Emergency Medicine - Hypothermia: By Daniel Grushka M.D.

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Emergency Medicine - Hypothermia: What You Need to Know
Whiteboard Animation Transcript
with Daniel Grushka, MD
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Hypothermia is defined, as a core body temperature of less than 35°C - it is a medical emergency in which the body’s core temperature drops below that required for normal cellular metabolism. Here are some important points to remember when presented with a patient in whom the diagnosis of hypothermia is being considered.
The first thing I do is take a focused history to determine the cause. While many associate hypothermia with cold weather, there are other more frequent causes. Think of it in a wide range of situations, including drug and alcohol ingestion, endocrine problems and malnutrition, burns, and even related to cardiac surgery that use a bypass machine.
On exam, I quickly determine if the hypothermia is mild (32 to 34.9°C), moderate (28 to 31.9°C) or severe (less than 28°C) based on the core temperature.
Signs associated with mild hypothermia are tachycardia, tachypnea, and dysarthria.
With moderate hypothermia - loss of shivering, dysrythmias, and a decreased level of consciousness; and with severe hypothermia - coma, asystole, apnea, and flaccidity.
The key to treating any patient with hypothermia is increasing body temperature.
In all cases I remove cold/wet clothes, and use blankets.
In those with more severe cases, I use warming blankets and internal warming is
often necessary.
Internal warming can be achieved through the use of warm fluids being delivered through IVs, GI, peritoneal and pleural lavage, and inhalational rewarming.
Those with all but the mildest form of hypothermia should be admitted to hospital.
It is important to assess the social aspects of any patient with hypothermia, as if the environment is deemed to be the causes, repeat episodes are a risk.