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The normal body temperature is 37.5-degree centigrade.

Any temperature below this can be termed hypothermia especially body temperature less than 35 degree needs immediate attention.

 

MANAGEMENT

 

AIMS

  • The aim of hypothermia is to bring the body temperature to normal efficiently.

  • Ideally, try to warm the child at about 0.5 to 2-degree centigrade every hour as faster rewarming can lead to pulmonary oedema

 

This involves multiple techniques as below

  • Remove the wet clothes if any

  • Treat the patient in a warm room – preferable above 21-degree centigrade

  • Use warm and humidified oxygen

  • Use warmed saline

  • Monitor ECG and look out for arrhythmias

  • If any gastric distention – pass a nasogastric tube for decompression

 

REWARMING METHODS

  • Depends on the age of the child, the duration of the event, severity

  • Use both passive and active methods for effective management

 

PASSIVE REWARMING

  • This can be used for milder cases where the temperature is above 32-degree centigrade

  • Wrap the child in warm blankets completely including the front and back

  • In certain places, you can warrant the use of ‘Bear hugger’ which pumps in warm air into the blanket

  • Remove all the wet clothes, blanket

 

ACTIVE REWARMING

  • The air the patient breaths can be warmed to 40-degree centigrade humidified oxygen

  • In extreme cases, peritoneal lavage is used. Here warmed saline to 45-degree centigrade is used and is flushed into the peritoneal cavity and left for about 15 minutes and replaced with fresh warm supply. The fluid helps to warm the interior organs

  • Extracorporeal method- is used in severe life-threatening hypothermia.Along with this method, defibrillators and normal CPR should be used as normal. Medications for resuscitation have to be used with caution.  

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