Normal human body temperature varies throughout the day and depending on location of measurement. It averages 37°C but can fluctuate between 36.4-37.5°C. Temperature is lowest in the morning and highest in the late afternoon/evening, and also depends on activity, hunger, sleepiness and external temperature. Temperature is typically measured rectally, orally, axillary or tympanically. Hypothermia occurs when core temperature drops below 35°C and can be caused by prolonged cold exposure, while heat-related illnesses like heat cramps, heat exhaustion and heat stroke happen when core temperature rises above normal due to exertion in hot weather.

1. TEMPERATURE
BY-
Jai pratap singh
mbbs

2. • Normal human body temperature,
also known
as normothermia or euthermia,
depends upon the place in
the body at which the measurement
is made, and the time of day and
level of activity of the person.

3. • In healthy adults, body
temperature fluctuates
about 0.5 °C (0.9 °F) throughout
the day, with lower temperatures
in the morning and higher
temperatures in the late
afternoon and evening, as the
body's needs and activities
change.

4. • The time of day and other circumstances
also affect the body's temperature. The
core body temperature of an individual
tends to have the lowest value in the
second half of the sleep cycle; the lowest
point, called the nadir, is one of the
primary markers for circadian rhythms.
The body temperature also changes
when a person is hungry, sleepy, or cold.

6. • Temperature control (thermoregulation) is part of
a homeostatic mechanism that keeps the organism
at optimum operating temperature, as it affects the
rate of chemical reactions. In humans the average
internal temperature is 37.0 °C (98.6 °F), though it
varies among individuals. However, no person always
has exactly the same temperature at every moment
of the day. Temperatures cycle regularly up and
down through the day, as controlled by the
person's circadian rhythm. The lowest temperature
occurs about two hours before the person normally
wakes up. Additionally, temperatures change
according to activities and external factors.

7. • In addition to varying throughout
the day, normal body temperature
may also differ as much
as 0.5 °C (0.9 °F) from one day to the
next, so that the highest or lowest
temperatures on one day will not
always exactly match the highest or
lowest temperatures on the next
day.

8. Diurnal variation in body temperature,
ranging from about 37.5 °C from 10
a.m. to 6 p.m., and falling to
about 36.4 °C from 2 a.m. to 6 a.m.

9. • Taking a patient's temperature is an initial
part of a full clinical examination. Sites used
for measurement include:
• In the anus (rectal temperature)

10. In the mouth (oral temperature)

11. Under the arm (axillary temperature)

12. In the ear (tympanic temperature)

13. In the vagina (vaginal temperature)

14. On the skin of the forehead

15. Over the temporal artery

16. In the gut (by swallowing a small
thermometer)

17. • The temperature reading depends on which
part of the body is being measured. The
typical daytime temperatures among healthy
adults are as follows:
• Temperature in the anus (rectum/rectal),
vagina, or in the ear (otic) is
about 37.5 °C (99.5 °F)
• Temperature in the mouth (oral) is
about 36.8 °C (98.2 °F)
• Temperature under the arm (axillary) is
about 36.5 °C (97.7 °F)

18. HYPOTHERMIA

19. HYPOTHERMIA
• Hypothermia is a potentially dangerous drop
in body temperature, usually caused by
prolonged exposure to cold temperatures.
• Normal body temperature averages 98.6
degrees. With hypothermia, core
temperature drops below 95 degrees. In
severe hypothermia, core body temperature
drops to 86 degrees or lower.

20. • HYPOTHYROIDISM IS OFTEN A
CONTRIBUTORY FACTOR IN THE OLD
AGE, WHILE ALCOHOL AND OTHER
DRUGS(e.g. PHENOTHIAZINES)
COMMONLY IMPEDE THE
THERMOREGULATORY RESPONSE IN
YOUNGER PEOPLE.
• MORE RARELY, HYPOTHERMIA IS
SECONDARY TO GLUCOCORTICOIDS
INSUFFICIENCY, STROKE, HEPATIC
FAILURE OR HYPOGLYCAEMIA.

21. C/F
• MILD
HYPOTHERMIA
 COLD AND SHIVERING
 CONFUSION
 DEHYDRATION
 ATAXIA
• SEVERE
HYPOTHERMIA
 COLD AND NOT
SHIVERING
 DEPRESSED CONSCIOUS
LEVEL
 MUSCLE STIFFNESS
 BRADYCARDIA
 HYPOTENSION
 ECG: J WAVES
 DYSRHYTHMIA

22. INVESTIGATION
 BLOOD GASES
 A FULL BLOOD COUNT
 ELECTROLYTES
 CHEST X-RAY
 ELECTROCARDIOGRAM (ECG)

23. MANAGEMENT
• CONTINUED HEAT LOSS IS PREVENTED BY
SHELTERING THE PT. FROM THE
COLD,REPLACING WET CLOTHING, COVERING
THE HEAD AND INSULATING HIM/HER FROM
THE GROUND.
• REWARMING RATES OF 1-2⁰C/HOUR ARE
EFFECTIVE IN LEADING TO A GRADUAL AND
SAFE RETURN TO PHYSIOLOGICAL NORMALITY.

25. • IN CASE OF SEVERE HYPOTHERMIA
WITH CARDIO- REWARMING AT THE
RATE GREATER THAN 2⁰C/HR
• THIS IS BEST ACHIVED BY
CARDIOPULMONARY BYPASS OR
EXTRACORPOREAL MEMBERANE
OXYGENATION.

