Delayed and intermittent CPR for severe accidental hypothermia

Resuscitation
Les GordonKen Zafren

Abstract

Cardiac arrest (CA) in patients with severe accidental hypothermia (core temperature <28 °C) differs from CA in normothermic patients. Maintaining CPR throughout the prehospital period may be impossible, particularly during difficult evacuations. We have developed guidelines for rescuers who are evacuating and treating severely hypothermic CA patients. A literature search was performed. The authors used the findings to develop guidelines. Full neurological recovery is possible even with prolonged CA if the brain was already severely hypothermic before CA occurred. Data from surgery during deep hypothermic CA and prehospital case reports underline the feasibility of delayed and intermittent CPR in patients who have arrested due to severe hypothermia. Continuous CPR is recommended for CA due to primary severe hypothermia. Mechanical chest-compression devices should be used when available and CPR-interruptions avoided. Only if this is not possible should CPR be delayed or performed intermittently. Based on the available data, a patient with a core temperature <28 °C or unknown with unequivocal hypothermic CA, evidence supports alternating 5 min CPR and ≤5 min without CPR. With core temperature <20 °C, evidence supports alternating...Continue Reading

References

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Citations

Aug 25, 2015·High Altitude Medicine & Biology·Tomasz DarochaRafal Drwila
Dec 15, 2015·Oxford Medical Case Reports·Vadim MeytesMohan Kilaru
Oct 20, 2015·Resuscitation·Anatolij TruhlářUNKNOWN Cardiac arrest in special circumstances section Collaborators
Sep 17, 2016·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Peter PaalHermann Brugger
Oct 4, 2016·The Annals of Thoracic Surgery·Øyvind Sverre SvendsenPaul Husby
Mar 5, 2017·Wilderness & Environmental Medicine·Christopher Van TilburgHermann Brugger
Oct 3, 2017·High Altitude Medicine & Biology·Paweł PodsiadłoHermann Brugger
Sep 6, 2018·High Altitude Medicine & Biology·Giacomo Strapazzon, Hermann Brugger
Mar 19, 2016·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Giacomo StrapazzonHermann Brugger
Jun 7, 2019·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·M PasquierV Rousson
Aug 10, 2019·BMC Emergency Medicine·Paweł PodsiadłoRobert Gałązkowski
Apr 15, 2020·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Seth TurnerChristian Martin-Gill
Feb 26, 2019·High Altitude Medicine & Biology·Peter MairBeat Walpoth
Feb 2, 2021·Wilderness & Environmental Medicine·Nicholas DanielKen Zafren
Mar 25, 2021·High Altitude Medicine & Biology·Christof MittermairPeter Paal
Mar 29, 2021·Resuscitation·Carsten LottUNKNOWN ERC Special Circumstances Writing Group Collaborators
Jun 16, 2021·Notfall & Rettungsmedizin·Carsten LottJasmeet Soar
Aug 30, 2021·Lancet·Jasmeet SoarMichael J A Parr

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