Hypothermia

Basics

Description

  • Body temperature <35°C
  • Risk factors:
    • Poor temperature regulation:
      • Very young
      • Advanced age
      • Comorbid condition
      • Intoxication
  • Pathophysiology:
    • Loss of heat:
      • Radiation: Most rapid, 50% of heat loss
      • Conduction
      • Convection
      • Evaporation
      • Respiration
    • Heat production:
      • Shivering
      • Nonshivering thermogenesis
      • Increased thyroxine
      • Increased epinephrine

Etiology

  • Dermal disease:
    • Burn
    • Exfoliative dermatitis
    • Severe psoriasis
  • Drug induced:
    • Ethanol
    • Phenothiazines
    • Sedative–hypnotics
  • Environmental:
    • Immersion
    • Nonimmersion
  • Iatrogenic:
    • Aggressive fluid replacement
    • Heat stroke treatment
  • Metabolic:
    • Hypoadrenalism
    • Hypopituitarism
    • Hypothyroidism
  • Neurologic:
    • Acute spinal cord transection
    • Head trauma
    • Stroke
    • Tumor
    • Wernicke disease
  • Neuromuscular inefficiency:
    • Age extreme
    • Impaired shivering
    • Lack of acclimatization
  • Sepsis

Pediatric Considerations
Infants have a large body surface to mass ratio Child abuse

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