injuries poisoning
Hypothermia
Key Points
Measure core temperature in the rectum or esophagus using an electronic thermometer or probe. Above about 32°C, insulation with heated blankets and warm fluids to drink are adequate treatment. Below about 32°C, active rewarming should be done, typically using forced-air hot air enclosures; heated, humidified oxygen; warm IV fluid; and sometimes heated lavage or extracorporeal methods (eg, cardiopulmonary bypass, hemodialysis). At lower temperatures, patients are hypovolemic and require fluid resuscitation. CPR is not done if there is a perfusing rhythm. When CPR is done in patients with a nonperfusing rhythm, defibrillation is deferred (after one initial attempt) until temperature reaches about 30°C. Advanced cardiac life-support drugs are usually not given until temperature reaches about 30° C. 