From the Guidelines
A body temperature of 8.6 degrees Celsius is not a viable human body temperature and is likely a measurement error or misinterpretation, as normal human body temperature ranges from 36.5 to 37.5 degrees Celsius, and hypothermia is generally defined as a body temperature below 35 degrees Celsius. When considering hypothermia, it's crucial to understand the severity based on body temperature: mild hypothermia is typically defined as a temperature above 34°C, moderate between 30°C to 34°C, and severe below 30°C 1. Given the context of hypothermia, the management strategies include:
- Preventing further heat loss by removing wet clothing and insulating the patient
- Using passive rewarming for mild cases
- Employing external warming techniques for moderate cases
- Utilizing core rewarming methods for severe cases, which may include cardiopulmonary bypass, warm-water lavage, or extracorporeal blood warming
- Administering warmed IV fluids and warm humidified oxygen as adjunctive measures 1. It's essential to prioritize immediate interventions that prevent further heat loss and initiate rewarming, especially in cases of severe hypothermia, as delays can significantly impact morbidity, mortality, and quality of life. In real-life clinical practice, if a patient presents with symptoms suggestive of severe hypothermia, immediate action should be taken to rewarm the patient using the most effective and available methods, considering the patient's overall condition and the resources at hand.
From the Research
Definition and Stages of Hypothermia
- Hypothermia is defined as a core body temperature below 35°C (95°F) 2, 3, 4, 5
- It is traditionally staged as mild, moderate, severe, and profound at temperatures of 35°C to 32°C (95°F to 89.6°F), 32°C to 28°C (89.6°F to 82.4°F), <28°C (<82.4°F), and <24°C (75.2°F), respectively 2
Clinical Presentation and Treatment
- A patient's clinical presentation may not always align with their core body temperature, emphasizing the importance of diagnosis and treatment based on core body temperature via a low-reading thermometer 2
- Treatment of hypothermia typically involves passive and active external and internal rewarming, such as removal of wet clothing, forced air patient warming system, warm blankets, and warm intravenous fluids 2, 6
Physiological Impact of Hypothermia
- Hypothermia can have both beneficial and detrimental effects on physiological processes, with therapeutic hypothermia being used in modern clinical medicine for organ protection and cerebral protection 3
- Accidental hypothermia can lead to circulatory failure, cardiac arrhythmias, and other complications, highlighting the need for prompt and effective treatment 3, 5
Prehospital Management
- Prehospital management of hypothermia is crucial, with treatment ideally beginning prehospital to prevent or manage deterioration of a cold patient 6
- Effective insulation systems, active external rewarming interventions, and warmed intravenous fluids are essential components of prehospital hypothermia management 6