Hey folks, Scott Weingar here. I'm in New York City, and it's winter here. It's been a pretty mild winter, but still, we've had a few patients come in in cardiac arrest, profoundly hypothermic.

And you know the axiom.

No patients did until they're warm and dead.

Which is wonderful to say, but what does it actually mean?

Well, that's what we're going to explore on the

patients who are pretty cold but they're not in cardiac arrest and they're not in cardiac arrest and they're not profoundly hypothermic and then you have the other

group so let's deal with the easy one first if patients come in 32

degrees Celsius or higher, then you don't have to do any extraordinary

measures.

If you put them in a corner with some warm blankets, they're eventually going to re-warm and they'll do it themselves and they'll do it about a

degree an hour is the average and they'll be just fine unless it really wasn't an environmental exposure hypothermia unless there was

something else going on. Now what could these something else be? Well one of the

big ones you better rule out right up front is hypoglycemia.

If your sugar gets low, you can't produce the energy to make heat,

and you could be really hypothermic. I've had patients come in.

No environmental exposure, you know, 30, 32 degrees

Celsius just from hypoglycemia. So that needs to be taken care of. You don't

want to wait for this patient to be warm for a couple hours before you find out that their sugar is 26.

What else?

Alcohol causes vasodilation.

It's going to make any environmental exposure much, much worse.

Malnutrition, and then you get the metabolic ones like Addison's and Mixedema.

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