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

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. To be read with comments pages.
A lire avec pages de commentaires.
Jean Chièze
FIPS 15th World Congress, Tignes, april 2005

3. Vital risk of hypothermia =
heart inefficiency
FIPS 15th World Congress, Tignes, april 2005

4. Heart contraction
 chemical conditions
and physical conditions : minimal temperature.
FIPS 15th World Congress, Tignes, april 2005

5. During the rescue,
risk
of passing below the threshold
 cardiac arrest
or ventricular fibrillation
drugs ineffective
defibrillation ineffective
FIPS 15th World Congress, Tignes, april 2005

6. Why ?
1 Cold blood
shell  core
How ?
• abrupt shifts of postures
• sometimes external rewarming
FIPS 15th World Congress, Tignes, april 2005

7. hypothermic
normal
FIPS 15th World Congress, Tignes, april 2005

8. cautions
DMTM Chamonix
• winch pulling up
• stretcher carrying horizontally
FIPS 15th World Congress, Tignes, april 2005

9. cautions
• external rewarming
may be dangerous
• internal rewarming is safer
FIPS 15th World Congress, Tignes, april 2005

10. cautions
• external rewarming
may be dangerous
• internal rewarming is safer
FIPS 15th World Congress, Tignes, april 2005

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. cautions
• blankets, caps...
• but also « caloric tourniquet »
FIPS 15th World Congress, Tignes, april 2005

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. If the first responder thinks
respiratory assistance is necessary
caution
gas insufflated
must be warmed
FIPS 15th World Congress, Tignes, april 2005

15. The rescuer must know
if the core temperature
is near the critical level (28-30°C)
A special thermometer is indispensable
FIPS 15th World Congress, Tignes, april 2005

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. How rewarm the gas ?
Soda lime
Ca(OH)2 + CO2  CaCO2 + H2O
2NaOH + CO2  Na2CO3+ H2O
+
FIPS 15th World Congress, Tignes, april 2005

18. Lloyd Soda lime
sl
O2
 CO2
FIPS 15th World Congress, Tignes, april 2005

19. Soda lime
Lloyd
FIPS 15th World Congress, Tignes, april 2005

20. Soda lime
Reviva
FIPS 15th World Congress, Tignes, april 2005

21. Soda lime
Little Dragon
FIPS 15th World Congress, Tignes, april 2005

22. Parachute
thermique Electricity
FIPS 15th World Congress, Tignes, april 2005

23. Electricity
Res-Q-Air
FIPS 15th World Congress, Tignes, april 2005

24. Cooking pot
Uvic
(butane/propane)
Heat Treat
FIPS 15th World Congress, Tignes, april 2005

25. Solid state oxygen
Aviox
FIPS 15th World Congress, Tignes, april 2005

26. hydrogen
combustion
Applinc O²
air + 0,1 % H
catalyst platinum
FIPS 15th World Congress, Tignes, april 2005

27. Available now
Little Dragon Res-Q-Air
jopo@freenetname.co.uk www.hypothermia-ca.com/res-q-air.htm
FIPS 15th World Congress, Tignes, april 2005

28. Conclusion 1
Every rescue team
possibly dealing with hypothermia
(everywhere !)
must have
- an hypothermic thermometer
- an air warmer
at one’s disposal
FIPS 15th World Congress, Tignes, april 2005

29. Conclusion 2
Insufflation
among hypothermic patient :
• none (cardiac arrest)
• or hot
FIPS 15th World Congress, Tignes, april 2005

30. Cold insufflation =
bear’s cobblestone
of resuscitation
FIPS 15th World Congress, Tignes, april 2005