Hypothermia and Arrest

Epidemiology and Risk Factors

Pathophysiology

• Cardiac arrest secondary to hypothermia typically has a better outcome, even with prolonged resuscitation

Modifications to Standard Life Support

BLS:

• Signs of life are obfuscated by hypothermia
• Mechanical (machine) CPR is preferred
• Intermittent CPR is permissible to preserve strength of pre-hospital staff when continuous CPR is not feasible
  5 minute breaks 5 minutely.

ALS:

• Use a low-reading thermometer to accurately record body temperature
• When core temperature <30°C:
  • Don’t defibrillate
  • Don’t give adrenaline
• When core temperature is 30-35°C:
  • Double the adrenaline dosing interval
• Rewarming should be performed:
  • 1^st line: Extracorporeal
  • 2^nd line: Warmed IV fluids and cavity lavage
  • 3^rd line: External warming

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References