Generally, a cold climatic condition is present in a severe environmental setting. A case report is presented of a 58-year-old man who died from accidental hypothermia associated with immersion in cold water while on a farm during warm weather. [ncbi.nlm.nih.gov]

• Hypothermia

  Early identification of hypothermia, binding algorithm and coordination leading to extracorporeal rewarming, are the most important elements in the deep hypothermia management. [ojs.kardiologiapolska.pl]

  The results presented here also suggest that in hypothermia, changes in cytokine release may vary depending on procedures such as the anesthetic drugs used, the duration of the therapy, or the rate of rewarming from hypothermia. [ncbi.nlm.nih.gov]

• Shivering

  Over half of them identified the initial symptom of AH as obvious shivering (69.4%) and apathy (45.0%). As for the aggravate symptoms, 60.9% chose the wrong answer of more obvious shivering instead of the right one-absence of shivering (5.4%). [ncbi.nlm.nih.gov]

  […] symptoms HT I 35–32° (95–89.6°) Conscious, shivering HT II 32–28° (89.6–82.4°) Impaired consciousness, no shivering HT III 28–24° (82.4–75.2°) Unconscious, no shivering, vital signs present HT IV 24–13.7° ( Unconscious, no vital signs, apparent death [omcr.oxfordjournals.org]

  […] by, last update April 24, 2019 OVERVIEW Hypothermia occurs when core body temperature is < 35°C mild: 32-35°C moderate: 28-32°C severe: < 28°C Swiss staging system I – clearly conscious and shivering II – impaired consciousness without shivering III – [lifeinthefastlane.com]

• Malnutrition

  KEYWORDS: Bio-heat transfer; Cardiomyopathy; Hypothermia modelling; Malnutrition; Thermoregulation [ncbi.nlm.nih.gov]

  Best Review Article accidentalhypothermia Back to top Predisposing factors hypoglycemia, malnutrition, ETOH, Addison’s, infection, and Myxedema (especially if failure to rewarm) Do not need to worry until temp hits 30-32° C, People die from poor judgment [crashingpatient.com]

  […] drowning, alpine environment, poverty (lack of heating or shelter) drugs/ tox – alcohol, sedatives, vasodilators Sepsis CNS disorders e.g. hypothalamic lesions, hypopituitarism Endocrine/ metabolic – hypothyroidism, adrenal insufficiency, hypothermia, malnutrition [lifeinthefastlane.com]

  Other causes include severe malnutrition or hypoglycemia and neuromuscular inefficiencies seen in the extremes of age. [emedicine.medscape.com]

• Myxedema

  Concomitant problems of alcoholism, stroke, myxedema, tuberculosis and paraplegia were also treated. Rapid external rewarming by immersion can result in a low mortality in patients with severe hypothermia. [ncbi.nlm.nih.gov]

  Myxedema coma, infections and neurological diseases were discarded. The cause of severe hypothermia was unclear, and the probable source was suspected to be accidental. [scielo.conicyt.cl]

  If patients aren’t rewarming 1°C/hr and they’re above 32°C, consider: sepsis, cortisol deficiency, myxedema, ethanol. The J wave or “Osborn” wave is found in many cases of hypothermia, often quoted at ~80%. [foamcast.org]

  Best Review Article accidentalhypothermia Back to top Predisposing factors hypoglycemia, malnutrition, ETOH, Addison’s, infection, and Myxedema (especially if failure to rewarm) Do not need to worry until temp hits 30-32° C, People die from poor judgment [crashingpatient.com]

• Chills

  The rapid and complete recovery experienced in the case presented is not surprising since the patient's premorbid condition was good, chilling had been rapid, metabolic exhaustion was mild, and internal rewarming was accomplished without delay, using [ncbi.nlm.nih.gov]

  Tourniquets are applied to the limb to inhibit circulation and avoid general chilling of the patient. The limb is chilled for 3 to 5 hours before amputation. General Hypothermia. [medical-dictionary.thefreedictionary.com]

  When mild or moderate, hypothermic patients present with symptoms that can be fairly misleading, these include, but are not limited to dizziness, confusion, dyspnea and chills. [news-medical.net]

  In 2001 the wind chill was changed to a new system based on the cooling effect on a human face. Wind chill is the term used for the cooling effect of wind in a cold environment. Convective cooling in water is greater than in air. [ahcmedia.com]

