A thought ?..

Hypothermia treatment pre-hospital:

Lets say you take 100 cups of 90 degree water. Add a single cup of 120 degree water to the total. The temp of the total is only going to be ~90.5 degrees. Mathematically, it is impossible to add enough warm fluids to artificially raise core temp. Hot chocolate and hand warmers can not reverse hypothermia! Not to say that the calories and hydration does not help, but stop believing that any real treatment for hypothermia exists pre-hospital, especially in a remote setting. What they taught/teach in class is/was taught simply because it is all that can be done, not because it will treat hypothermia.

In other words Specific heat is the quantity of heat required to raise the temperature of 1g of the substance by 1degC. The human body for all practical purposes is a big bag of water. It takes 1 calorie of energy to raise the temperature of 1 gram of water 1 degree Celsius. A liter (1kg) of saline dumped into a 70kg patient just isn’t going to do anything, and you can’t flood the patient with IV fluid to warm them up. Now – you certainly SHOULD give warm IV fluid, because giving room temp (or lower) fluid to someone who is already hypothermic doesn’t exactly help them. But also remember – room temp fluid is 30degF colder than normal body temp. You can only give warmed IV fluids a few degrees warmer than normal body temp or you’ll start cooking RBC’s.

Thus to treat the truly hypothermic PT, prompt removal from the environment and transport to a trauma center is the only cure, where even the newest high tech methods can only raise CBT 9*C an hour…


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