Hypothermia - Protocol for ED CORE TEMP < 34º INITIAL THERAPY • Remove wet garments • Avoid rough movements and excess activity • Continuous core temp monitoring (rectal or esophageal probe) • Cardiac monitoring • Ventilate with warm humidified O2 (42-46º) • Cover with BAIR Hugger INVESTIGATIONS • Stat POCT Glucose • CBC, Chem 7, INR, Ca, Mg, P04, LFTs, alb, Lipase, CK • ECG • ABG • Chest Xray MILD-MODERATE HYPOTHERMIA (30-34ºC) • Infuse Normal Saline 1000 cc bolus (large bore IV) • Rapid - Level 1 fluid warmer • Slow - Hot Line fluid warmer • Warmed bladder lavage (use Normal Saline) SEVERE HYPOTHERMIA (<30ºC) Perfusing Rhythm • Intubate • Page Staff Cardiac Surgeon and ICU • Consider inotropic support with epinephrine • Consider paralysis to suppress shivering • If hemodialysis considered, page Staff Nephrologist Non-Perfusing Rhythm • Intubate • Consider inotropic support • Page Staff Cardiac Surgeon to request mechanical circulatory support: ECMO/CPB • Continue CPR • Max 3 shocks for ventricular arrhythmias • Max 3 doses of epinephrine IV until temp is > 29ºC (consider doubling interval between doses) #Hypothermia #Protocol #management #treatment #algorithm
