131 - Hypothermia and Frostbite

نویسنده

  • Robert L. Stephen
چکیده

Accidental hypothermia is generally manifested as progression from an initial state of catecholamine release and stimulation (mild hypothermia) to one marked by a predictable slowing of metabolism and all critical body functions to the extent that patients may appear dead. The profound physiologic changes and metabolic slowing all reverse with rapid rewarming, and reports of remarkable neurologically intact survival despite hours of pulselessness and resuscitation are not infrequent. This has given rise to the adage “No one is dead until they are warm and dead.” Not surprisingly, there is little strong scientific evidence for treatment recommendations because trials cannot be conducted. The medical literature is composed mostly of animal experiments, case reports and series, and retrospective reviews. Still, rational approaches can be inferred from the extant literature for this uncommon but serious problem (Table 131.1). Frostbite is a freezing injury to soft tissues secondary to cold exposure and results in loss of circulation to and therefore viability of the affected area. The extremities, nose, ears, and male genitalia are the most commonly affected areas.

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تاریخ انتشار 2013