Acute Thermoregulatory Disorders

Harchelroad, Fred

doi:10.1016/s0749-0690(18)30396-3

Cited by 13 publications

(3 citation statements)

References 56 publications

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“…Other possible causes of hypothermia include impaired peripheral regulation induced by diabetes mellitus and neuropathy, impaired central regulation induced by cerebrovascular accidents, intracranial hemorrhages, and drugs, and sepsis, uremia, and trauma. [1][2][3][4] Patients admitted to the ED should be given a finger-stick test, and any history of drug use, alcohol consumption, and any relevant medical history should be determined promptly to facilitate the diagnosis of hypothermia.…”

Section: Discussionmentioning

confidence: 99%

Comatose patient with hypothermia, dyspnea, and general edema in the emergency department: a case report

Tsai

Lin³

et al. 2018

J Int Med Res

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Patients presenting to the emergency department with hypothermia are rare and often require prompt diagnosis and management. Myxedema coma, which may cause severe hypothermia, is a true endocrine emergency requiring early and appropriate treatment. We report on a 47-year-old woman with a history of hyperthyroidism who underwent thyroidectomy 5 years previously, with no regular medication or examinations. She presented to the emergency department with a 1-month history of progressive dyspnea associated with general weakness. She also showed hypothermia, decreased mental status, and general edema. Echocardiography revealed increased pericardial effusion without tamponade. Laboratory examination suggested myxedema coma and hypothyroidism. She received thyroxine, glucocorticoid supplement, and intensive supportive care, after which she gradually improved and was discharged. This case suggests that myxedema coma should be considered in patients with hypothyroidism or a history of thyroidectomy who present with change in consciousness, hypothermia, or other symptoms related to critical or slow presentation in multiple organs. Moreover, long-standing hypothyroidism or precipitating acute events such as sepsis, cerebrovascular accidents, gastrointestinal bleeding, cold exposure, trauma, and some medications may also cause myxedema coma. Myxedema coma is associated with a high mortality, and patients suspected to be suffering from this condition should be treated without delay.

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Section: Discussionmentioning

confidence: 99%

Comatose patient with hypothermia, dyspnea, and general edema in the emergency department: a case report

Tsai

Lin³

et al. 2018

J Int Med Res

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“…One side-effect of antipyretic drugs is that they can hide the effect of treatment and delay correct medi-cation (3). If cooling is necessary, ice water or cold water immersion should be avoided (15). Surface cooling should always be combined with antipyretic drugs to prevent shivering (10).…”

Section: Antipyresismentioning

confidence: 99%

Nursing Care in Fever: Assessment and Implementation

Sund‐Levander¹,

Wahren²,

Emeritus³

1998

Nordic Journal of Nursing Research

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“…Twenty-five years later, Schen then aged 85 years, pleaded with the young doctors managing him for an episode of dehydration to treat him with SC hydration because he had no veins. 4 This effect is worsened substantially in the presence of cognitive impairment, frailty or immobility and in those with pre-existing pathologies such as congestive heart failure, kidney failure and liver cirrhosis. 2 Normal ageing is associated with decreased total body water, decreased intracellular fluid, reduced perception of thirst, decreased glomerular filtration rate, decreased renal capacity to dilute and concentrate urine, abnormal secretion of vasopressin, increased natriuretic hormone secretion, decreased plasma renin activity and decreased aldosterone production.…”

Section: Introductionmentioning

confidence: 99%

Subcutaneous hydration by hypodermoclysis

López¹,

Reyes‐Ortiz

2010

Rev. Clin. Gerontol.

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Subcutaneous hydration, or hypodermoclysis (HDC), is a very simple technique that should be practised more often by doctors and nurses who care for older patients. It involves less discomfort, generates less cost and has fewer adverse effects than the intravenous route and may reduce the need for admission to the emergency department. The main indication is the management of mild to moderate dehydration, and prevention of dehydration in patients who are intolerant of oral intake. It should not be administered in situations of severe dehydration, in emergency situations, or in patients with fluid overload. Isotonic or hypotonic solutions must be used with appropriate electrolytes. Certain medicines can be given simultaneously by HDC and this may be especially valuable in palliative care settings. In most cases there is no need to add hyaluronidase.

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Acute Thermoregulatory Disorders

Cited by 13 publications

References 56 publications

Comatose patient with hypothermia, dyspnea, and general edema in the emergency department: a case report

Comatose patient with hypothermia, dyspnea, and general edema in the emergency department: a case report

Nursing Care in Fever: Assessment and Implementation

Subcutaneous hydration by hypodermoclysis

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