Hypothermia

Initial Therapy for All Patients

Establish and maintain ABCs per protocol.
Remove wet garments, and protect Pt against further heat loss.
Monitor core temp and cardiac rhythm.
Manage dysrhythmias. Note: Watch for tachycardia (early), bradycardia (late), and J waves.

Pulse and Breathing Present	No Pulse or Respiration
34°-36°C (mild) Passive rewarming. Active external rewarming.	Initiate CPR. Defibrillate VF/VT: biphasic 200 J; monophasic 360 J. Intubate and confirm placement. Ventilate with warm, humidified O₂ (42°-46°C). Establish IV and infuse warm normal saline (43°C).
30°-34°C (moderate) Passive rewarming. Active external rewarming of truncal areas only.	Core temp <30°C Continue CPR, withhold drugs, limit to one shock for VF/VT. Active internal rewarming sequence.
<30°C (severe hypothermia) Active internal rewarming sequence. Continue rewarming until a core temp of >35°C is achieved or return of spontaneous circulation or resuscitative efforts cease.	Core temp >30°C Continue CPR. Drugs as indicated, but spaced longer apart. Repeat shocks for VF/VT as core temp rises. Active internal rewarming.

Active Internal Rewarming