Hypothermia

Overview

The body’s temperature regulatory mechanism maintains energy balance by dissipating and absorbing heat energy. Extremeness in any direction is biologically harmful. 

Hypothermia is a state where heat loss from the body critically exceeds heat gain. Therefore, the body dissipates more heat energy than it gains or absorbs. This happens when a person is exposed to exceeding cold stress. This challenging condition makes it difficult for the body’s heat mechanism to regulate its temperature optimally. 

Factually, the threshold for hypothermia is 35° celsius; hence, below the given temperature, you begin to experience hypothermia. 

Aside from physical conditions, risk factors like drug abuse, endocrine disorders, etc., can cause hypothermia. Common symptoms include shivering, confusion, and loss of organ functions which can lead to death. Hence, severe hypothermia can lead to death.

Meanwhile, hypothermia can be described as mild (at 35 – 32°celsius), moderate (between 32 – 28°celsius), and severe (below 28°celsius).

Key Facts

• Hypothermia is a state where heat loss from the body is more than heat gain
• It is commonly caused by constant exposure to heat.
• It can be mild, moderate, or intense.
• Other factors are drugs and alcohol, autoimmune diseases
• Symptoms are shivering, pale skin, cold to the touch, and loss of consciousness.
• It can be prevented by wearing clothes that keep you from the cold weather.
• It is being treated by warming
• Hypothermia can lead to complications like frostbite, pancreatitis, cold diuresis, coma, and eventually death

Symptoms

Symptoms range from mild to moderate to severe. At a level, metabolic, cardiac(heart), and respiratory functions deteriorate. This makes the little heat retained be used for brain protection. Eventually, all heat is lost, cerebral blood flow decreases, the brain stops working, and death sets in. 

Common symptoms are:

• Feeling cold and shivering. Shivering is the body’s normal response to cold. During shivering, serious muscular movement is engaged to generate heat to remedy the cold.
• You begin to feel overwhelmed, confused, and exhausted because the nervous system gradually loses its functions.
• Pale skin
• Hands fumble
• Unsteadiness of gait. This occurs as the person loses nervous coordination.
• Difficulty in breathing and eventually coma.

Diagnosis

Diagnosis is appropriate for hypothermia. Some people may evaluate the condition as something that can be easily seen with the eyes. However, a diagnosis will spot hidden symptoms, complications, and effects on organs. Therefore, diagnosis for hypothermia includes the following;

• Physical Examination

The doctor will collect the patient’s medical history to identify risk factors. 

Cloth removal is necessary; then, a blanket is placed on the patient. Extra lab tests include a full blood count and others. 

For hypothermic patients, results will show a high hemoglobin level due to cold diuresis.

• Imaging

Imaging techniques are recommended for patients that might have gone through trauma or head injury. X-ray Imaging will show that patients with severe hypothermia have pulmonary edema. CT scan is to be considered, especially when the patient suffers from mental confusion, while Ultrasound will provide an analysis of cardiac activities.

• Electrocardiogram (ECG)

ECG will detect a slow impulse rate in a hypothermic patient. Prolonged ECG means the impulse is slow. Bradycardia and a high risk of ventricular arrhythmias are common in patients with hypothermia. 

The ECG-hypothermia-associated wave is the Osborn J wave.  Ventricular fibrillation often occurs below 28 °C and asystole below 20 °C 

• Thermometer and Similitudes

For body temperature reading, special low-reading rectal thermometers or rectal thermistor probes should be considered. Clinical thermometers may be flawed in detecting hypothermia. Tympanic thermometry and bladder probes are equally suitable.

Causes

Common causes of hypothermia include:

• Constant exposure to cold. This could result from not appropriately protecting yourself during the winter or snow.
• Accident. For instance, falling in Iceland. Intense snow period. 
• Age factor. 60-year-old adults are at more risk of hypothermia. 
• Babies are prone to hypothermia; hence suitable clothing is recommended.
• Drug abuse and alcoholism may lead to hypothermia 
• Some autoimmune diseases are risk factors for hypothermia

When exposed to cold temperatures, the body loses more heat energy. This happens through the skin via radiation, exhalation, etc. When the condition is extreme, heat loss becomes more rapid. The Hypothalamus, the part of the brain that regulates temperature, begins its work. 

• Muscular movement, seen as shivering, is engaged to produce heat.
• Vasoconstriction of blood vessels takes place.

But when it becomes severe, body organs fail in their respective functions. The retained heat is used for the brain—finally, the brain losses its functions, and coma sets in, leading to death.

Prevention

Common ways to prevent hypothermia include the following, 

• Toddlers need to dress appropriately for cold weather. Sweaters, gloves, caps, hats, etc., are recommended. Heavyweight dresses are suitable for winter and snowy seasons. 
• Moderate the use of air conditioners. In extreme situations, AC can lead to hypothermia. 
• During the cold, dress in heavyweight clothes. Use a mitten or gloves. Cover yourself with a blanket.
• Avoid alcohol and caffeine; they make the body readily lose more heat than it gains.
• Avoid lifestyles like smoking and drug abuse. Some hypothermic conditions are associated with drugs and alcohol.
• Eat enough food so that metabolism can generate heat. 
• Exercise adequately. It will help initiate metabolism. 

Typical Treatment

Treatment for hypothermia includes first aid practices. This is because some cases are emergencies. However, available treatments for hypothermia are:

• The passive external rewarming method is practiced for mild cases. It’s necessary to cover the person with a thick blanket or warm dress. Hot beverages and tea can be given to the patient. Blankets or warm clothes will help to retain heat. However, this method needs glucose.
• Active external rewarming is for moderate cases. By convection, a heated air medium can transfer heat to the body via electricity or chemical reactions. 

• The irrigation method has to do with irrigating body cavities with warm fluid. It’s a static core warming method. 
• Extracorporeal rewarming involves using machines like heart-lung machines to pass humidified warm air across the chest or abdomen. This warming method is employed in severe hypothermic conditions.
• Warm intravenous fluids are as well to be considered, while substances like caffeine and alcohol that makes the body readily lose heat are to be avoided.

Conclusion

Hypothermia is a case that can be handled by being watchful. When it begins, immediate actions will prevent it from falling into a severe state. However, when someone is being exposed to a highly calm environment without control. Hypothermia turns severe. Death sets in. This can be seen in war situations, homelessness, etc. Also, if it arises due to an autoimmune disorder, then clinical management practices need to be observed. Meanwhile, for drug-induced hypothermia, such a lifestyle should be abandoned. Persistent hypothermia can lead to complications like frostbite, cold diuresis, pancreatitis, hyperkalemia, coma, and death.

MOST COMMON