Hypothermia (Hyperthermia)

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Hypothermia (Hyperthermia). Dr. Stella Yiu Staff Emergency Physician. LMCC objectives. List clinical findings of hypothermia Investigate Initiate resuscitation for severe hypothermia. 1. Clinical findings of hypothermia. Normal temp: 36.5 – 37.5 C. Effects. - PowerPoint PPT Presentation

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Hypothermia Hyperthermia

Hypothermia(Hyperthermia)Dr. Stella YiuStaff Emergency Physician

LMCC objectivesList clinical findings of hypothermia

Investigate

Initiate resuscitation for severe hypothermia1. Clinical findings of hypothermiaNormal temp: 36.5 37.5 CEffects

By Patrick J. Lynch, medical illustrator (Patrick J. Lynch, medical illustrator) [CC-BY-2.5 (http://creativecommons.org/licenses/by/2.5)], via Wikimedia Commons

Image credit: US public domainMild (32-35C)

By Patrick J. Lynch, medical illustrator (Patrick J. Lynch, medical illustrator) [CC-BY-2.5 (http://creativecommons.org/licenses/by/2.5)], via Wikimedia Commons

Image credit: US public domainMild: Tachycardic, hyperventilationNeuro: Mumbles, grumbles, stumbles, fumbles, tumbles + shiver6Moderate (28-32C)

Image credit: US public domain

Photo credit: Greg OConnell, Flickr creative commonsModerate (28-32C)Image credit: James Heilman, MD

Photo credit: Greg OConnell, Flickr creative commons

Severe (30-32) and deadHyperthermiaLMCC objectivesList predisposing illnesses

List clinical findings

Select investigations

Manage patient by various cooling methodsCausesEnvironment Decreased heat dissipation

Metabolic heat1. Predisposing illnessMetabolic causes: Heat productionMetabolic heatThyroid, pheochromocytomaMalignant hyperthermiaNMSSepsisDecreased heat loss: Drugs Decreased heat dissipation

ObesityDrugs (anticholinergics, serotonin, sympathomimetics)2. Clinical findingsCase: The rave girlHeat stroke: Hot + confusedT> 40Orthostatic BP, HR

CNS: Confusion, ataxic, cerebral edema, seizureCVS: CHF, pulmonary edema, CV collapse

Lab findings: Liver, RenalLiver: necrosis

Rhabdomyolysis

DIC3. Cooling methods

Basic cooling: Photo credit: Kenneth Lu, Flickr creative commons45

Photo credit: yellowcloud, flickr creative commonsMore aggressive coolingTub immersion

GI/Peritoneal lavage

Cardiac bypassStop cooling when temp < 40LMCC objectivesList predisposing illnesses

List clinical findings

Select investigations

Manage patient by various cooling methods