Wilderness Medicine: Hypothermia and CPR

Dr. Donner discusses considerations when performing CPR on a hypothermic patient. This is video 5 of 7 of the hypothermia series.
MedWild provides wilderness medicine, wilderness survival, and search and rescue instructional videos on a variety of topics: high altitude illness, traveler’s diarrhea, shoulder dislocation and reduction, shelter building, bushcraft, space blankets, hypothermia, medical kits, survival kits, frostbite, snake bites, fire craft, ropes and knots, orthopedic injuries and sam splints, cold water immersion and more.
Instructor: Howard Donner, MD
Co-Author “Field Guide to Wilderness Medicine”
Served as a physician for Denali National Park, Himalayan Rescue Association, and the 1998 NOVA Everest expedition. Served as a medical operations consultant for NASA for over 5 years. Whitewater rafting guide, commercial pilot, and certified flight instructor.
Recommended Audience: Outdoor enthusiasts and health care professionals including physicians, nurses, search and rescue teams, EMT, paramedics, ski patrol, corpsman, guides, instructors, wilderness first responders, and anyone else interested in educational and “how to” videos on wilderness emergency medicine, travel medicine, search and rescue, expedition medicine, backcountry first aid, wilderness survival training, and military medicine. Dr. Donner’s draws on his extensive backcountry and travel experience to highlight key signs, symptoms, treatments, and improvised techniques and skills.
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Produced by Kyle Allred PA-C
Please Note: MedWild Videos are for educational purposes and not intended to replace recommendations by your health care provider.

[@MedWild]

See the instructor in this video (Dr. Howard Donner) give presentations and teach a variety of hands-on workshops at the upcoming National CME Conferences on Wilderness Medicine. All medical specialities are welcome! wilderness-medicine.com

[@TechnikMeister2]

FYI: Down here in OZ two weeks ago we had a fishing boat capsize 400km off the Tasmanian coast. Water temp was less than 10C. An Orion search and rescue dropped two rafts and a Paramedic (how you do that out of an Orion at 250kph is another story). The paramedic was able to treat the mild hypothermia but one woman was in severe. No vital signs. He started CPR and got a chain of people doing ten minutes a time and they kept it up for 11 hours, in the raft, in the patrol boat, in the heli, and still going to the ER. The woman lived with 5 broken ribs. So yes. It can be done.

[@johnn.gillespie4212]

A great addition to BSA/Wilderness first aid training for scouts.

[@reidtillery2856]

Since a severely hypothermic patient is extremely vulnerable to v-fib, and since any jostling or rough treatment (e.g. chest compressions) can cause the patient's heart to fibrillate, and since it is nearly impossible to defibrillate a hypothermic heart, does it not also make sense to refrain from providing CPR and hope for the best (there may be some minimal and undetectable metabolic activity going on) since the patient is likely in a "metabolic icebox" state, and may revive once rewarming is done at a medical facility?

[@Cyndel2006]

wonderful information. thank you.

[@MedWild]

+Cyndel2006 Thank you for the feedback

[@frankblangeard8865]

In a hospital if a patient suffers a witnessed cardiac arrest and the heart is restarted within minutes using a defibrillator followed by advanced life support then the chances of survival are about 19%.

[@reidtillery2856]

From what I understand, this assessment in pessimistic. King Count Washington, for example, has a survival rate of witnessed, out-of-hospital cardiac arrest in excess of 50%.

[@frankblangeard8865]

@@reidtillery2856 You should contact the American Heart Association and let them know about this hugely successful performance. They will want to know how it is accomplished.

[@reidtillery2856]

@@frankblangeard8865 Maybe you'll want to contact the King County medical director. Those guys have had wonderful success out there.