• Constipation

  The patient also may experience ileus, constipation, and gastric dilatation. Genitourinary. The patient may have polyuria as a result of cold diuresis, or may have anuria as a result of hypovolemia and renal failure. Musculoskeletal. [ahcmedia.com]

• Hypotension

  Author information 1 Texas Health Harris Methodist Hospital Fort Worth, USA. [email protected] Abstract A potential cause of such emergent issues as cardiac arrhythmias, hypotension, and fluid and electrolyte shifts, accidental hypothermia can [ncbi.nlm.nih.gov]

  We report a 77-year-old female patient who was admitted to the Emergency Department with impairment of consciousness, hypotension, bradycardia and hypothermia. She required endotracheal intubation and transfer to Intensive Care Unit (ICU). [scielo.conicyt.cl]

  Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med 1994; 331:1105-1109. 4. Gross D, Landau EH, Assalia A, Krausz MM. [books.google.it]

• Cyanosis

  In mild hypothermia, patients present with shivering, ataxia, cyanosis, dysarthria, tachycardia, and tachypnea. [crashingpatient.com]

  Patients may have a wide variety of dermatologic manifestations of hypothermia, including erythema, pallor, cyanosis, edema, pernio, frostnip, frostbite, panniculitis, cold urticaria, gangrene, and necrosis. CNS. [ahcmedia.com]

• Confusion

  In recent years, alterations in resuscitation care that sometimes confused or discouraged resuscitation teams have largely been supplanted by an emphasis on safe, rapid, effective rewarming. [ncbi.nlm.nih.gov]

  Victims of accidental hypothermia present year-round and in all climates with a potentially confusing array of signs and symptoms, but increasing severity of hypothermia produces a predictable pattern of systemic organ dysfunction and associated clinical [rc.rcjournal.com]

  Indexing Annotation English : do not confuse with HYPOTHERMIA, INDUCED for cooling of organs during surgery or for therapy; relation to BODY TEMPERATURE : see Manual 23.27+ See Related English : Cold-Shock Response Rewarming Allowable Qualifiers English [decs.bvs.br]

• Altered Mental Status

  He may exhibit poor judgment, slurred speech, or altered mental status. In severe cases of hypothermia, the patient may present with altered mental status including coma, as well as depression of cardiac, respiratory and renal function. [crashingpatient.com]

  Age Very young and elderly persons are at increased risk and may present to the emergency department with symptoms that are not clinically obvious or specific for hypothermia, such as altered mental status. [emedicine.medscape.com]

  Less obvious is the elderly cardiac patient without adequate heating in the home who presents to the emergency department with a complaint of altered mental status. [ahcmedia.com]

• Irritability

  Tip: Avoid jostling the hypothermic patient too much because of myocardial irritability. Don’t send your patient into an arrhythmia. Go to the ALiEM Cards site for more resources. [aliem.com]

  Moreover, these patients may be irritable and have mood changes, lassitude and poor judgment. These symptoms are misleading, because they may be mistaken for other medical conditions, such as alcohol intoxication and stroke. [news-medical.net]

  Irritation to the cardiac membrane can precipitate ventricular fibrillation and cardiac arrest. Patient movement should be held to a minimum and invasive monitoring utilized only if absolutely necessary [ 4 ]. [omcr.oxfordjournals.org]

  The heart becomes quite irritable at temperatures below 30°C. [ahcmedia.com]

• Dysarthria

  Subjects with core body temperatures dropping from 95°F to 90°F develop amnesia, dysarthria, confusion, and disruptive behavior. 1 Further cooling as the body temperature falls to 82.4°F yields stupor, paradoxical undressing, and hallucinations. [mdedge.com]

  In mild hypothermia, patients present with shivering, ataxia, cyanosis, dysarthria, tachycardia, and tachypnea. [crashingpatient.com]

  Fine motor skills decline, manifested as difficulty with zippers, buttons, etc., followed by dysarthria and decline in gross motor skills. [ahcmedia.com]

• Stupor

  Subjects with core body temperatures dropping from 95°F to 90°F develop amnesia, dysarthria, confusion, and disruptive behavior. 1 Further cooling as the body temperature falls to 82.4°F yields stupor, paradoxical undressing, and hallucinations. [mdedge.com]

