abstracts 2010 - Schweizerische Gesellschaft für Gebirgsmedizin
abstracts 2010 - Schweizerische Gesellschaft für Gebirgsmedizin
abstracts 2010 - Schweizerische Gesellschaft für Gebirgsmedizin
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5. Prevention of further cooling out<br />
Organised rescue<br />
Mountain rescue vs. sea rescue<br />
• Heatpacks on the trunc<br />
• Warm, moist air / oxygen<br />
• Forced warm air / water<br />
• Warm perfusions ?<br />
• Portable forced air warming<br />
devices?<br />
6.<br />
Questions in accidental hypothermia<br />
M 9<br />
M 10<br />
• Lowest reversible acc.HT: 13,7 o Celsius?<br />
• Maximal afterdrop in C: 3-4 o • Maximal afterdrop in C: 3-4 Celsius ?<br />
• Longest successfull CPR: 6h 30 min.?<br />
• Longest time without circulation: 2-4 hours?<br />
• Longest survival submersion: 66 minutes?<br />
• Longest survival in avalanche: 44h / 13 d?<br />
• Cooling rates in the snow: 3 – 8 Co /hour?<br />
Hypothermia in the field<br />
Take home messages 1- 5:<br />
1. Hypothermia staging I -IV:<br />
Consciousness, Shivering, breathing/pulse<br />
2. Monitoring: g ECG and core-temperature p<br />
3. Breathing +: tympanic thermometer<br />
Breathing - : esophageal thermometer<br />
4. Asystolic hypothermia: Triage is for the<br />
patient and for the rescue-staff essential!<br />
5. Lowest actual reversible temp.: 13,7 o Celsius<br />
Prevention of further cooling out:<br />
Warm, moist air / oxygen<br />
Little Dragon<br />
E.Lloyd, Preceedings Int.Congress of Mountain Medicine 1997, Interlaken<br />
Wendling J., Durrer B., Preceedings Int.Congress of Mountain Medicine 1997, Interlaken<br />
Accidental hypothermia: an experimental study of inhalation rewarming. Hayward JS et al.<br />
Aviat Space Environ Med Oct 1975; 46(10) :1236-40<br />
The field treatment of hypothermia is<br />
the art of the possible!<br />
Hypothermia in the field<br />
Take home messages 6-10:<br />
6. Trauma rewarming with heparin-coated ECC<br />
7. HT III: Intubation and loosing time?<br />
88. HT III + II : Post P t rescue collapse ll possible! ibl !<br />
Preoxygenation reduces this risk!<br />
9. On-site prevention from further cooling out!<br />
10.There are still many questionmarks regarding<br />
the on – site therapy of accidental HT. A warm<br />
welcome to the Int. HT registry! ☺<br />
5
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