Podcast
Questions and Answers
A patient is found outdoors in cold weather, is confused, and shivering. Which of the following is the most appropriate first step in managing this patient, assuming you do not know their temperature?
A patient is found outdoors in cold weather, is confused, and shivering. Which of the following is the most appropriate first step in managing this patient, assuming you do not know their temperature?
- Administer intravenous antibiotics to combat potential infection.
- Immediately begin active external rewarming with hot packs to the chest and abdomen.
- Administer a rapid bolus of cold intravenous fluids to help raise the patient's core temperature.
- Initiate active warming with hot packs to the armpits and groin, ensuring they are not directly on the skin. (correct)
Which historical factor would be least relevant when assessing a patient for potential hypothermia?
Which historical factor would be least relevant when assessing a patient for potential hypothermia?
- History of alcohol or drug use.
- Time of exposure to cold and any wind chill factors.
- Patient's preferred method of cooking food. (correct)
- Patient's age.
During the physical examination of a patient suspected of hypothermia, which combination of assessments is most critical?
During the physical examination of a patient suspected of hypothermia, which combination of assessments is most critical?
- Detailed neurological exam and full dermatological assessment.
- Mental status, cardiac, and neurological assessments. (correct)
- Ophthalmological evaluation and endocrine system review.
- Focused musculoskeletal exam and gastrointestinal auscultation.
Which of the following is the most accurate classification of a patient with a core body temperature of 92°F (33.3°C)?
Which of the following is the most accurate classification of a patient with a core body temperature of 92°F (33.3°C)?
A patient presents with altered mental status, shivering, and a history of recent cold exposure. Which of the following conditions should be included in the initial differential diagnosis, besides hypothermia?
A patient presents with altered mental status, shivering, and a history of recent cold exposure. Which of the following conditions should be included in the initial differential diagnosis, besides hypothermia?
Flashcards
Hypothermia
Hypothermia
A condition where the body loses heat faster than it can produce it, leading to a dangerously low body temperature.
Hypothermia: Signs and Symptoms
Hypothermia: Signs and Symptoms
Altered mental status, cold and clammy skin, shivering, bradycardia, and hypotension.
Hypothermia: Risk Factors
Hypothermia: Risk Factors
Very young and old, exposure to cold, drug/alcohol use, and certain medical conditions/medications.
Conditions Mimicking Hypothermia
Conditions Mimicking Hypothermia
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Hypothermia: Treatment
Hypothermia: Treatment
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Study Notes
Hypothermia
History
- Hypothermia can affect individuals of any age, including the very young and the very old.
- Exposure to decreased temperatures is a common factor, but hypothermia can occur even in normal temperatures.
- Relevant factors in a patient's history include past medical conditions, medications, drug or alcohol use, infections, and time of exposure to cold, wetness, or wind.
Signs and Symptoms
- Altered mental status or coma may be present.
- The patient's skin may feel cold and clammy.
- Shivering is a common symptom, though not always present.
- The patient may experience extremity pain.
- Bradycardia (slow heart rate) can occur.
- Hypotension or shock may develop.
Differential Diagnosis
- Consider sepsis, environmental exposure, hypoglycemia, stroke, head injury, and spinal cord injury.
Pearls
- A thorough examination should include assessment of mental status, heart, lungs, abdomen, extremities, and neurological function.
- Extremes of age (very young and very old) are more prone to cold emergencies.
- Accurate measurement and documentation of the body temperature is critical.
- If the patient's temperature is unknown, treatment should be based on the suspected temperature.
- Active warming methods include the use of hot packs in the armpit and groin areas.
- Direct placement of hot packs on the skin should be avoided to prevent burns.
- IV administration of warm saline or lactated Ringer's solution may be considered.
- It is important to be familiar with and adhere to cardiac arrest resuscitation guidelines for hypothermic patients.
Hypothermia Categories
- Mild hypothermia is defined as a body temperature of 90°-95° F (33°-35° C).
- Moderate hypothermia is defined as a body temperature of 82°-90° F (28°-32° C).
- Severe hypothermia is defined as a body temperature below 82° F (<28° C).
Hypothermia Mechanisms
- Radiation
- Convection
- Condensation
- Evaporation
Active Heating Measures
- Hot packs should be applied to the armpits and groin, taking care not to place them directly onto the skin.
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Description
Understand hypothermia, its signs and symptoms, and differential diagnosis. Learn about risk factors, including exposure to cold and underlying medical conditions. Key considerations include altered mental status, shivering, bradycardia, and hypotension.
