Hypothermia: stop cold insufflating

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Heart contraction depends on a chemical reaction but we must not forget that it is possible, only above a certain temperature.

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Hypothermia: stop cold insufflating

  1. 1. Hypothermia :stop cold insufflating !Halte à l’insufflation froide ! Claude Hébette, Hôpital de Moûtiers 1971 - 1998 Véronique Legrand, Annecy Lucien Cadoz, FIPS FIPS 15th World Congress, Tignes, april 2005
  2. 2. To be read with comments pages.A lire avec pages de commentaires. Jean Chièze FIPS 15th World Congress, Tignes, april 2005
  3. 3. Vital risk of hypothermia = heart inefficiency FIPS 15th World Congress, Tignes, april 2005
  4. 4. Heart contraction chemical conditionsand physical conditions : minimal temperature. FIPS 15th World Congress, Tignes, april 2005
  5. 5. During the rescue,riskof passing below the threshold cardiac arrestor ventricular fibrillation drugs ineffective defibrillation ineffective FIPS 15th World Congress, Tignes, april 2005
  6. 6. Why ? 1 Cold blood shell  coreHow ?• abrupt shifts of postures• sometimes external rewarming FIPS 15th World Congress, Tignes, april 2005
  7. 7. hypothermicnormal FIPS 15th World Congress, Tignes, april 2005
  8. 8. cautionsDMTM Chamonix • winch pulling up • stretcher carrying horizontally FIPS 15th World Congress, Tignes, april 2005
  9. 9. cautions• external rewarming may be dangerous• internal rewarming is safer FIPS 15th World Congress, Tignes, april 2005
  10. 10. cautions• external rewarming may be dangerous• internal rewarming is safer FIPS 15th World Congress, Tignes, april 2005
  11. 11. Why ? (contind.)2 Heat loss • through the skin • but also through the airway = caloric haemorrhage (Conn) 70 m² FIPS 15th World Congress, Tignes, april 2005
  12. 12. cautions• blankets, caps...• but also « caloric tourniquet » FIPS 15th World Congress, Tignes, april 2005
  13. 13. Why ? (contind.) 3 Inhalation of cold air or oxygen  lungs , near heart especially in case of intubation FIPS 15th World Congress, Tignes, april 2005
  14. 14. If the first responder thinksrespiratory assistance is necessary cautiongas insufflated must be warmed FIPS 15th World Congress, Tignes, april 2005
  15. 15. The rescuer must knowif the core temperatureis near the critical level (28-30°C)A special thermometer is indispensable FIPS 15th World Congress, Tignes, april 2005
  16. 16. How to rewarm air or oxygen ? • soda lime + CO2 • electricity • cooking pot + water ! • « solid oxygen » • hydrogen + oxygen ( + catalyst) FIPS 15th World Congress, Tignes, april 2005
  17. 17. How rewarm the gas ? Soda lime Ca(OH)2 + CO2  CaCO2 + H2O 2NaOH + CO2  Na2CO3+ H2O + FIPS 15th World Congress, Tignes, april 2005
  18. 18. Lloyd Soda lime sl O2  CO2 FIPS 15th World Congress, Tignes, april 2005
  19. 19. Soda limeLloyd FIPS 15th World Congress, Tignes, april 2005
  20. 20. Soda limeReviva FIPS 15th World Congress, Tignes, april 2005
  21. 21. Soda limeLittle Dragon FIPS 15th World Congress, Tignes, april 2005
  22. 22. Parachutethermique Electricity FIPS 15th World Congress, Tignes, april 2005
  23. 23. ElectricityRes-Q-Air FIPS 15th World Congress, Tignes, april 2005
  24. 24. Cooking potUvic (butane/propane)Heat Treat FIPS 15th World Congress, Tignes, april 2005
  25. 25. Solid state oxygenAviox FIPS 15th World Congress, Tignes, april 2005
  26. 26. hydrogen combustionApplinc O² air + 0,1 % H catalyst platinum FIPS 15th World Congress, Tignes, april 2005
  27. 27. Available nowLittle Dragon Res-Q-Airjopo@freenetname.co.uk www.hypothermia-ca.com/res-q-air.htm FIPS 15th World Congress, Tignes, april 2005
  28. 28. Conclusion 1Every rescue teampossibly dealing with hypothermia(everywhere !)must have - an hypothermic thermometer - an air warmerat one’s disposal FIPS 15th World Congress, Tignes, april 2005
  29. 29. Conclusion 2Insufflationamong hypothermic patient : • none (cardiac arrest) • or hot FIPS 15th World Congress, Tignes, april 2005
  30. 30. Cold insufflation =bear’s cobblestoneof resuscitation FIPS 15th World Congress, Tignes, april 2005

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