  Grade °C °F Physiologic Changes Mild 35 95.0 Maximum shivering, impaired judgment, confusion 34 93.2 Tachycardia, tachypnea, increased SVR, cold diuresis 33 91.4 Bradycardia, respiratory depression, hyperglycemia, dysarthria, ataxia Moderate 32 89.6 Stupor [crashingpatient.com]

Results of an extensive diagnostic workup revealed only adrenal insufficiency, and the electrocardiographic abnormalities resolved after warming. [ncbi.nlm.nih.gov]

• Potassium Increased

  As hypothermia progresses, the sodium levels tend to decrease while potassium increases, presumably due to a reduction in enzymatic activity of the cell membrane sodium–potassium pump. [medintensiva.org]

• Hematocrit Increased

  For each 1°C drop in core temperature, the hematocrit increases approximately 2%. • Serum electrolytes: Hypokalemia or hyperkalemia may occur and should be monitored closely during the rewarming process. [ahcmedia.com]

• Prolonged PR Interval

  Multiple other findings eventually develop including a shortened QT interval, ST depression, bundle branch blocks, widened QRS, prolonged PR interval, flattened T wave and ultimately a sine wave. Hyperparathyroidism (D) may lead to hypercalcemia. [foamcast.org]

• Prolonged QT Interval

  An increased PR interval, a widened QRS complex, and a prolonged QT interval signal progressing hypothermia. [nursingcenter.com]

• Electrocardiogram Change

  CONCLUSIONS: Electrocardiogram changes in accidental hypothermia are frequent and characteristic for this entity improving diagnosis in usually unconscious patients, and in many cases, it may be the diagnostic clue in patients with conscience deficit [ncbi.nlm.nih.gov]

It is a unit functioning within the structure of the Cardiac Surgery Clinic, established in order to improve the effectiveness of the treatment of patients in the advanced stages of severe hypothermia. [ojs.kardiologiapolska.pl]

By combining methods used for the resuscitation of burn injury with the treatment principles for frostbite, a highly effective treatment protocol results. [ncbi.nlm.nih.gov]

In the patient with the poorer prognosis, the plasma IL-8 level on admission was not elevated remarkably but after rewarming the level rose significantly. [ncbi.nlm.nih.gov]

The etiology of hypothermia was exposure to cold air (64%) and cold water immersion (36%). Two (18%) were treated with extracorporeal membrane oxygenation and the rest with cardiopulmonary bypass. [ncbi.nlm.nih.gov]

Applicable To Accidental hypothermia Hypothermia NOS Use Additional Use Additional Help Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10data.com]

Etiology Decreased heat production Several etiologies related to endocrine derangements may cause decreased heat production. These include hypopituitarism, hypoadrenalism, and hypothyroidism. [emedicine.medscape.com]

A predefined set of epidemiological and clinical data was retrieved. RESULTS: Eighty-four patients were included (median age: 47 years). [ncbi.nlm.nih.gov]

The loss of body heat, either from the decreased heat production, increased heat loss, or alterations in thermoregulation are important in the epidemiology of this injury. [dtic.mil]

This review will detail the pathophysiological consequences of hypothermia, as well as the most recent principle recommendations in dealing with it. Copyright © 2016. Published by Elsevier Masson SAS. [ncbi.nlm.nih.gov]

This article reviews the epidemiology, pathophysiology, clinical presentation, and treatment of accidental hypothermia. [rc.rcjournal.com]

Pathophysiology Breath holding underwater > involuntary gasp > aspiration/laryngospasm > LOC > active aspiration > death 90% “wet drowning” and 10% “dry drowning” Aspiration leads to loss of surfactant, atelectasis, V/Q mismatch, and ARDS Hypoxemia leads [emdocs.net]

Pathophysiology The body's core temperature is tightly regulated in the "thermoneutral zone" between 36.5°C and 37.5°C, outside of which thermoregulatory responses are usually activated. [emedicine.medscape.com]

This issue focuses on methods of effective rewarming and prevention of further morbidity and mortality. [ncbi.nlm.nih.gov]

Regular consumption of high-energy food rich in carbohydrates aids the body in heat production, while 13-17 c (3-4L) of water a day prevents rapid dehydration from evaporation. [science.jrank.org]