Paediatric Hypothermia
PREDISPOSITION
- radiation (large surface area to volume ratio, large head)
- convective (repeated examinations with exposure to atmosphere)
- conductive (loss of heat into bed)
- thermoregulatory response altered (sedation or paralysis, neurological injury)
PREVENTION
Environmental
- adequate ambient temperature
- maintain dry skin
- cover head with a cap or beanie
- warm blankets
- heating blanket
- forced air warmers
- infra-red radiant heaters
Clinical
- minimise exposure to environment during clinical examination
- continuous or intermittent thermal monitoring
- avoiding cold fluids
- giving warm fluids (39 degrees) to prevent further heat loss
- warm ventilator gases (37 degrees if normothermic, 42 degrees if hypothermic)
Rewarming strategies
- gastric or bladder lavage with 42 degrees normal saline
- peritoneal lavage with 42 degrees potassium free dialysate (20mL/kg at 15/60 cycles)
- pleural or pericardial lavage
- endovascular warming
- extracorporeal blood rewarming (ECMO or dialysis)
Critical Care
Compendium
Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the Clinician Educator Incubator programme, and a CICM First Part Examiner.
He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.
His one great achievement is being the father of three amazing children.
On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.
| INTENSIVE | RAGE | Resuscitology | SMACC