Describe the initial resuscitation in hypothermia.
Initial resuscitation: ABCDE approach
Unresponsive patient: Check pulses for 60 seconds; start CPR if pulseless. (See “Hypothermic cardiac arrest” for details).
Provide supplemental oxygen.
Initiate IV fluid resuscitation preferably through 2 large-bore peripheral IVs.
Remove wet clothing and ensure a warm environment.
Ensure continuous core temperature monitoring during resuscitation.
Start rewarming techniques based on hypothermia stage.
ACLS guidelines (picture)
Describe the passive rewarming technique.
Patients with mild hypothermia may only require passive rewarming.
Insulation (e.g., with blankets) allows patients to retain body heat.
Active movement can increase heat generation.
Describe the active rewarming technique.
Indications
Moderate to severe hypothermia
Unsuccessful passive rewarming
Active external rewarming
Methods include warming blankets, radiant heat, and forced warm air.
Rewarm the torso before the extremities.
Active internal rewarming
Warmed IV fluids
Extracorporeal blood rewarming
Indications include:
Hypothermic cardiac arrest
Unsuccessful rewarming with other techniques
Options include venovenous rewarming, hemodialysis, and extracorporeal life support (ECLS).
Last changed2 years ago
