Hypothermia medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Medical Therapy

• If any symptoms of hypothermia are present, especially confusion or changes in mental status, the local emergency service should be immediately contacted.
• If the person is unconscious, check their airway, breathing, and circulation. Pulse check should take at least 45 seconds, as the heart rate may be extremely slow. If necessary, begin rescue breathing or CPR. If the victim is breathing less than 6 breaths per minute, begin rescue breathing.
• Take the person inside to room temperature and cover him or her with warm blankets. If going indoors is not possible, get the person out of the wind and use a blanket to provide insulation from the cold ground. Cover the person's head and neck to help retain body heat.
• Once inside, remove any wet or constricting clothes and replace them with dry clothing.
• Warm the person. Apply warm compresses or packs to the neck, chest wall, armpits and groin. If the person is alert and can easily swallow, give warm, sweetened, non-alcoholic fluids to aid the warming.
• Stay with the person until medical help arrives.
• Assume that you should obtain a doctor if the victim has been exposed for 24 hours or more.
• Do not use direct heat (such as hot water, a heating pad, or a heat lamp) to warm the person.
• Do not give the person alcohol - alcohol acts as a vasodilator, increasing blood flow to the body's extremities, and thereby increasing heat loss.
• Do not rub the person's limbs because this may cause further tissue damage.
• Handle gently and with extreme care. Any rough handling of an extremely hypothermic person could cause their heart to stop.
• Passive rewarming to prevent further heat loss
• Active external rewarming
• Active core rewarming
• Treat underlying etiologies
• Fluids
• Levothyroxine
• IV thyroxine
• IV hydrocortisone
• Antibiotics
• Vasopressors
• Positive inotropes
• Crystalloid solutions or blood products

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