Wilderness Medicine: Hypothermia Rewarming
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- เผยแพร่เมื่อ 15 ต.ค. 2024
- Dr. Donner discusses how to properly rewarm a hypothermic patient. This is video 7 of 7 in the hypothermia series.
MedWild provides wilderness medicine, wilderness survival, and search and rescue instructional videos on a variety of topics: high altitude illness, traveler’s diarrhea, shoulder dislocation and reduction, shelter building, bushcraft, space blankets, hypothermia, medical kits, survival kits, frostbite, snake bites, fire craft, ropes and knots, orthopedic injuries and sam splints, cold water immersion and more.
Instructor: Howard Donner, MD
Co-Author “Field Guide to Wilderness Medicine”
Served as a physician for Denali National Park, Himalayan Rescue Association, and the 1998 NOVA Everest expedition. Served as a medical operations consultant for NASA for over 5 years. Whitewater rafting guide, commercial pilot, and certified flight instructor.
Recommended Audience: Outdoor enthusiasts and health care professionals including physicians, nurses, search and rescue teams, EMT, paramedics, ski patrol, corpsman, guides, instructors, wilderness first responders, and anyone else interested in educational and “how to” videos on wilderness emergency medicine, travel medicine, search and rescue, expedition medicine, backcountry first aid, wilderness survival training, and military medicine. Dr. Donner’s draws on his extensive backcountry and travel experience to highlight key signs, symptoms, treatments, and improvised techniques and skills.
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See the instructor in this video (Dr. Howard Donner) give presentations and teach a variety of hands-on workshops at the upcoming National CME Conferences on Wilderness Medicine. All medical specialities are welcome! wilderness-medicine.com
Thanks for the question. I spoke with Dr. Donner who said that better choices for rewarming in the field include insulated hot water bottles (perhaps heated from a fire), hypothermia wraps, skin to skin contact etc.
Fire typically does little for raising core temperature and runs the risk of burning the patient. If fire is the only option, keep the patient supine (as hypothermic patients are typically dehydrated), and be very cautious about burns/ sparks.
may I ask how keeping a hypothermic person supine can help dehydration? Is there a link or Im simply not getting smth?
I love the way this doctor instructs us. Thank you for this informative and interesting video.
You're right that it could cause the rescuer to become hypothermic as well. If you've been exposed to the same conditions as the victim, there's a good chance that you're borderline hypothermic too - in which case cuddling up to a human iceblock will do you no favours! If you come across someone in the wilds who's suffering, it could literally save their lives however. The key thing is not to put yourself in danger, otherwise EMS will have two casualties to deal with...
As with many wilderness medicine questions, it depends... I am assuming that the rescuer is relatively normothermic and that the heat exchange through skin to skin contact will not jeopardize the rescuer . Skin to skin contact inside a hypothermic wrap or sleeping bag can be effective for thermally stabilizing patients (i.e. preventing them from losing more heat), but not for rapid rewarming- which would be the definitive treatment for someone with severe, hemodynamically unstable, hypothermia.
skin to skin treatment method is preferably administered with at least 3 persons, and in an enclosed area
if there are no enclosed areas nearby, then dig a hole large enough to fit everybody inside, and deep enough to evade the more harsh environment above.
Helpful to know. I always hear mixed things about hypothermia so this clarifies some of that for our -5°F winters in Michigan.
With severe hypothermia you should avoid rapid rewarming from the outside,- this can cause the after-drop phenomena, where the cold blood from the periphery (skin/superficial muscle) gets less viscous as it worms and heads to the core organs- dropping the core temperature further. These patients need to be rewarmed slowly from the inside out,(body temp IV fluids) - ideally while monitoring for cardiac emergencies in an advanced cardiac support environment.
I think this is mostly in issue for very rapid rewarming. Examples I was given were "immersion in a hot spring," or "exposure to a hot engine room." I doubt that skin-to-skin contact, hot water bottles, or the use of a hypothermia wrap could possibly warm a patient so quickly that this would be an issue. Just think about how much heat
The other concern here is the availability of IV fluids, and getting those fluids to the proper 40 C you'd want for rewarming, in a backcountry setting.
Good information.
Can you give them heated O2
Thermaly Stabilize lol. thanks for that :)
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