appropriate warming method?
A. Pleural lavageB. Bladder irrigationC. IntubationD. Dry blanket and a snackE. Blanket with forced warm air
MCQ 4: 12 M found in snow. After 2hrs CPR and warming, asytolic. Core temp 27.5C. What is the most appropriate step?A. Stop resuscitation B. DefibrillationC. Continue CPR and warmingD. Warm water immersionE. Stop warming
LMCC objectives
List predisposing illnesses
List clinical findings
Select investigations
Manage patient by various cooling methods
Metabolic causes: Heat production
Metabolic heatThyroid, pheochromocytomaMalignant hyperthermiaNMSSepsis
Heat stroke: Hot + confusedT> 40Orthostatic BP, HR
CNS: Confusion, ataxic, cerebral edema, seizureCVS: CHF, pulmonary edema, CV collapse