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Hypothermia Management in the Wilderness

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1. Hypothermia Management in the Wilderness

Hypothermia Management in the Wilderness Hypothermia Management in the Wilderness Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Hypothermia Management in the Wilderness Hypothermia Management in the Wilderness Aka: Hypothermia Management in the Wilderness From Related Chapters II. Management: Methods of rewarming in wilderness ral Move the patient to warm, dry environment Remove wet clothing Avoid excessive movement (risk of arrhythmia) Passive external rewarming Warm dry blanket Hot water bottle Wrapped hot rocks Warm next to another body Radiant heat source Heat pads Immersion Active core rewarming Heated airway inhalation

2018 FP Notebook

2. Accidental Hypothermia Management

indicated in suspected May be used if refractory to all other measures XII. References Civitarese and Sciano (2018) Crit Dec Emerg Med 32(2): 3-16 Herbert and Brown in Herbert (2014) EM:Rap 14(1):1-4 Danzl in Marx (2002) Rosen's Emergency Med, p. 1979-96 Danzl in Auerbach (2001) Wilderness Med, p. 135-77 Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Accidental Hypothermia Management." Click on the image (or right click) to open (...) Accidental Hypothermia Management Accidental Hypothermia Management Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Accidental

2018 FP Notebook

3. CRACKCast E140 – Accidental Hypothermia

28-22 degrees Celsius Profound Hypothermia 20-9 degrees Celsius 9 degrees Celsius is defined as the lowest therapeutic hypothermia survival level Note: There is a five level “Swiss staging” system that is used in some places (also supported by the International Commission for Mountain Emergency Medicine). This system is used by the International Commission of Alpine Rescue (ICAR). However, it’s not favored by all experts in the field of wilderness medicine because the clinical (especially (...) ) NOTE: Some experts recommended against providing CPR to patients with PEA arguing that the patients may have a small amount of cardiac output (without a palpable pulse) that would be disrupted with CPR. The goal in these cases is to WARM the patient up and thereby direct all human efforts to correcting the main underlying problem (i.e. not the pulselessness, but the hypothermia!). Defibrillation: Not a lot of evidence to guide our management on this, so consensus seems to support: Trial

2018 CandiEM

4. Hypothermia Management in the Wilderness

Hypothermia Management in the Wilderness Hypothermia Management in the Wilderness Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Hypothermia Management in the Wilderness Hypothermia Management in the Wilderness Aka: Hypothermia Management in the Wilderness From Related Chapters II. Management: Methods of rewarming in wilderness ral Move the patient to warm, dry environment Remove wet clothing Avoid excessive movement (risk of arrhythmia) Passive external rewarming Warm dry blanket Hot water bottle Wrapped hot rocks Warm next to another body Radiant heat source Heat pads Immersion Active core rewarming Heated airway inhalation

2015 FP Notebook

5. Management of Poisoning

Management of Poisoning Management of Poisoning MOH Clinical Practice Guidelines Dec/2011 Ministry of Health, Singapore College of Medicine Building 16 College Road Singapore 169854 TEL (65) 6325 9220 FAX (65) 6224 1677 WEB www.moh.gov.sg ISBN 978-981-08-9904-2 College of Family Physicians Singapore Singapore Medical Association Pharmaceutical Society of Singapore Society for Emergency Medicine in Singapore Toxicology Society (Singapore) Singapore Paediatric Society Chapter of Emergency (...) and grades of recommendationCLINICAL PRACTICE GUIDELINES Management of Poisoning MOH Clinical Practice Guidelines December/2011Published by Ministry of Health, Singapore 16 College Road, College of Medicine Building Singapore 169854 Printed by Golden City Colour Printing Co. (Pte.) Ltd. Copyright © 2011 by Ministry of Health, Singapore ISBN 978-981-08-9904-2 Available on the MOH website: http://www.moh.gov.sg/cpg Statement of Intent These guidelines are not intended to serve as a standard of medical care

