IBCC Episode 65 - Hypothermia

The Internet Book of Critical Care Podcast

Adam Thomas

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

5 • 714 Ratings

🗓️ 21 November 2019

⏱️ 22 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this episode we cover both accidental and non-accidental hypothermia. Come listen for a good review on:

Clinical Clues
Passive and Active re-warming
Modification of standard ACLS approach
Complications of hypothermia
and much much more...

PS: Many apologies to cardiac anesthesiologists and perfusionists: core after-drop is a thing, but we don't want to cloud the issue of priorities in rewarming.

Transcript

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0:00.0	Welcome back to the IBCC podcast. I'm here with Adam Thomas and we're going to talk about hypothermia.
0:10.2	And today we're going to mix it all. Non-accidental and accidental hypothermia. We're going to talk about the mild, moderate, severe.
0:16.2	And we're going to bust out all the fun toys you get to use to treat this, including some passive
0:21.5	techniques and some active techniques. So Josh, let's dive right into it, definitions and
0:26.7	clinical consequences. Get me started here. It's just the very basic here. Hypothermia typically
0:31.4	defines its temperature under 35C or 95 Fahrenheit. And one important point to realize, just in
0:36.5	general is if you see folks in the hospital
0:38.6	who are developing hypothermia, that's really bad and probably more scary to me than fever.
0:43.5	These can be sepsis patients or patients with other profound shock or metabolic derangements.
0:48.6	Respect the hypothermia.
0:49.6	Now in the table, Josh has posted, he's broken this down by traditional categories.
0:54.0	And to be honest, most of this is just picked by's broken this down by traditional categories. And to be
0:54.2	honest, most of this is just picked by somebody who thought these were important categories
0:58.6	and then lumped in some symptoms. Now, we will accept that this is not gospel, but it's an
1:04.1	approach for you guys to structure how to assess your patient and immediately understand
1:08.8	where they're going. So Josh, walk me through mild, which is 32 to 35 degrees Celsius. Moderate, which is 28 to 32, severe, which is less than 28
1:17.8	degrees Celsius. So your mild hypothermia around 90 to 95 degrees Fahrenheit, these are folks
1:22.3	who are alert, they're shivering, they may have very mild mental status changes, but they
1:26.3	should be basically intact. There's a sympathetic response here, so folks will be tachycardic and they may have very mild mental status changes, but they should be basically intact.
1:27.7	There's a sympathetic response here, so folks will be tachycardic and they may be hypertensive.
1:32.2	And this by itself is not really life-threatening.
1:35.2	And you know, these folks will respond to pretty conservative measures.
	...

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