abstracts 2010 - Schweizerische Gesellschaft für Gebirgsmedizin
abstracts 2010 - Schweizerische Gesellschaft für Gebirgsmedizin
abstracts 2010 - Schweizerische Gesellschaft für Gebirgsmedizin
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Int.Commission for Mountain Emergency Medicine<br />
Swiss Society for Mountain Medicine<br />
Accidental Hypothermia<br />
On - site treatment<br />
Bruno Durrer, Air Glaciers, Lauterbrunnen, CH<br />
Dilemmas<br />
On- site Hypothermia (HT)<br />
1. Assessment<br />
2. On-site Triage<br />
3. On-site treatment<br />
4. Post rescue collapse<br />
5. Prevention of cooling out<br />
6. ??? in acc. HT<br />
1.1 Clinical on-site assessment<br />
• Basic survey: No vital signs!<br />
• Lethal injuries? j<br />
• Signs of decomposition?<br />
• Frozen body: nose and<br />
mouth blocked by ice,<br />
Chest compression?<br />
• Livores, rigor mortis??<br />
Hypothermia HT IV or V ???<br />
1.1 Clinical on-site assessment<br />
Hypothermia<br />
Clinical criterias: 1. Consciousness<br />
M 1<br />
2. Shivering<br />
3. Breathing/Pulse<br />
HT I Alert, shivering CO HT I Alert, shivering C 35 - 32<br />
HT II Drowsy, C O 32 - 28<br />
non-shivering<br />
HT III Unconscious C O 28 - 24<br />
HT IV Not breathing C O 24 - 13 ?<br />
HT V Dead C O < 13 / < 9?<br />
Brugger H., Durrer B., et al. Field management of avalanche victims. Resuscitation 51:7-15<br />
1.1 Clinical on-site assessment<br />
Hypothermia HT IV or V ???<br />
• Livores ?<br />
In the field it is very difficult to<br />
distinguish g between livores and<br />
pressure marks due to the cold.<br />
• Rigor mortis vs. cold rigidity ?<br />
In the field very difficult to<br />
distinguish!<br />
Chest compression possible?<br />
Heller AR..et al.,Rigor mortis – a definite sign of death ?<br />
Anaesthesiol Intensivmed 2005 Apr;40(4):225-9<br />
1
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