Acute Medicine | Cardiorespiratory arrest 02 knowledge B for GPs

Acute Management of Accidental Hypothermia and its Complications
Session Overview
Description
This session looks at the diagnosis and management of an accidental hypothermic patient presenting either with or without cardio respiratory arrest, and common complications. The initial rescue and recovery is not covered in this session.

Learning Objectives
By the end of this session you will be able to:

• Recognise cardiopulmonary arrest and conduct resuscitation in a hypothermic patient
• Categorise and treat a patient with hypothermia
• Judge the lack of success in resuscitation and know when to stop
• Manage a hypothermic patient without cardio respiratory arrest
• Demonstrate an understanding of the complications and risks associated with a hypothermic patient

Hypothermia can occur in people with normal thermoregulation who are exposed to cold environments, particularly wet or windy conditions, or following immersion in cold water.

Drowning is a common cause of accidental hypothermia and death. The most detrimental consequence of drowning is hypoxia. The duration of hypoxia is the critical factor in determining the victim’s outcome. Therefore appropriate and prompt advanced life support plays a crucial role in outcomes which are usually better in victims who have spontaneous circulation and breathing when they reach hospital.

When thermoregulation is impaired, for example, in the elderly and very young, hypothermia may follow a mild cold insult. The risk of hypothermia is also increased by drug or alcohol ingestion, illness, injury or neglect.

Severe hypothermia is associated with marked depression of cerebral blood flow and oxygen requirement, reduced cardiac output and decreased arterial pressure so the victim can appear to be dead. Resuscitation can help full neurological recovery in such cases.