To prevent further decrease in core body temperature, patients should be removed from the cold environment as soon as possible.
Evaporative heat loss occurs when a wet surface comes into contact with the air. The presence of wet clothing increases this type of heat loss by five times the normal rate. For this reason, wet clothing should be promptly removed.
Passive rewarming techniques are used for patients with mild hypothermia. These interventions include dressing the patient in warm clothing, while allowing the patient to spontaneously rewarm.
Heated blankets are used during active rewarming of hypothermic patients. Areas of the body that are in direct contact with the heated blanket should be frequently assessed for burns.
IV solutions can be warmed up to 98.6ºF (37ºC) when treating patients with moderate to severe hypothermia.
Supplemental oxygen can be heated and humidified during active internal or core rewarming. For treatment of moderate to severe hypothermia, oxygen may be heated up to 111.2°F (44°C).
Gastric lavage with warm fluids is another intervention that can be used to treat moderate to severe hypothermia. A nasogastric tube is used to give warm fluids to the patient, warming their internal organs.
It is important to remember that the patient’s trunk should be warmed first before the extremities. This pattern of rewarming reduces the risk of afterdrop or a further decrease in body temperature due to rewarming efforts. Afterdrop occurs when cold peripheral blood returns to the central (core) circulation that can lead to rewarming shock characterized by hypotension and arrhythmias.
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