Treatment of Hypothermia – Medical care by the Rescuer, Transport Personnel and Hospital

Treatment of Hypothermia

Medical care by the Rescuer, Transport Personnel and Hospital

Heat loss in water is increased 25-fold. Water below the temperature of 28° C (82° F) can be considered as cold. The degree of hypothermia depends on exposure time, water temperature, insulation and more.

Hypothermia is a condition in which the core body temperature falls below 35° C (95° F). The symptoms prevailing in mild hypothermia (35° – 33° C) are confusion and shivering ,In moderate hypothermia (33° – 30° C) shivering is replaced by muscle stiff-ness, the level of consciousness falls rapidly, blood pressure drops and pulse rate falls. In severe hypothermia (<30° C) the main findings are coma, absence of reflexes, and progressive depression of heart rate and respiration with deepening hypothermia.

Treatment

In treating and handling a hypothermal patient it is essential to handle the victim with utmost care and consideration as the heart is extremely susceptible to arrhythmias at subnormal temperatures.

Treatment of the conscious patient:

Patients suffering from cold who are still conscious are normally no problem to treat. Wet clothes should be removed and further heat loss prevented by wrapping the patient in insulated sheets or blankets. He can be treated at normal room temperature. The patient’s body temperature rises as a result of his own heat production. If possible the patient should be kept in an intensive care unit for observation.

Treatment the unconscious patient:

The patient must not be moved around or handled unnecessarily. Leave wet clothes on and prevent further heat loss by covering him carefully. Oxygen should be given from a mask if possible. No attempt must be made to warm the patient actively or revive him at the scene of the accident. Treatment requires the resources of hospital. A hypothermic patient shall not be declared dead, unless rewarming has been attempted without success.

Treatment at hospital of the mild to moderate hypothermic patient usually only requires prewarmed, humid oxygen and intravenous (IV) infusion of glucose. Severe hypother-mia needs more active treatment such as peritoneal lavage or probably best if possible heart-lung machine.

Abstract by Hans Aström