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Accidental Hypothermia: A Medical Emergency With Multidisciplinary Implications FREE TO VIEW

Diana Cimpoesu*, PhD; Irina Ciumanghel, MD; Ovidiu Popa, MD
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University of Medicine and Pharmacy, Iasi, Romania

Chest. 2012;142(4_MeetingAbstracts):397A. doi:10.1378/chest.1390224
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SESSION TYPE: Non Pulmonary Critical Care Posters

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: To asses the profile, the survival rate and the complications in the patients with accidental hypothermia admitted in the Emergency Department (ED).

METHODS: Analysis of the accidental hypothermia cases presented in the ED of St. Spiridon Hospital Iasi between November 1st 2011 and February 29th 2012, winter weather with 10 days of yellow code and 6 days of orange code.

RESULTS: The study included 14 patients: 28,5% with mild hypothermia, 42,86% with moderate hypothermia, 28,5% with severe hypothermia. The profile of our study’s hypothermic patient: mean age 64,93 years, 57,1% men, 28,6% homeless people, associated pathology 64,3%. The mortality rate in our ED was 14,3% and after 30 days 28,6%. The most frequent cardiac arrhythmia at presentation in ED was sinusal bradycardia (28,6%) followed by PVC. The frequency of cardiac arrest was 28,6% and the most frequent arrest rhythm was VF (50%). The mean central temperature was 29,7 °C and the J wave (Osborne) was recorded at 14,8% of the patients. 28,6% were transferred to ICU, 14,3% needed hemodialysis. There is a statistically significant correlation between the initial temperature, the survival rate and GCS at presentation in the ED. All patients benefited from combined reheating therapy (external and internal). The survival rate was 25% for those with severe hypothermia, 83,4% for those with moderate hypothermia and 100% for those with mild hypothermia.

CONCLUSIONS: The correct application of the resuscitation and therapy guidelines on the hypothermic patient leads to a reduced mortality. The evolution depends on the severity of hypothermia and the type of complications.

CLINICAL IMPLICATIONS: Accidental hypothermia requires a complex therapy centered on reheating and maintaining the vital functions, including sometimes prolonged cardiopulmonary resuscitation.

DISCLOSURE: The following authors have nothing to disclose: Diana Cimpoesu, Irina Ciumanghel, Ovidiu Popa

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University of Medicine and Pharmacy, Iasi, Romania




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