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Accidental Hypothermia

  • Carrie Harvey
  • Ivan Nathaniel CoEmail author
Chapter
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Abstract

Accidental hypothermia, defined as a core temperature <35 °C secondary to unanticipated cold exposure, is prevalent in all geographic regions and carries significant morbidity and mortality. The adage that “a person is not dead until warm and dead” remains true and aggressive resuscitation is therefore indicated in nearly every patient who presents with accidental hypothermia. Unfortunately, no strong evidence-based guidelines exist as the literature surrounding optimal management consists almost exclusively of case reports. Still, the amount of information on the topic allows the provider to develop a rationale treatment plan specific to the patient’s presentation and available resources. This chapter will review the existing evidence surrounding the accurate diagnosis of accidental hypothermia, basics of rewarming strategies, appropriate selection of rewarming modality, and controversial aspects of management.

Keywords

Environmental hypothermia Osborne wave Passive rewarming Active external rewarming Active internal rewarming Body cavity lavage Continuous arteriovenous rewarming Continuous venovenous rewarming Extracorporeal membrane oxygenation Cardiopulmonary bypass 

Abbreviations

°C

Degrees Celsius

ACLS

Advanced Cardiac Life Support

AHA

American Heart Association

CAVR

Continuous arteriovenous rewarming

CPB

Cardiopulmonary bypass

CPR

Cardiopulmonary resuscitation

CVVHD

Continuous venovenous hemodiafiltration

CVVR

Continuous venovenous rewarming

CXR

Chest X-ray

ECG

Electrocardiogram

EMS

Emergency medicine services

IV

Intravenous

PRBC

Packed red blood cells

VA-ECMO

Venoarterial extracorporeal membrane oxygenation

VF

Ventricular fibrillation

VT

Ventricular tachycardia

VV-ECMO

Venovenous extracorporeal membrane oxygenation

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Emergency MedicineMichigan MedicineAnn ArborUSA
  2. 2.Department of Emergency Medicine and Department of Internal Medicine, Division of Pulmonary and Critical CareMichigan MedicineAnn ArborUSA

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