Accidental Hypothermia: 2021 Update

Peter Paal, Mathieu Pasquier, Tomasz Darocha, Raimund Lechner, Sylweriusz Kosinski, Bernd Wallner, Ken Zafren and Hermann Brugger
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Peter Paal: Department of Anesthesiology and Intensive Care Medicine, St. John of God Hospital, Paracelsus Medical University, 5020 Salzburg, Austria
Mathieu Pasquier: International Commission for Mountain Emergency Medicine (ICAR MedCom), 8302 Kloten, Switzerland
Tomasz Darocha: Department of Anesthesiology and Intensive Care, Medical University of Silesia, 40-001 Katowice, Poland
Raimund Lechner: Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Therapy, Military Hospital, 89081 Ulm, Germany
Sylweriusz Kosinski: Faculty of Health Sciences, Jagiellonian University Medical College, 34-500 Krakow, Poland
Bernd Wallner: Department of Anesthesiology and Critical Care Medicine, Medical University of Innsbruck, 6020 Innsbruck, Austria
Ken Zafren: International Commission for Mountain Emergency Medicine (ICAR MedCom), 8302 Kloten, Switzerland
Hermann Brugger: International Commission for Mountain Emergency Medicine (ICAR MedCom), 8302 Kloten, Switzerland

IJERPH, 2022, vol. 19, issue 1, 1-25

Abstract: Accidental hypothermia is an unintentional drop of core temperature below 35 °C. Annually, thousands die of primary hypothermia and an unknown number die of secondary hypothermia worldwide. Hypothermia can be expected in emergency patients in the prehospital phase. Injured and intoxicated patients cool quickly even in subtropical regions. Preventive measures are important to avoid hypothermia or cooling in ill or injured patients. Diagnosis and assessment of the risk of cardiac arrest are based on clinical signs and core temperature measurement when available. Hypothermic patients with risk factors for imminent cardiac arrest (temperature < 30 °C in young and healthy patients and <32 °C in elderly persons, or patients with multiple comorbidities), ventricular dysrhythmias, or systolic blood pressure < 90 mmHg) and hypothermic patients who are already in cardiac arrest, should be transferred directly to an extracorporeal life support (ECLS) centre. If a hypothermic patient arrests, continuous cardiopulmonary resuscitation (CPR) should be performed. In hypothermic patients, the chances of survival and good neurological outcome are higher than for normothermic patients for witnessed, unwitnessed and asystolic cardiac arrest. Mechanical CPR devices should be used for prolonged rescue, if available. In severely hypothermic patients in cardiac arrest, if continuous or mechanical CPR is not possible, intermittent CPR should be used. Rewarming can be accomplished by passive and active techniques. Most often, passive and active external techniques are used. Only in patients with refractory hypothermia or cardiac arrest are internal rewarming techniques required. ECLS rewarming should be performed with extracorporeal membrane oxygenation (ECMO). A post-resuscitation care bundle should complement treatment.

Keywords: accidental hypothermia; cardiac arrest; cardiopulmonary resuscitation; emergency medicine; extracorporeal life support; rewarming (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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