Hypothermia

From ArticleWorld

Hypothermia is a medical condition characterized by a dropping of core body temperature below normal rates, and a disturbance of the normal metabolism.

Hypothermia begins to occur when core temperature drops below 35 degrees Celsius. The condition becomes critical if one's core temperature drops below 32 degrees Celsius, and temperatures under 27 degrees Celsius are almost always fatal. Some people have survived to temperatures as low as 14 degrees Celsius, but this is very uncommon.

It is not exactly known why people who fall critically unconscious in extremely cold water can sometimes be resuscitated after they should have been long dead by hypothermia and drowning. Specialists presume that this has to do with an extreme slowing of the metabolism, allowing the brain to survive to longer periods of hypoxia.

Types of hypothermia

There are three basic types of hypothermia:

• Acute hypothermia, which is the most dangerous. Temperature drops considerably within minutes or seconds and can cause shock. It occurs, for example, when a person falls into the water of a surface-frozen lake.

• Subacute hypothermia which is less dangerous. It occurs after prolonged exposure to a cold environment.

• Chronic hypothermia occurs without exposure to extremely cold environments, but spontaneously, cased by an underlying diseases.

Symptoms and signs

The first symptoms include cold skin, even on the torso, shivering and tremor. Depending on the severity of the condition, pallor, hypokinesia, weakness, continuous bleeding, amnesia, confusion and delirium may occur. Most of these symptoms are specific, but some or not, so considerable care must be taken.

First aid and treatment

The purpose of the first aid should be raising the body temperature. Emergency medical help should be immediately called. The victim should be taken to shelter as soon as possible, and, if this can be done, put in a bath with mildly warm water, with clothes on. Place cotton-wrapped bottles with hot water between the legs and hands of the subject, and give him warm drink and food. Do not administer hot liquids as this may cause a temperature shock. Monitor the victim continuously, because he or she may require Cardio-pulmonary resuscitation.

However, if the hypothermia is very severe and the victim becomes incoherent and delirates, rewarming should be carried out under strict medical supervision. Immediately call for help and continue administering liquids. Be careful when doing this, because sudden warming can cause cardiac arrhythmia.

Under no circumstance should you massage the victim, give alcohol or treat eventual frostbites. Do not let the victim stand and do not remove clothes. In general, do not perform any action that would divert the blood flow established by the organism. The body will direct the blood to the vital organs, and normal circulation should be established gradually.

In hospital, rewarming is done either externally, or internally, with intravenous hot liquids, if the hypothermia is extremely severe. Strict observation is maintained, because under such circumstances, the heart is very sensible. Death is not pronounced while the patient is still cold: the human body has a remarkable mechanism of protecting from cold, and spectacular resuscitations have been reported, even after several hours of unconsciousness.

In fact, medical practice uses artificially-induced hypothermia, in order to increase survival rates before heart surgeries, or after resuscitation from heart arrest.

Codes:

• ICD-10 code: T68
• ICD-9 code: 780.9, 991.6