E155 Thermoregulation Strategies & Hypothermia

first aid in the field for severe hypothermia

• move the pt gently

• cover with blankets

• warm (not hot) beverages (if pt is conscious)

• warm, dry compress on neck and chest only

ER treatments for severe hypothermia

• warm infusion - infuse warm salien through IV

• airway rewarming - warm humidified air thru a nasal cannula or O2 mask

• irrigation - use a catheter to irrigate body cavities (abs and/or pleural) with warm saline

do not allow the pt to make suddent movements, especially sitting up

tense muscles = pass out

cardiac issues (cardiac arrest) from the rush of blood and dispersal to extremities

do not apply a warm compress to the arms or legs

induce heat shock locally; redistribution of blood to periphery

do not give an alcoholic beverage

vasodilation = lose more heat at periphery

cutaneous heat retention

arteriovenous shunt = causes blood to go back to core instead of periphery to stay warm

• reduce blood flow to the skin

• arterioles vasoconstrict

cutaneous heat loss

arterioles vasodilate = increase blood flow to the skin

• little blood in the shunt to release blood at the skin surface

when heat is released, how is it being carried away from the body?

radiation = cannot see wavelengths but this is still the main mech

• not convection b/c requires fluids, like air

mechanism of metabolism

like a water turbine where water flowing down gradient generates energy

• uncoupling protein produces heat by bringing H+ out of the cell and down conc gradient

• NADH serves as the e shuttle that moves e- from glycolysis and citric acid cycle (H2O as byproduct)

plants generating heat

when the lotus is warm, it releases organic for insect to smell

counter current exchange

always moving down conc gradient until it is fully warmed

changes in blood temp as it travels from the foot of a penguin back to the body

increases in temp as it moves toward the core