2020 Ministry of Health, Singapore

6. WHO Guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents

pain in adults and adolescents are intended to provide evidence-based guidance to health-care providers on appro- priate approaches to initiating and managing cancer pain in adolescents and adults, including older persons. The guidelines can act as the basis for national guidelines and for the inclusion of cancer pain management and care in primary health care programmes, using a person-centred and integrated approach. AIMS OF THE GUIDELINES The aims of these guidelines are: To provide management (...) guidance to health-care providers (i.e. the end-users of these guidelines: physicians, nurses, pharmacists and caregivers) on the adequate relief of pain associated with cancer or its treatment in adults and adolescents. To assist policy-makers, programme managers and public health personnel to create and facilitate appropriately balanced policies on opioids and prescribing regulations for effective and safe cancer pain management. SCOPE OF THE GUIDELINES The scope of these guidelines includes medical

2019 World Health Organisation Guidelines

7. Acute pain management: scientific evidence (3rd Edition)

Acute pain management: scientific evidence (3rd Edition) ? ? ? ? Acute Pain Management: Scientific Evidence Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine ? ? ? Endorsed by: Faculty?of?Pain?Medicine,?Royal?College?of? Anaesthetists,?United?Kingdom?? Royal?College?of?Anaesthetists,? United?Kingdom?? Australian?Pain?Society? Australasian?Faculty?of?Rehabilitation?Medicine? College?of?Anaesthesiologists,?? Academy?of?Medicine,?Malaysia? College (...) and New Zealand College of Anaesthetists, 630 St Kilda Road, Melbourne, Victoria 3004, Australia. Website: www.anzca.edu.au Email: ceoanzca@anzca.edu.au This document should be cited as: Macintyre PE, Schug SA, Scott DA, Visser EJ, Walker SM; APM:SE Working Group of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine (2010), Acute Pain Management: Scientific Evidence (3rd edition), ANZCA & FPM, Melbourne. Copyright information for Tables 11.1 and 11.2 The material

2015 National Health and Medical Research Council

8. Acute Pain Management: Scientific Evidence

Acute Pain Management: Scientific Evidence ACUTE PAIN MANAGEMENT: SCIENTIFIC EVIDENCE Fourth Edition 2015 Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine Edited by: Stephan A Schug Greta M Palmer David A Scott Richard Halliwell Jane T rinca© Australian and New Zealand College of Anaesthetists 2015 ISBN Print: 978-0-9873236-7-5 Online: 978-0-9873236-6-8 This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced (...) and Faculty of Pain Medicine (2015), Acute Pain Management: Scientific Evidence (4th edition), ANZCA & FPM, Melbourne. Copyright information for Tables 10.1 and 10.2 The material presented in Table 10.1 and Table 10.2 of this document has been reproduced with permission from Prescribing Medicines in Pregnancy, 2015, Therapeutic Goods Administration. It does not purport to be the official or authorised version. © Commonwealth of Australia 2015 This work is copyright. You may download, display, print

2015 Clinical Practice Guidelines Portal

9. Rewarming Methods in Hypothermia

Rewarming Methods in Hypothermia Rewarming Methods in Hypothermia Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Rewarming Methods (...) not available within 6 hours Direct lavage after thoracotomy Increases core temp by 14.4 F (8 C) X. References Civitarese and Sciano (2018) Crit Dec Emerg Med 32(2): 3-16 Danzl in Marx (2002) Rosen's Emergency Med, p. 1979-96 Danzl in Auerbach (2001) Wilderness Med, p. 135-77 Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Rewarming Methods in Hypothermia." Click on the image (or right click) to open the source website in a new browser

2018 FP Notebook

10. Accidental Hypothermia

Accidental Hypothermia Accidental Hypothermia Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Accidental Hypothermia Accidental (...) ) Increased risk with electrolyte abnormalities (e.g. or ) XVI. Management See See See Field Triage Mild Hypothermia Initiate passive and Transport to hospital if any associated injury (e.g. , , ) Moderate to severe Hypothermia Initiate passive and Transport to hospital capable of invasive rewarming If hemodynamic instability or core <82 F (28 C) Transport to capable facility if available (otherwise to nearest hospital with ICU) ral Feel for a pulse for 1 minute at femoral or carotid (weak, slow pulses

