Cardiac Arrest Secondary to Accidental Hypothermia: Rewarming Strategies in the Field

Willmore, Robert

doi:10.1016/j.amj.2019.09.012

Cited by 3 publications

(1 citation statement)

References 33 publications

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“…Hypothermia is a state of decreased core body temperature with the distinction of several stages: mild, moderate, and severe hypothermia. In severe hypothermia (below 28 • C), all life processes slow down significantly with bradycardia, dilated pupils, lack of pupil reaction to light, and cardiac arrhythmias leading to cardiac arrest [14]. The above symptoms of hypothermia (especially in the deep stage) are identical to the clinical symptoms occurring in clinical death.…”

Section: Presumed Causes Of Lazarus Syndromementioning

confidence: 98%

Lazarus Phenomenon or the Return from the Afterlife—What We Know about Auto Resuscitation

Rzeźniczek

Gaczkowska

Kluzik

et al. 2023

JCM

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Autoresuscitation is a phenomenon of the heart during which it can resume its spontaneous activity and generate circulation. It was described for the first time by K. Linko in 1982 as a recovery after discontinued cardiopulmonary resuscitation (CPR). J.G. Bray named the recovery from death the Lazarus phenomenon in 1993. It is based on a biblical story of Jesus’ resurrection of Lazarus four days after confirmation of his death. Up to the end of 2022, 76 cases (coming from 27 countries) of spontaneous recovery after death were reported; among them, 10 occurred in children. The youngest patient was 9 months old, and the oldest was 97 years old. The longest resuscitation lasted 90 min, but the shortest was 6 min. Cardiac arrest occurred in and out of the hospital. The majority of the patients suffered from many diseases. In most cases of the Lazarus phenomenon, the observed rhythms at cardiac arrest were non-shockable (Asystole, PEA). Survival time after death ranged from minutes to hours, days, and even months. Six patients with the Lazarus phenomenon reached full recovery without neurological impairment. Some of the causes leading to autoresuscitation presented here are hyperventilation and alkalosis, auto-PEEP, delayed drug action, hypothermia, intoxication, metabolic disorders (hyperkalemia), and unobserved minimal vital signs. To avoid Lazarus Syndrome, it is recommended that the patient be monitored for 10 min after discontinuing CPR. Knowledge about this phenomenon should be disseminated in the medical community in order to improve the reporting of such cases. The probability of autoresuscitation among older people is possible.

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Section: Presumed Causes Of Lazarus Syndromementioning

confidence: 98%

Lazarus Phenomenon or the Return from the Afterlife—What We Know about Auto Resuscitation

Rzeźniczek

Gaczkowska

Kluzik

et al. 2023

JCM

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2022 Systematic Review of Evidence-Based Guidelines for Prehospital Care

Martin‐Gill

Brown

Cash

et al. 2022

Prehospital Emergency Care

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Special Patient Populations 2.0 MEDICAL OVERSIGHT OF EMS 2.1 Medical Oversight 2.1.1 Medical Oversight of EMS Systems 2.1.2 Legal Issues 2.2 EMS Systems 2.2.1 Public Safety Answering Points 2.2.2 Design of System Components 2.2.3 Delivery Systems with Special Considerations Thomas 2014 2.3 EMS Personnel 2.3.1 Scope of Practice Models 2.3.2 Education Bhanji 2015 Miller 2004 Powers 2018 2.3.3 EMS Provider Health and Wellness Patterson 2018 2.4 System Management 2.4.1 System Finance 2.4.2 Legislation and Government 2.4.3 Public Health 2.4.4 System Status Management 3.0 QUALITY MANGEMENT AND RESEARCH 3.1 Quality Improvement Principles and Programs 3.1.1 Data Collection, Management, and Analysis 3.1.2 Quality Improvement Programs Kronick 2015 3.1.3 Evidence-based Practice 3.2 Research 3.2.1 Data Collection, Management, and Analysis 3.2.2 Fundamental Knowledge of Biostatistics and Epidemiology 3.2.3 EMS Research Design 4.0 SPECIAL OPERATIONS 4.1 Mass Casualty Management 4.1.1 Incident Command System (ICS) 4.1.2 Triage 4.1.3 Patient Care in Mass Casualty Events / Scene Management 4.2 Chemical / Biological / Radiological / Nuclear / Explosive (CBRNE) 4.2.1 Toxic Exposure / Poisoning / Hazardous Materials (HAZMAT) 4.2.2 Explosive Incidents 4.2.3 Weapons of Mass Destruction and Related Injury 4.3 Mass Gathering 4.3.1 Planning and Operations 4.3.2 Personnel Needs 4.3.3 Training and Drills 4.3.4 Design of Temporary Treatment Facilities 4.3.5 Equipment 4.3.6 Communications 4.4 Disaster Management 4.4.1 National Incident Management System (NIMS) & National Response Framework 4.4.2 Catastrophic Events 4.4.3 Health and Medical Resources 4.4.4 Special Response Considerations 4.5 EMS Operations 4.5.1 Tactical 4.5.2 Technical Rescue 4.5.

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Prehospital management of accidental hypothermia

Otworowski¹,

Sośnicki²,

Cipora³

et al. 2020

Emerg Med Serv

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The accidental hypothermia can be diagnosed if a body temperature fall below the 35°C. It is frequently encountered in Poland. It was the cause of death of 1836 people between 2009 and 2012. The aim of our paper was to present the current state of the art regarding prehospital management of the hypothermic patient. The gold standard of internal body temperature measurement is by an esophageal probe. The hypothermic patient should be handled very carefully. The wet clothes should be cut and the patient should be covered with insulation materials. Active rewarming should be initiated in all of the patients in severe and mild hypothermia. After finding an unconscious person who is likely to be in hypothermia, the search for signs of life should take 60 seconds. When CPR is started it should be conducted with standard protocols. Infusion fluids should be heated and the preferred ones are: 0,9% NaCl and crystalloids. No antiarrhythmic or vasoconstrictive drugs should be given in patients with internal body temperature below 30°C. Conclusions: We should encourage providers to equip the rescue teams with the active rewarming devices and insulation materials. The prevention of further heat loss in hypothermic patient is of the greatest importance. The life support should be centered around cardiopulmonary resuscitation with quality chest compressions and adequate ventilation. The definitive treatment of patients suffering from deep hypothermia is most effective in specialist centres dedicated to treating this condition. Air transportation is preferred to land transportation.

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Cardiac Arrest Secondary to Accidental Hypothermia: Rewarming Strategies in the Field

Cited by 3 publications

References 33 publications

Lazarus Phenomenon or the Return from the Afterlife—What We Know about Auto Resuscitation

Lazarus Phenomenon or the Return from the Afterlife—What We Know about Auto Resuscitation

2022 Systematic Review of Evidence-Based Guidelines for Prehospital Care

Prehospital management of accidental hypothermia

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