100 Cases in Clinical Medicine

(Rick Simeone) #1

The management of hypothermia is gradual passive rewarming with replacement of fluids
by warmed colloids as rewarming takes place. The increase of temperature should be
0.5–1°C per hour. If this is not achieved by covering the patient with blankets, then warmed
inspired oxygen, warm intravenous fluids, bladder or peritoneal lavage might be consid-
ered. Drugs and physical disturbance should be limited since the myocardium is often irri-
table and susceptible to arrhythmias.



  • Hypothyroidism should be considered as a possible contributor to hypothermia.

  • Even when alcohol is a cause of unconsciousness, other causes must be excluded.

  • The diagnosis of hypothermia requires a thermometer capable of reading low temperatures.

  • J-waves on the ECG are specific signs of hypothermia.

  • Hypothermia in the elderly is treated by gradual passive rewarming.


KEY POINTS

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