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The Internet Book of Critical Care Podcast

IBCC Episode 47 Hyperthermia

The Internet Book of Critical Care Podcast

Adam Thomas

Foam, Medicine, Health & Fitness, Science, Criticalcare, Medicaleducation

5714 Ratings

🗓️ 31 July 2019

⏱️ 30 minutes

🧾️ Download transcript

Summary

In this episode, we follow-up on the very "heated" debate that this post sparked on the interwebs. Come listen to all things ICU level-hyperthermia. We've got the ice baths. The cold fluids. The dry air. We cover it all!

Transcript

Click on a timestamp to play from that location

0:00.0

All right, so welcome back to the Internet Book of Critic Prepare podcast. I'm here with Adam Thomas.

0:10.1

And we're going to talk about hyperthermia and heat stroke. Josh, this really lit up Twitter.

0:15.2

It's fitting for heat stroke because people were throwing some hot fire around for sure.

0:20.9

Yeah, that was a little surprising, but it was interesting.

0:24.1

So today we're going to talk about approach for the definition diagnosis of hypothermia

0:28.2

and then a package approach, multiple approaches to get that temperature down as soon as possible.

0:36.2

We're not emphasizing just one approach.

0:39.5

We're going to talk about lots of them, okay?

0:42.4

That's the caveat.

0:43.7

Make sure you read the post and understand that we can do multiple things at once.

0:48.3

We all agree on that, Josh?

0:49.7

Agreed, totally.

0:50.8

All right, let's talk about the definition and diagnosis.

0:53.1

What is hypothermia and why is it not fever?

0:55.8

Yeah, so fever is basically hypothalamically mediated increase in body temperature. Typically, it's driven by cytokines. And that's going to max out. Usually it around 104 degrees Fahrenheit or 40C, maybe a little bit higher. But there's a maximum temperature that your thalamus.

1:12.4

Your hypothalamus isn't crazy.

1:13.3

It's not going to kill you.

1:18.1

Hyperthermia, on the other hand, is basically an imbalance of heat generation and clearance of heat from the body where the musculature or your environment or for various reasons,

1:22.7

more heat is being generated than can be cleared and is just heat overload.

1:26.5

So on presentation, the discriminating factors here are absolute temperature.

1:31.3

So like Josh said, if you're over 41 degrees, you've got to start looking at hypothermia and not

1:35.7

fever.

...

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