Fwd: Daily bolus of LR: Hypothermia

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February 7, 2011 by dailybolusoflr

Mild hypothermia (32-35°C)
Most people shiver vigorously
Patients may present with altered mental status or slowing
This phase is relatively hemodynamically stable
In this temperature range, increased HR and RR are often seen
“Cold” diuresis may be seen

Moderate hypothermia (28-32°C)
Body does things to decrease oxygen consumption: hypoventilation, decreased HR, decreased renal flow Most patients present in stupor, and are often noted to start undressing
Typically, this phase is noted by lack of shivering
Below 30°C, patients develop a higher risk for arrhythmia

Severe hypothermia (<28°C)
Patients are highly susceptible to ventricular fibrillation
These patients are usually oliguric and often in pulmonary edema
Most patients are unresponsive

Classic EKG finding is the Osborne wave with its positive deflection found between the QRS and the ST segment. The slide attached shows this.

However prolongation of any interval may be present.


Linda Regan, MD FACEP
Program Director, Emergency Medicine Residency
Johns Hopkins Medical Institutions

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