Hypothermia

Calculation Methods

Dosage calculations related to hypothermia in EMS:

• adenosine: 6mg rapid IV push, then 12mg if needed (IV rapid push with flush)
• dextrose: D50W 25g IV (adult), D25W 2-4 mL/kg (peds) (IV/IO)
• nitroglycerin: 0.4mg SL q5min x3 doses (SL)

Pediatric dosing: always calculate by weight (mg/kg). Use Broselow tape if weight is unknown.

Equipment & Tools

Equipment used in hypothermia assessment and treatment:

Waveform capnograph

Measures end-tidal CO2 continuously with waveform display. Available sizes: Mainstream (inline), Sidestream (sampling)

BVM

Bag-valve-mask for manual ventilation. Available sizes: Adult (1500mL), Pediatric (500mL), Infant (250mL)

King airway

Supraglottic blind-insertion airway device. Available sizes: Size 3 (4-5 ft), Size 4 (5-6 ft), Size 5 (over 6 ft)

Clinical Significance

In prehospital care, understanding hypothermia can mean the difference between a positive patient outcome and a critical miss. A construction worker stung by wasps, developing urticaria, stridor, and hypotension. Anaphylaxis: epinephrine 0.3mg IM, IV fluids, diphenhydramine, albuterol for bronchospasm.

Related pharmacology: adenosine at 6mg rapid IV push, then 12mg if needed, indicated for SVT (narrow complex tachycardia).

Overview

Core temperature below 95°F (35°C) from cold exposure causing shivering, confusion, and dysrhythmias. Recognition, classification, and rewarming tested on EMT and Paramedic exams.

In prehospital assessment, temperature reference range: adult 97.8-99.1 F (36.5-37.3 C), pediatric same range, rectal preferred under 2yo. Deviations from these norms guide treatment decisions in the field.

Professional Standards

Professional standards for hypothermia are established by the relevant certification body and regulatory agencies. Certified professionals must demonstrate competency through examination and maintain credentials through continuing education. Scope of practice is defined by state law and facility policy. Never perform tasks outside your authorized scope.