Page 35 - Color Atlas Of Pathophysiology (S Silbernagl Et Al, Thieme 2000)

A. Hypothermia
Core temperature Core temperature
Muscle tremors Behavioral changes
Predisposition: Not possible/insufficient:
Infant, young child
Helpless, unable to appreciate Cold water Shock, loss of
danger, large surface to mass ratio, (accident at sea, consciousness,
low heat production at rest, falling through ice), effect of alcohol or drugs,
thin subcutaneous tissue snow avalanche, barbiturates
(attempted suicide)
fall into glacier crevasse,
In the elderly mountain accident
Disorientation, narrow range of Psychiatric illness,
thermal regulation Sleeping rough, hypothyroidism,
malnutrition Parkinson’s disease
°C Hypothermia, Cold Injury
37 Accidental hypothermia
Stage Symptoms Metabolism Level of Cardiovascular Rewarming
consciousness system, respiration
35 Metabolism Wide awake Tachycardia,
and agitated
pain (distal
vasoconstriction
Hyperglycemia
blankets
I Agitation 33 Cold tremors, O 2 consumption Confused peripheral Warm room, Plate 2.3
parts of limbs)
Blood
pressure
Exhaustion 31 Muscle rigidity Hypoglycemia Hallucinations, Bradycardia Electric blanket,
warm infusion,
somnolent
Depressed
hemodialysis
breathing
Pupillary reflex
II still Arrhythmias
29 active Metabolism Unconscious Ventricular
light
III Paralysis Wide, Metabolism Coma fibrillation Extracorporeal
circulation
insensitive
Asystole
pupils
Apnea
Core temperature
B. Complications of Rewarming
Rewarming
Peripheral vasodilation Increased cardiac load
Myocardial injury
Hypovolemia
Cold
Blood peripheral blood
Acidic pressure reaches
peripheral blood body core
reaches
body core
Hypothermia
(after-drop) Arrhythmia
Shock
Acidosis Heart failure 25
Silbernagl/Lang, Color Atlas of Pathophysiology © 2000 Thieme
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