The document discusses hypothermia, including who is at risk, clinical manifestations, and management. Those at highest risk include the elderly, malnourished, burned patients, and those with impaired thermoregulation from medications, alcohol, or medical conditions. Clinical manifestations range from shivering and increased heart rate at mild hypothermia to arrhythmias and cardiac arrest at very low body temperatures. Management focuses on removing the patient from cold, removing wet clothes, warming with blankets and fluids, and irrigating body cavities with warm saline if very severe.
3. PEOPLE WHO ARE LIKELY TO BE
HYPOTHERMIC
• The newly born and the very old have an increased risk for accidental
hypothermia because of their impaired ability to adapt to a cooler
environment
• The elderly have both a decreased metabolic rate and diminished
sympathetic vasoconstrictor response to cold conditions
• Malnourished and starving people have decreased heat production,
which places them at risk for hypothermia
• People who are burned may loose a considerable amount of heat via
their wounds, placing them at risk of hypothermia
4. Continued…
• Trauma victims are also at risk through loss of blood and the exposure of
injured tissues to cool air
• Patients with decreased metabolic rate ( hypothyroidism) produce less
body heat and are vulnerable to hypothermia
• The use of medication in patients may also impair the body’s heating-
generating mechanisms, for example , muscle relaxants and
phenothiazines.
• Also medications that will impair the ability to vasoconstrict, such as beta-
blockers and vasodilators may put a patient at risk
• Alcohol, coupled with exposure to cold is often a cause of hypothermia
5. CLINICAL MANIFESTATION OF HYPOTHERMIA
• A very low temperature of less than 35 degrees is recorded.
Measuring temperature in hypothermia can be problematic and
should be done with a special low reading thermometer
• Exposure to cold causes vasoconstriction with increased blood
pressure, heart rate and cardiac output. As the body temperature falls
the blood pressure and the heart rate also drop
• At a body temperature of 32 degrees or less, the victim is hypotensive
and atrial , and ventricular dysrhythmias may also occur
• At body temperature around 27 degrees, cardiac arrest from
ventricular fibrillation occurs
6. Cont…
• Metabolic acidosis may occur due to a built up of lactic acid in tissues
that are poorly perfused due to vasoconstriction
• Shivering may also occur due to the build up of lactic acid
• Hypothermia affects coagulation
• Alterations in CNS function in hypothermia begin with fatigue and
apathy, progress to impaired judgement, hallucinations and bizarre
behavior and culminate in coma
• Due to cold diuresis urine output increase in hypothermia
7. MANAGEMANENT OF HYPOHTERMIA
• Remove the victim from the cold environment
• Remove any wet clothes as the will exacerbate heat loss
• Cover the victim in warm blankets
• Provide warm fluids if the victim is conscious
• Give warm intravenous fluids
• Irrigate body cavities such as the peritoneum or mediastinum with
warm saline