References

Balvers K, van der Horst M, Graumans M Hypothermia as a predictor for mortality in trauma patients at admittance to the Intensive Care Unit. J Emerg Trauma Shock. 2016; 9:(3)97-102

Bersten AD. Oh's Intensive Care Manual, 8th edn. Philadelphia PA: Elsevier; 2018

Bouthoorn SH, van der Ploeg T, van Erkel NE, van der Lely N. Alcohol intoxication among Dutch adolescents: Acute medical complications in the years 2000–2010. Clin Pediatr (Phila). 2011; 50:(3)244-251 https://doi.org/10.1177/0009922810388509

Bukur M, Hadjibashi AA, Ley EJ Impact of prehospital hypothermia on transfusion requirements and outcomes. J Trauma Acute Care Surg. 2012; 73:(5)1195-1201 https://doi.org/10.1097/TA.0b013e31826fc7d9

Brown DJA, Brugger H, Boyd J, Paal P. Accidental Hypothermia. New Engl J Med. 2012; 367:1930-1938

Danel T, Libersa C, Touitou Y. The effect of alcohol consumption on the circadian control of human core body temperature is time dependent. Regulat Integrat Physiol. 2001; 281:(1)R52-55

Spontaneous hypothermia on intensive care unit admission is a predictor of unfavorable neurological outcome in patients after resuscitation: an observational cohort study. 2010. https//tinyurl.com/y7qbhbm3 (accessed 17 January 2019)

Danzl DF. Accidental hypothermia, 6th edn. In: Auerbach PS (Ed). Philadelphia PA: Elsevier Mosby; 2012

Dolan B, Holt L. Accident and emergency: theory to practice, 3rd edn. Edinburgh: Elsevier; 2013

Dunne B, Christoua E, Duff O, Merrya C. Extracorporeal-assisted rewarming in the management of accidental deep hypothermic cardiac arrest: a systematic review of the literature. Heart Lung Circ. 2014; 23:(11)1029-1035 https://doi.org/10.1016/j.hlc.2014.06.011

Freer L, Imray CHE. Frostbite, 6th edn. In: Auerbach PS (ed). Philadelphia PA: Elsevier Mosby; 2012

A systematic review of the effectiveness of cutaneous warming systems to prevent hypothermia. 2010. https//tinyurl.com/yb99j287 (accessed 17 January 2019)

Harash A, Gussak I, Cassuto J, Winters SL. Clinical significance of j waves in patients undergoing therapeutic hypothermia for out of hospital cardiac arrest. Pacing electrophysiol. 2017; 40:(2)154-161

Henriksson O, Lundgren PJ, Kuklane K Protection against cold in prehospital care: wet clothing removal or addition of a vapor barrier. Wilderness Environment Med. 2015; 26:(1)11-20 https://doi.org/10.1016/j.wem.2014.07.001

UK Ambulance Service Clinical Practice Guidelines.London: JRCALC; 2016

Kirkegaard H, Søreide E, de Haas I Targeted temperature management for 48 vs 24 hours and neurologic outcome after out-of-hospital cardiac arrest: a randomized clinical trial. JAMA. 2017; 318:(4)341-350 https://doi.org/10.1001/jama.2017.8978

Kheirbek T, Kochanek AR, Alam AB. Hypothermia in bleeding trauma; a friend or foe?. Scand J Trauma Resus Emerg Med. 2009; 17 https://doi.org/10.1186/1757-7241-17-65

Hypothermia treatment & management. 2018. https//tinyurl.com/yamf5ztu (accessed 17 January 2019)

Mallet ML. Pathophysiology of accidental hypothermia. Int J Med. 2002; 95:(12)775-785

Mitchell EL, Medzon R. Introduction to Emergency Medicine.Philadelphia PA: Lippincott Williams and Wilkins; 2005

Myers RD. Alcohol's effect on body temperature: hypothermia, hyperthermia or poikilothermia?. Brain Res Bull. 1981; 7:(2)209-220

