Hypothermia

Rewarm gradually

Red flags
  • Cardiac arrest (VF risk)
  • Core temp <28 °C
  • Rewarming shock

First steps

  • Handle gently (VF risk)
  • Remove wet clothing, insulate
  • Warm humidified O₂, warm IV fluids
  • Continuous core temp monitor

Key investigations

  • Core temp (oesophageal)
  • ABG (uncorrected)
  • K+, glucose, coag

Differentials

  • Myxoedema coma, sepsis, drug OD

Initial management

  • Mild (32-35): passive external rewarming
  • Moderate (28-32): active external (Bair Hugger) + core (warm IV)
  • Severe (<28): ECMO/CPB if arrest
  • Withhold drugs if <30 °C; halve doses 30-35 °C

Referral

  • ICU
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