26. COLD INJURY

27. FREEZING COLD INJURY ( FROST
BITE)
• THIS REPRESENT THE DIRECT FREEZING OF
THE BODY TISSUES AND USUALLY AFFECTS THE
EXTREMITIES
THE FINGERS
TOES
EARS
FACE

28. •RISK FACTORS
1)SMOKING
2)PERIPHERAL VASCULAR
DISEASE
3)DEHYDRATION
4)ALCOHOL CONSUMPTION

30. • REWARMING SHOULD NOT OCCUR UNTIL IT
CAN BE ACHIVED RAPIDLY IN A WARM BATH.
• GIVE ASPIRIN 300 mg & OXYGEN AS SOON AS
POSSIBLE.
• FROST BITTEN EXTRIMITES SHOULD BE
REWARMED IN WARM WATER AT 40-42⁰C,
WITH ANTISEPTIC ADDED.
• VASODIALATORS SUCH AS PENTOXIFYLLINE
IMPROVES TISSUE SURVIVAL.
• WOUND DEBRIDMENT MAY BE NECESSARY,
AMPUTATION SHOULD BE DELAYED FOR 60-90
DAYS.

31. NON FREEZING COLD INJURY
(TRENCH OR IMMERSION FOOT)
• RESULT FROM PROLONG
EXPOSURE TO COLD, DAMP
CONDITION.
• THE LIMB (USUALLY THE FOOT)
APPEARS COLD,ISCHEAMIC AND
NUMB, BUT THERE IS NO
FREEZING OF THE TISSUE.

33. • ON REWARMING , THE LIMB
APPEARS MOTTLED AND
THEREAFTER BECOMES
HYPERAEMIC, SWOOLEN AND
PAINFUL.
•T/T
a) GRADUAL REWARMING
b) PAIN- AMITRIPTYLINE(50 mg)

34. CHILBLAINS
• ARE TENDER, RED OR PURPLISH SKIN
LESIONS THAT OCCUR IN THE COLD AND
WET.
• OFTEN SEEN –
HORSE RIDERS
CYCLIST
SWIMMERS
WOMEN>MEN
• SHORT LIVED, PAINFUL NOT USUALLY
SERIOUS

35. HEAT RELATED
ILLNESS

36. • WHEN GENERATION OF HEAT EXCEEDS THE
BODY’S CAPACITY FOR HEAT LOSS, CORE
TEMPERATURE RISES.
• D/D
I. Heat illness( heat exhaution,heat stroke)
II. Sepsis, include meningitis
III. Malaria
IV. Drug overdose
V. Malignant hyperpyrexia
VI. Thyroid storm

37. HEAT CRAMP
• Heat cramps are painful, brief muscle
cramps. Muscles may spasm or jerk
involuntarily. Heat cramps can occur
during exercise or work in a hot
environment or begin a few hours later.
• Heat cramps usually involve muscles
that are fatigued by heavy work such as
calves, thighs, and shoulders.

38. •Causes of Heat
Cramps
• The exact cause of heat cramps is
unknown. They are probably related
to electrolyte problems.
• Electrolytes include various
essential minerals, such as
sodium, potassium, calcium,
and magnesium. They undergo

39. •Symptoms of Heat
Cramps
• Muscle spasms that are:
• Painful
• Involuntary
• Brief
• Intermittent
• Usually self-limited (go away on their
own)

40. HEAT SYNCOPE
•SIMILAR TO A VASOVAGAL
FAINT.
•IS RELATED TO
PERIPHERAL
VASODILATATION IN HOT
WEATHER.

41. HEAT EXHAUSTION

42. • OCCURS WITH PROLONGED EXERTION IN
HOT AND HUMID WEATHER, PROFUSE
SWEATING AND INDEQUATE SALT AND
WATER REPLACEMENT.
• ELEVATION IN CORE (Rectal)TEMP. TO
BETWEEN 37-40⁰C
• BLOOD ANALYSES – EVIDENCE OF
DEHYDRATION WITH MILD ELEVATION OF
BLOOD UREA, SODIUM, HAEMATOCRIT.

43. T/T

44. HEAT STROKE
• WHEN CORE BODY TEMPERATURE RISES
ABOVE 40⁰C & IS A LIFE THREATENING
CONDITION.
• SYMPTOMS-
HEADACHE
NAUSEA
VOMITING
MUSCLE TREMOR
CONFUSION
AGGRESSION OR LOSS OF CONSCIOUSNESS

46. • COMPLICATION-
HYPOVOLUMIC SHOCK
LACTIC ACIDOSIS
DISSEMINATED INTRAVASCULAR
COAGULATION
RHABDOMYLOSIS
HEPATIC & RENAL FAILURE
PULMONARY & CEREBRAL OEDEMA.

47. • THE PT. SHOULD BE
RESUSCITATED WITH RAPID
COOLING BY SPRAYING WITH
WATER, FANNING AND ICE PACKS
IN THE AXILLA AND GROINS.
• COLD CRYSTALLOID I.V. FLUID IS
GIVEN BY SOLUTION CONTAINING
POTASSSIUM SHOULD BE
AVOIDED.

49. THANK
YOU