Hypothermia in adults: A strategy for detection and Tx

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Applied Evidence

Hypothermia in adults: A strategy for detection and Tx

J Fam Pract. 2018 May;67(5):E1-E7

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References

1. McCullough L, Arora S. Diagnosis and treatment of hypothermia. Am Fam Physician. 2004;70:2325-2332.

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Prognosis varies with severity, the health of the patient

In healthy, mildly hypothermic patients, full recovery is common if heat loss is minimized and the cause is treated. Moderately hypothermic patients who receive proper care can also have a favorable result. Outcomes for severe hypothermia vary with duration, comorbidities, and severity of core body temperature loss.¹⁵

Heated crystalloid IV fluids do not treat hypothermia, but do help reduce further heat loss and can be helpful in patients in need of volume resuscitation.

Immediate initiation of rewarming by pre-hospital providers improves outcomes, and higher mortality has been demonstrated with hospital admission temperatures <35°C (95°F).¹⁵Almost 100% of primary hypothermia patients with cardiac stability who were treated using active external and minimally invasive rewarming techniques survived with an intact neurologic system.¹² Fifty percent of patients who endured cardiac arrest or who were treated with extracorporeal rewarming had an intact neurologic system. In cardiac arrest cases without significant underlying disease or trauma, and in which hypoxia did not precede hypothermia, full recovery is possible (and has been observed).¹²

CASE

Mr. S was given a diagnosis of mild to moderate hypothermia and transferred to the nearest ED for further treatment. His age had put him at increased risk of hypothermia. The work-up included laboratory testing (CBC, chemistry panel, thyroid-stimulating hormone, urinalysis, and blood cultures), electrocardiography, chest radiography, and CT of the head.

The chest radiograph showed pneumonia. Based on the results of blood culture, bacterial infection (pneumonia) was determined to be the underlying cause of hypothermia. Mr. S was started on antibiotics.

CORRESPONDENCE
Natasha J. Pyzocha, DO, Bldg 1058, 1856 Irwin Dr, Fort Carson, CO 80913; natasha.j.pyzocha.mil@mail.mil.

Hypothermia in adults: A strategy for detection and Tx

References

Prognosis varies with severity, the health of the patient

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