Rationale
Hypothermia is defined as a core body temperature below 35 °C, and it can represent a medical emergency. Severe hypothermia is defined as a core body temperature below 28 °C. Frostbite is a potentially serious and common cold-related injury.
Causal Conditions
(list not exhaustive)
- Decreased heat production (e.g., hypothyroidism)
- Increased heat loss (e.g., exposure)
- Impaired thermoregulation (e.g., neurologic, metabolic, alcohol-related)
Key Objectives
Given a patient with hypothermia and/or a cold-related injury, the candidate will diagnose the cause, severity, and complications, and will initiate an appropriate management plan. In particular, the candidate will recognize the severity of hypothermia and provide urgent therapy.
Enabling Objectives
Given a patient with hypothermia and/or a cold-related injury, the candidate will
- list and interpret critical clinical findings, including those that
- determine the severity, and
- determine whether concomitant illnesses or the use of alcohol or substances may have precipitated the condition;
- list and interpret critical investigations, including those for
- underlying causes (e.g., thyrotropin [thyroid-stimulating hormone] level), and
- effects on organ systems (e.g., coagulation profile, lactate level, electrocardiography)
- construct an effective initial management plan, including
- initiating life-saving treatment in case of severe hypothermia,
- determining best next steps based on an understanding of the advantages and disadvantages of active and passive external rewarming and active core rewarming as well as appropriate rewarming of frostbitten areas,
- conducting ongoing monitoring of the patient during rewarming to identify complications (e.g., arrhythmia, infection),
- determining if the patient requires further specialized care, and
- determining if the hypothermic patient is in cardiac arrest, and recognizing the need for rewarming prior to ceasing resuscitation.
