Hypothermia

Hypothermia:
• core temperature <35 degrees (severe if <28 degrees) • in older patients usually due to a combination of age related impairments in homeostatic mechanisms; low room temperature (social isolation, poor housing, income); impaired thermoregulation (eg during disease, such as heart failure); immobility; hypothyroidism; autonomic neuropathy; lack of awareness of cold (eg dementia); increased exposure to cold (eg fall outdoors in cold weather); sedative medication • presentation – lethargy; confusion; irritable; loss of fine motor control; shivering; tachycardia; bradycardia; reduced respiration. If severe  coma; arrhythmias • management – oxygen; slowly rewarm(removal of wet clothing; hot air blankets; warm humidified oxygen); monitor vitals; maybe antibiotics for prophylaxis of pneumonia; treat predisposing factors • complications – arrythmias; pneumonia; pancreatitis; acute renal failure; disseminated intravascular coagulation • prevention – modify risk factors; education; alarms; home heating; financial aid