Advanced Medical Life Support. Assessment based approach. College of Paramedics.Burlington: Jones and Bartlett; 2019

National Institute for Health and Care Excellence. Hypothermia: prevention and management in adults having surgery [CG 65]. 2008. https//www.nice.org.uk/Guidance/CG65 (accessed 17 January 2019)

Paal P, Gordon L, Strapazzon G Accidental hypothermia-an update: The content of this review is endorsed by the International Commission for Mountain Emergency Medicine (ICAR MEDCOM). Scand J Trauma Resusc Emerg Med. 2016; 24:(1) https://doi.org/10.1186/s13049-016-0303-7

Porth C. Essentials of pathophysiology: concepts of altered states, 4th edn. Philadelphia PA: Lippincott Williams and Wilkins; 2014

Polderman KH, Herold I. Therapeutic hypothermia and controlled normothermia in the intensive care unit: Practical considerations, side effects, and cooling methods. Crit Care Med. 2009; 37:(3)1101-1120

Rubiano AM, Sanchez AI, Estebanez G, Peitzman A, Sperry J, Puyana JC. The effect of admission spontaneous hypothermia on patients with severe traumatic brain injury. Injury. 2013; 44:(9)1219-1225 https://doi.org/10.1016/j.injury.2012.11.026

Reinberg A, Clench J, Aymard N Variations circadiennes des effets de l'éthanol et de l'éthanolémie de l'homme adulte sain. Etude chronopharmacologique. J Physiol (Paris). 1975; 70:(1)1-22

Reynolds BR, Forsythe RM, Harbrecht BG, Cuschieri J, Minei JP, Maier RV. Hypothermia in massive transfusion: Have we been paying enough attention to it?. J Trauma Acute Care Surg. 2012; 73

Sholl MJ. Hypothermia. In: Mitchell EL, Medzon R (eds). Philadelphia PA: Lippincott Williams and Wilkins; 2005

Svendsen OS, Grong K, Andersen KS, Husby P. Outcome after rewarming from accidental hypothermia by use of extracorporeal circulation. Ann Thorac Surg. 2017; 103:(3)920-925

Thorsen K, Ringdal KG, Soreide E, Hagemo J, Soreide K. Clinical and cellular effcts of hypotermia, acidosis and coagulopathy in major injury. Br J Surg. 2011; 98:(7)894-907

van Hoof JJ, Schreurs CJ, van der Lely N. Characteristics of adolescents with acute alcohol intoxication: role of population density. 2017; https://doi.org/10.1080/1067828X.2018.1481480

clinical practice

Hypothermia: exploring causes and treatment options

02 January 2019
Features
02 January 2019
Volume 11 · Issue 1

Abstract

The regulation of a patient's body temperature is a key part of a paramedic's duty during treatment. Preventing hypothermia by keeping a core body temperature above 35°C and providing sufficient warming devices to prevent changes in body temperature requires careful assessment, monitoring and training. Critical factors in achieving this include assessment of the patient's exposure to the cold, and understanding of the risks linked to hypothermia—especially in older patients who are at risk of a fatal reaction if the body's temperature drops.

After completing this module the paramedic will be able to:

Paramedics play a vital role in maintaining a patient's body temperature—especially in the prehospital environment and trauma situations. It is important that paramedics are able to perform accurate temperature measurements and initiate timely intervention, as evidence shows that this can reduce hypothermia-associated mortality (Kirkegaard et al, 2017).

According to the National Institute for Health Research (NIHR) (Galvao et al, 2010), the issue of keeping patients warm during a stay in hospital is an important one, but one that can pose a challenge. Preventing hypothermia—that is, a core body temperature below 35°C—and providing sufficient warming devices in order to prevent changes in a patient's body temperature requires careful assessment, monitoring and training. This issue is particularly important in patients who are admitted to the intensive care unit (ICU) or the emergency department (ED).

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