ABC ahead of rewarming in the treatment of accidental hypothermia
Bjerregaard, J.; Kjærgaard, B.
Ugeskrift for Laeger 176(1): 64-67
2014
ISSN/ISBN: 1603-6824 PMID: 24629613 Document Number: 675617
The treatment of accidental hypothermia is still controversial and is missing detailed evidence-based guidelines. Current knowledge suggests that advanced trauma life support principles must be prioritized ahead of rewarming. In case of cardiac arrest, initiation of extracorporeal circulation before rewarming and prolongation of hypothermia at 33 °C to reduce reperfusion injury and cerebral hyperthermia is recommended but is not as yet implemented as standard treatment. We propose a simplified clinical approach to on-site triage of hypothermia: 1. Awake below 35 °C (Glasgow Coma Scale > 8). 2. Unconscious below 32 °C. 3. Absent respiration and circulation below 32 °C.