Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia

Ken Zafren

doi:10.1016/j.emc.2017.01.003

Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia

Emerg Med Clin North Am. 2017 May;35(2):261-279. doi: 10.1016/j.emc.2017.01.003.

Author

Ken Zafren¹

Affiliation

¹ Alaska Department of Health and Social Services, State of Alaska, Juneau, AK, USA; International Commission for Mountain Emergency Medicine (ICAR MEDCOM), Zürich, Switzerland; Department of Emergency Medicine, Stanford University Medical Center, Stanford, CA, USA; Alaska Native Medical Center, Anchorage, AK, USA. Electronic address: kenzafren@gmail.com.

PMID: 28411927
DOI: 10.1016/j.emc.2017.01.003

Abstract

Accidental hypothermia is an unintentional drop in core temperature to 35°C or below. Core temperature is best measured by esophageal probe. If core temperature cannot be measured, the degree should be estimated using clinical signs. Treatment is to protect from further heat loss, minimize afterdrop, and prevent cardiovascular collapse during rescue and resuscitation. The patient should be handled gently, kept horizontal, insulated, and actively rewarmed. Active rewarming is also beneficial in mild hypothermia but passive rewarming usually suffices. Cardiopulmonary resuscitation should be performed if there are no contraindications to resuscitation. CPR may be delayed or intermittent.

Keywords: Accidental hypothermia; Afterdrop; Avalanche; Cardiac arrest; Circumrescue collapse; Hypothermia; Rewarming; Thermoregulation.

Publication types

Review

MeSH terms

Cardiopulmonary Resuscitation / methods*
Emergency Medical Services / methods*
Heart Arrest / therapy
Humans
Hypothermia / diagnosis
Hypothermia / physiopathology
Hypothermia / therapy*
Rewarming / methods*
Shock / therapy