[Management of severe accidental hypothermia].
Accidental hypothermia is an environmental condition with basic principles of classification and resuscitation that apply to mountain, sea or urban scenarios. Along with coagulopathy and acidosis, hypothermia belongs to the lethal triad of trauma victims requiring critical care. A customized healthcare chain is involved in its management, extending from on site assistance to intensive care, cardiac surgery and/or the extracorporeal circulation protocols. A good classification of the degree of hypothermia preceding admission contributes to improve management and avoids inappropriate referrals between hospitals. The most important issue is to admit hypothermia victims in asystolia or ventricular fibrillation to those hospitals equipped with the medical technology which these special clinical scenarios require. This study attempts to establish the foundations for optimum management of accidental hypothermia from first emergency care on site to treatment in hospital including, resuscitation and rewarming with extracorporeal circulation.
Unidad de Medicina Intensiva, Hospital General,San Jorge, Huesca, España. mlavellanas@ono.com
M L
ML
Avellanas
A
A
Ricart
J
J
Botella
F
F
Mengelle
I
I
Soteras
T
T
Veres
M
M
Vidal
D000059:Accidents; D000465:Algorithms; D055875:Avalanches; D003131:Combined Modality Therapy; D003422:Critical Care / Q000379:methods; D019468:Disease Management; D004632:Emergency Medical Services; D005112:Extracorporeal Circulation; D015199:Extracorporeal Membrane Oxygenation; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy; D006801:Humans; D007035:Hypothermia / Q000145:classification / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D010360:Patient Transfer; D017410:Practice Guidelines as Topic; D012151:Resuscitation / Q000379:methods*; D017694:Rewarming / Q000379:methods; D012720:Severity of Illness Index; D014693:Ventricular Fibrillation / Q000209:etiology / Q000628:therapy; D014947:Wounds and Injuries / Q000150:complications / Q000628:therapy