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How is CPR different in hypothermia?
- careful intubation and movement
- check signs of life for 1 minute
- hold drugs until above 30 degrees then double the interval between doses
- 3 shocks below 30 degrees and then focus on rewarming
How should we rewarm?
- ambient room temp
- forced air blanket
- Warm (40-46c) humidified oxygen
- Warm Intravenous fluid
- Gastric,bladder/pleural/peritoneal irrigation with warmed fluids (at 40c)
- Extracorporal rewarming (cardiopulmonary bypass)
What are the ECG changes in hypothermia?
- J waves
- ST/T changes
- QRS broadening
How should we manage frost bite?
- don’t rewarm until in a definitive environment. Refreezing of something partially thawed a disaster warm (37-39) water
- give NSAID
- allow to dry in air, don’t towel
- avoid early debridement and allow to naturally separate
- thrombolysis has been done early in severe cases