Fast Five Quiz: Frostbite and Hypothermia

Richard H. Sinert, DO


December 03, 2020

According to guidelines on the out-of-hospital treatment of accidental hypothermia from the Wilderness Medical Society, core temperature should not be the sole basis for treatment. Esophageal temperature is recommended as the most accurate minimally invasive method of measuring core temperature. The probe should be inserted into the lower third of the esophagus. In a patient whose airway has not been secured by a supraglottic airway or endotracheal intubation, or in a patient with a secured airway but where no esophageal probe is available, the recommended method for obtaining a core temperature is an epitympanic thermometer designed for field conditions, with an isolating ear cap.

The guidelines state that external rewarming in the field is useful in both shivering and nonshivering patients. Exogenous (active) rewarming methods that provide significant external heat include large chemical heat pads, large electric heat pads or blankets, warm water bottles, and the Norwegian-designed charcoal-burning Heat Pac (ensure adequate ventilation, owing to carbon monoxide emissions). To achieve the most effective rewarming, external heat should be concentrated on the axillae, chest, and back (in that order). These areas have the highest potential for conductive heat transfer.

Read more about the treatment of hypothermia.


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