Pediatric emergency medicine trisk 1953 1953
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TABLE 90.7
MANAGEMENT OF HYPOTHERMIA
Initial management
Provide supplemental oxygen
Cardiopulmonary resuscitation for asystole, ventricular fibrillation, or any
nonperfusing rhythm (use Echo to distinguish PEA from perfusing rhythm if
pulses are not palpable)
Laboratory determinations
Arterial blood gas analysis corrected for temperature
Complete blood cell count, platelet count
Prothrombin time, partial thromboplastin time
Electrolytes, blood urea nitrogen, creatinine, glucose
Amylase, Lipase
Urine drug screen
Monitoring
Heart rate, electrocardiogram, respiratory rate, blood pressure
Temperature
Consider central venous pressure
Treatment
Correct hypoxemia, hypercarbia
Correct hypokalemia
Correct hypoglycemia, dextrose 0.5–1 g/kg IV
Tolerate hyperglycemia
Temperature
≥32°C (89.6°F): passive rewarming or simple external rewarming
<32°C (89.6°F) (acute): external or core rewarming
<32°C (89.6°F) (chronic): core rewarming
Fluid replacement
(acute) 5% dextrose in normal saline at maintenance rates
(chronic) normal saline and/or fresh frozen plasma to maintain blood
pressure
