Hipotermia accidental

Abstract

Accidental hypothermia is an infrequent and under-diagnosed pathology, which causes fatalities every year. Its management requires thermometers to measure core temperature. An esophageal probe may be used in a hospital situation, although in moderate hypothermia victims epitympanic measurement is sufficient. Initial management involves advance life support and body rewarming. Vigorous movements can trigger arrhythmia which does not use to respond to medication or defibrillation until the body reaches 30°C. External, passive rewarming is the method of choice for mild hypothermia and a supplementary method for moderate or severe hypothermia. Active external rewarming is indicated for moderate or severe hypothermia or mild hypothermia that has not responded to passive rewarming. Active internal rewarming is indicated for hemodynamically stable patients suffering moderate or severe hypothermia. Patients with severe hypothermia, cardiac arrest or with a potassium level below 12 mmol/l may require cardiopulmonary bypass treatment.

The Pathophysiological Mechanisms of the Onset of Death Through Accidental Hypothermia and the Presentation of „the Little Match Girl” Case

“…Active external rewarming (immersion in warm water, electric blankets, environmental heaters, convective air blankets) is indicated for moderate or severe hypothermia or mild hypothermia that has not responded to passive rewarming. Active internal rewarming (warm pleural lavage, colonic lavage, peritoneal lavage, mediastinal lavage, inhalational gases, intravenous fluids) is indicated for hemodynamically stable patients suffering moderate or severe hypothermia [ 79 , 80 ]. In 1967, Lash reported peritoneal dialysis used in the treatment of hypothermia, in the treatment of patients with severe, prolonged depression of body temperature [ 81 ].…”