Hypothermia in clinical practice

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Abstract

Hypothermia or cold injury is a fairly common occurrence. The number of frostbite and cold injury varies annually in the regions of Russia and is directly related to the peculiarities of the local climate. In cities with a temperate climate, cold injury makes up no more than 1% of the total structure of injuries, while in the Far North it reaches 6-10%, being a characteristic problem for this area. The pathogenesis of frostbite is complex and diverse. Due to cold exposure, hemorheology disorders occur in the affected segments, persistent endothelial dysfunction is formed with changes in peripheral innervation in the focus of alteration and perifocally, which leads to thrombosis and necrosis of the affected limb tissues.

Basic help algorithm:

  1. To ensure transportation to a warm room, active outdoor warming,
  2. to cover with a heat-insulating blanket, in the absence of offer the usual.
  3. Offer warm water in a small amount for hypovolemia
  4. Warm infusions with isotonic solutions of crystalloids.
  5. Warming should be started from the trunk, not from the limbs, to avoid collapse.
  6. Hemodialysis, used only in a hospital setting.

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About the authors

Valeriy P. Kutsenko

St. Petersburg State Pediatric Medical University of the Ministry of Health of Russia of the Russian Federation

Author for correspondence.
Email: val9126@mail.ru
ORCID iD: 0000-0001-9755-1906

Ph.D.Sci., Associate Department of Modern Methods of Diagnostics and Radiobeam Therapy named after V.I. Professor S.A. Reinberg

Russian Federation, St. Petersburg

Darya D. Kovaleva

St. Petersburg State Pediatric Medical University of the Ministry of Health of Russia of the Russian Federation

Email: dasha753k@gmail.com
ORCID iD: 0000-0002-6236-4526

Student

Russian Federation, St. Petersburg

Valentina I. Pusina

Physicians Military Medical Academy named after S.M. Kirov MO RF

Email: pusinapharm@mail.ru
ORCID iD: 0000-0003-3475-8023

Senior Nurse 2nd (Department of the Therapy for Advanced Training)

Russian Federation, St. Petersburg

Olga M. Lustina

Physicians Military Medical Academy named after S.M. Kirov MO RF

Email: lustina1958@mail.ru

Senior Nurse 2nd (Department of the Therapy for Advanced Training)

Russian Federation, St. Petersburg

Pavel V. Seliverstov

Physicians Military Medical Academy named after S.M. Kirov MO RF

Email: seliverstov-pv@yandex.ru
ORCID iD: 0000-0001-5623-4226

Candidate of Medical Sciences, Associate Professor, 2nd Department (of Therapy for Advanced Training)

Russian Federation, St. Petersburg

References

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  5. International Hypothermia Registry [https://www. hypothermia-registry.org].
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Supplementary files

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1. JATS XML
2. Photo

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3. Pic. 1. Classification of general and local cold injury

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4. Pic. 2. Osborne’s prong on the ECG

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5. Pic. 3. Algorithm of the order and volume of cold injury care

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