abstracts 2010 - Schweizerische Gesellschaft für Gebirgsmedizin

Hypothermia - myths and facts
Oliver Reisten (Air Zermatt, oliver.reisten@air-zermatt.ch), Steve Teale (Scottish Mountain
Rescue)
Abstract
Background
Treatment of hypothermia is traditionally related with the danger of the so called „after drop“. Does the
“after drop” really exist?
Methods
Various mountain rescue organizations worldwide were asked on their experience in treating
hypothermia. Own and other observations on hypothermia cases were matched. Literature was
reviewed.
Results
Many organizations and individuals still perform treatment of hypothermia respecting the potential
danger of the so called “after drop”. Some different treatment regimen show a good outcome thus not
respecting the principle of “after drop”. The literature is not showing evidence for the classical “after
drop” in mountain rescue. The “after drop” is still transmitted into every next generation learning to
treat hypothermia even though there is no evidence. Complications such as fibrillation, circulation
breakdown, asystole and coma are related to other pathophysiology than “after drop”
Conclusions
Attention should rather be paid on energy situation in hypothermic patients than on rescue without
moving etc. as expected from the dread of “after drop”. People who are somehow able to move - even
though very few - can move without the risk of the phenomenon “after drop”. There is evidence for the
“after drop” only in immersion situations. The “after drop” in the classical mountain rescue setting can
be regarded as a myth. Quick rescue without too much care about the position, moving of the victim
etc. is important in terms of gaining time. Energy supply, warming of any kind and active moving as
long as possible can safely be performed.