2018 FP Notebook

11. Accidental Hypothermia Management

indicated in suspected May be used if refractory to all other measures XII. References Civitarese and Sciano (2018) Crit Dec Emerg Med 32(2): 3-16 Herbert and Brown in Herbert (2014) EM:Rap 14(1):1-4 Danzl in Marx (2002) Rosen's Emergency Med, p. 1979-96 Danzl in Auerbach (2001) Wilderness Med, p. 135-77 Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Accidental Hypothermia Management." Click on the image (or right click) to open (...) Accidental Hypothermia Management Accidental Hypothermia Management Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Accidental

2015 FP Notebook

12. Hypothermia (Treatment)

Hypothermia (Treatment) Hypothermia Treatment & Management: Prehospital Care, Emergency Department Care, Complications Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNzcwNTQyLXRyZWF0bWVudA== processing (...) > Hypothermia Treatment & Management Updated: Nov 08, 2018 Author: James Li, MD; Chief Editor: Joe Alcock, MD, MS Share Email Print Feedback Close Sections Sections Hypothermia Treatment Prehospital Care Prehospital management focuses on preventing further heat loss, rewarming the body core temperature, and avoiding precipitating ventricular fibrillation or another malignant cardiac rhythm. This should be the preeminent concern. Conscious patients can develop ventricular fibrillation suddenly; prehospital

2014 eMedicine Emergency Medicine

13. Hypothermia (Follow-up)

Hypothermia (Follow-up) Hypothermia Treatment & Management: Prehospital Care, Emergency Department Care, Complications Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNzcwNTQyLXRyZWF0bWVudA== processing (...) > Hypothermia Treatment & Management Updated: Nov 08, 2018 Author: James Li, MD; Chief Editor: Joe Alcock, MD, MS Share Email Print Feedback Close Sections Sections Hypothermia Treatment Prehospital Care Prehospital management focuses on preventing further heat loss, rewarming the body core temperature, and avoiding precipitating ventricular fibrillation or another malignant cardiac rhythm. This should be the preeminent concern. Conscious patients can develop ventricular fibrillation suddenly; prehospital

2014 eMedicine Emergency Medicine

14. Accidental Hypothermia

Accidental Hypothermia Accidental Hypothermia Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Accidental Hypothermia Accidental (...) ) Increased risk with electrolyte abnormalities (e.g. or ) XVI. Management See See See Field Triage Mild Hypothermia Initiate passive and Transport to hospital if any associated injury (e.g. , , ) Moderate to severe Hypothermia Initiate passive and Transport to hospital capable of invasive rewarming If hemodynamic instability or core <82 F (28 C) Transport to capable facility if available (otherwise to nearest hospital with ICU) ral Feel for a pulse for 1 minute at femoral or carotid (weak, slow pulses

2015 FP Notebook

15. Rewarming Methods in Hypothermia

Rewarming Methods in Hypothermia Rewarming Methods in Hypothermia Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Rewarming Methods (...) not available within 6 hours Direct lavage after thoracotomy Increases core temp by 14.4 F (8 C) X. References Civitarese and Sciano (2018) Crit Dec Emerg Med 32(2): 3-16 Danzl in Marx (2002) Rosen's Emergency Med, p. 1979-96 Danzl in Auerbach (2001) Wilderness Med, p. 135-77 Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Rewarming Methods in Hypothermia." Click on the image (or right click) to open the source website in a new browser

2015 FP Notebook

16. Therapeutic Hypothermia After the Return of Spontaneous Circulation

Therapeutic Hypothermia After the Return of Spontaneous Circulation Therapeutic Hypothermia After the Return of Spontaneous Circulation - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Therapeutic (...) Hypothermia After the Return of Spontaneous Circulation The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT01617291 Recruitment Status : Terminated (A similar study was recently published with definitive results.) First Posted : June 12, 2012 Last Update Posted : February 14, 2014 Sponsor: University

