Accidental Hypothermia

摘要

b Accidental hypothermia is an unexpected decrease of core temperature (CT) of less than 35 degrees C. A protective strategy from cold exposure is a crucial attitude. Temperature measurement is essential for diagnosing hypothermia and assessing severity. During non-trauma related cold exposure, several adaptive processes will slowly and physiologically affect vital signs. For patients with severe hypothermia and vital signs, hemodynamic and neurological instability should not benefit from any specific treatment. Cardiac arrest (CA) may occur if CT decreases under 30-32 degrees C. Due to high risks of CA during movements (rescue collapse), any hypothermic patient should be monitored for vital signs before any mobilization. Hypothermic patients should always be moved carefully. In case of CA, only oesophagus core temperature measurement is relevant. If hypothermia is suspected to be the cause of CA, continuous cardiopulmonary resuscitation should be performed. Patients should be transported to a medical center with extracorporeal life support (ECLS) facilities. Setting up ECLS will mostly depend on potassium rate but other factors will also have to be taken into account (age, gender, CT value, low flow duration, and possible asphyxia). Hypothermic CA outcome is potentially excellent, along with full neurological recovery.