Evidence-Based Management Of Accidental Hypothermia In The Emergency Department
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Evidence-Based Management Of Accidental Hypothermia In The Emergency Department
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Publication Date

January 2016 (Volume 18, Number 1)

CME

This issue includes 4 AMA PRA Category 1 CreditsTM; 4 ACEP Category I credits; 4 AAFP Prescribed credits; and 4 AOA Category 2A or 2B CME credits.

Authors
 
Megan L. Rischall, MD
Emergency Department, Hennepin County Medical Center, Minneapolis, MN; Assistant Professor of Emergency Medicine, University of Minnesota, Minneapolis, MN
 
Andrea Rowland-Fisher, MD
Emergency Department, Hennepin County Medical Center, Minneapolis, MN
 
Peer Reviewers
 
Stephen V. Cantrill, MD, FACEP
Department of Emergency Medicine, Denver Health Medical Center, University of Colorado School of Medicine, Denver, CO
 
Tatiana Havryliuk, MD, FAWM
Attending Physician, Department of Emergency Medicine, Mount Sinai St. Luke's Hospital, New York, NY
 
Abstract

Accidental hypothermia is defined as an unintentional drop in core body temperature below 35°C. It can present in any climate and in any season, as it is not always a result of environmental exposure; underlying illnesses or coexisting pathology can play important roles. Although there is some variability in clinical presentation, hypothermia produces a predictable pattern of physiologic responses and clinical manifestations, and effective treatment has yielded many impressive survival case reports. Treatment strategies focus on prevention of further heat loss, volume resuscitation, implementation of appropriate rewarming techniques, and management of cardiac dysrhythmia. Rewarming may be passive or active and/or internal or external, depending on severity and available resources. This issue focuses on methods of effective rewarming and prevention of further morbidity and mortality.

Excerpt From This Issue

Emergency physicians in 3 different cities encounter 3 distinct patients with 1 thing in common: a low core body temperature.

Minneapolis, Minnesota: On a cold winter day, an emergency physician receives a call from EMS asking for advice: They were called to a nearby park where an unidentified middle-aged woman was found on the ground near a park bench. She has no palpable pulse, and there is an unknown downtime. On exam, her pupils are fixed and dilated, and her body feels cold to the touch. The paramedic is concerned that any resuscitation efforts would be futile and asks if any interventions should be made.

 

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