2012 Clinical Trials

17. Initial Evaluation and Management of the Burn Patient

Initial Evaluation and Management of the Burn Patient Initial Evaluation and Management of the Burn Patient: Overview, Initial Evaluation and Resuscitation, Evaluation of the Burn Wound Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDM1NDAyLW92ZXJ2aWV3 processing > Initial Evaluation and Management of the Burn Patient Updated: Jan 10, 2018 Author: Robert L Sheridan, MD; Chief Editor: John Geibel, MD, DSc, MSc, AGAF Share Email Print Feedback Close Sections Sections Initial Evaluation and Management of the Burn Patient Overview Overview Outcomes for burn patients have improved dramatically over the past 20 years, yet burns still cause substantial morbidity and mortality. [ , ] Proper evaluation and management, coupled with appropriate early

2014 eMedicine Surgery

18. Hypothermia

to move independently. With rising interest in wilderness exploration, and outdoor and water sports, the incidence of hypothermia secondary to accidental exposure may become more frequent in the general population. Alcohol Alcohol consumption increases the risk of hypothermia in two ways: and temperature controlling systems in the brain. Vasodilation increases blood flow to the skin, resulting in heat being lost to the environment. This produces the effect of an individual feeling warm, when (...) conditions can build an or to shelter. The promotes using life vests to protect against hypothermia through the 50/50/50 rule: If someone is in 50 °F (10 °C) water for 50 minutes, he/she has a 50 percent better chance of survival if wearing a life jacket. [ ] A can be used to increase survival in cold water. Babies should sleep at 16-20 °C (61-68 °F) and housebound people should be checked regularly to make sure the temperature of the home is at least 18 °C (64 °F). Management Degree Rewarming technique

2012 Wikipedia

19. Standards for Studies of Neurological Prognostication in Comatose Survivors of Cardiac Arrest: A Scientific Statement From the American Heart Association

temperature management (TTM), neurological prognostication testing may not be accurately applied until several days after ROSC. Neurological Basis of Prognostication Brain injury is the main determinant of functional outcomes in patients with critical illness. Neurological assessments in comatose survivors of cardiac arrest are the basis for neurological prognostication. As an organ sensitive to ischemia and hypoxia, the brain is injured directly as a result of loss of blood flow during arrest (no-flow (...) and limitations as reliable prognostic markers of brain injury after cardiac arrest. Neurological prognostication of unfavorable outcome is based on the absence or limitations of function of a particular injured area of the brain as determined by clinical assessment or diagnostic testing. This determination is susceptible to errors caused by any one or a combination of the following: (1) clinical confounders that may unduly suppress that particular brain function (ie, hypotension, hypothermia, concurrent

2019 American Heart Association

20. CRACKCast E143 – Diving Injuries and Dysbarism

diving other than Dysbarism Environmental exposures Hypothermia Sunburn Trauma (harpoon injury) Aquatic exposures: Submersion accidents (drowning) Motion sickness Marine envenomations (see Ch. 61 – box jellyfish, blue octopus, rockfish) All the other dysbarisms and barotraumas are due to rapid pressure-volume changes in air-filled cavities or nitrogen dissolved into body tissues coming out… [2] What is the ideal gas law? Wikipedia [3] Describe the following laws: …let’s talk about some laws (...) to the dive mask eye-nose interface if the diver doesn’t exhale through their nose. Can cause facial / conjunctival edema, petechial hemorrhages, subconjunctival hemorrhages. Sinus barotrauma barosinusitis is the 2nd most common complaint among divers. Can occur on descent or ascent, causing facial pain/epistaxis At depth : – too much funny gas: huffing that helium balloon Nitrogen narcosis Oxygen toxicity Contaminated gases Hypothermia Ascent: – opening a shaken bottle of pop Rapid up Alternobaric

2018 CandiEM

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