Hypothermia

Hypothermia

A decreased core body temperature, specifically any temperature < 95° Fahrenheit (< 35° C).

Age

The primary statistic relevant to hypothermia-related deaths, as the elderly have difficulty maintaining thermoregulation due to hypothalamus aging/dysfunction.

Clinical Signs and Stages of Hypothermia - I

MILD stage characterized by normal mental status and shivering, occurring at 90 - 95 degrees.

Clinical Signs and Stages of Hypothermia - II

MODERATE stage characterized by altered mental status and no shivering, occurring at 82 - 90 degrees.

Clinical Signs and Stages of Hypothermia - III

SEVERE stage where the individual is unconscious, occurring at 75 - 82 degrees.

Clinical Signs and Stages of Hypothermia - IV

SEVERE stage where the individual appears dead, occurring at 56.7 - 82 degrees.

Don't Write Anyone Off Just Yet

Emphasizes the importance of considering resuscitative measures in hypothermic patients who appear dead, as end-organ damage is slowed by cold.

The Perfect Storm

Environmental factors like low outdoor temperature, wet conditions, and wind can combine to create dangerous conditions for hypothermia.

Alcohol Consumption

Alcohol can give the user a feeling of being warmed, potentially leading to inadequate shelter against cold and hypothermia.

Paradoxical Undressing

Phenomenon where patients with extreme hypothermia remove their clothes in an attempt to warm up, caused by the failure of the vasoconstriction response.

Terminal Burrowing

A behavior seen in extreme hypothermia where patients dig or try to get into small spaces, likely an ancient brainstem-triggered survival instinct.

Special Assessment Considerations

In suspected hypothermia cases, initial examination should focus on ABCs, mental status assessment, and testing temperature by placing the hand on the upper abdomen.

Treatment of Hypothermia - Mild to Moderate

Involves warmed blankets, warm environment, and removal of wet clothing, with transport for those with mental status changes.

Treatment of Hypothermia - Severe

Requires IV administration of warmed saline, aggressive ABC management, and other measures in addition to those for mild/moderate cases.