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Hypothermia (Differential Diagnosis (Hypoglycemia, Alcohol Toxicity, Drug…
Hypothermia
Etiology
Exposure to cold that causes a drop in core body temperature (<35C, 95F)
Winter season, hiking
Pathophysiology
Heat loss occurs when the body is exposed to cold temperatures for long periods of time.
Body tries to compensate by peripheral vasoconstriction and shivering
Failure of the body to compensate results in organ damage and a decrease in heart rate, which also decreases cardiac output
Clinical Signs and Symptoms
Moderate (28-32C, 82-90F)
Reduces HR, RR, CO, and consciousness; hallucinations; mydriasis; loss of shivering and airway protection
Severe (<28C, <82F)
Coma, areflexia, apnea, pulmonary edema, olugira, hypotension, bradycardia, ventricular arrhythmias, asystole
Mild (32-35C, 90-95F)
Tachypnea, tachycardia, increased BP, confusion, ataxia, dysarthria, shivering, excessive diuresis
Diagnostic Tests
Core temperature measurement using a low temp probe in esophagus, bladder or rectum
Electrolytes, glucose should be normal; coagulation panel (hypothermia inhibits blood coagulation
ABG for correct values in patient's current temp
Chest x-ray for aspiration pneumonia and pulmonary edema
Differential Diagnosis
Hypoglycemia
Alcohol Toxicity
Drug overdose
Stroke
Brain Trauma
PEA
Respiratory Management
Remove any wet clothing; if no signs of life, immediately begin CPR
Warm Oxygen support
Intubate patient for airway protection, use Heater temp of 42-45C. DO NOT use HME. Adjust Minute Ventilation to achieve appropriate pH. Hypothermia shifts the Oxyhemoglobin curve to the left.