Prehospital management of accidental hypothermia

Abstract

The accidental hypothermia can be diagnosed if a body temperature fall below the 35°C. It is frequently encountered in Poland. It was the cause of death of 1836 people between 2009 and 2012. The aim of our paper was to present the current state of the art regarding prehospital management of the hypothermic patient. The gold standard of internal body temperature measurement is by an esophageal probe. The hypothermic patient should be handled very carefully. The wet clothes should be cut and the patient should be covered with insulation materials. Active rewarming should be initiated in all of the patients in severe and mild hypothermia. After finding an unconscious person who is likely to be in hypothermia, the search for signs of life should take 60 seconds. When CPR is started it should be conducted with standard protocols. Infusion fluids should be heated and the preferred ones are: 0,9% NaCl and crystalloids. No antiarrhythmic or vasoconstrictive drugs should be given in patients with internal body temperature below 30°C. Conclusions: We should encourage providers to equip the rescue teams with the active rewarming devices and insulation materials. The prevention of further heat loss in hypothermic patient is of the greatest importance. The life support should be centered around cardiopulmonary resuscitation with quality chest compressions and adequate ventilation. The definitive treatment of patients suffering from deep hypothermia is most effective in specialist centres dedicated to treating this condition. Air transportation is preferred to land transportation.