Indoor accidental hypothermia in the elderly: an emerging lethal entity in the 21st century

Paal, Peter; Rauch, Simon

doi:10.1136/emermed-2018-207804

Cited by 7 publications

(6 citation statements)

References 14 publications

(14 reference statements)

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“…One should also take into account the fact that a large proportion of patients worldwide suffer from sub-chronic and chronic so-called "urban" hypothermia. The significance of this problem will probably continue to increase in our aging society [19]. Since recognition of severe urban hypothermia based on clinical symptoms is very difficult, the only way to confirm the diagnostic suspicion is to measure core temperature.…”

Section: Discussionmentioning

confidence: 99%

Implementation of European Resuscitation Council guidelines: measurement of core body temperature in Emergency Medical Services in Europe

Podsiadło¹,

Darocha²,

Kosiński³

et al. 2020

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Introduction: Precise assessment of core body temperature is required for the optimal treatment of hypothermic patients according to European Resuscitation Council (ERC) guidelines. Core temperature is the cutoff criterion for some crucial therapeutic decisions in the treatment of severe hypothermia. Because the medical equipment is expensive, it is likely that pre-hospital services are equipped according to the minimal legal requirements. Aim of the research: To identify the legal provisions for suitable equipment and staff eligibility for core temperature measurement in European emergency medical services. Material and methods: The questionnaires that consisted of two questions pertaining to legal regulations were distributed among Ministries of Health and ERC representatives in every country of the European Union. Results: Eighteen out of 28 countries returned completed questionnaires. None of the analysed countries have official legal requirements regarding ambulance equipment with thermometers suitable for measuring core temperature. Most of the analysed countries have no legal provisions pertaining to the eligibility of medical staff to measure core temperature in ambulances. Conclusions: Official regulations in European countries do not require emergency medical services to be equipped with thermometers suitable for measuring core temperature. Medical staff eligibility in this field has not been established in most countries. This may limit the possibilities for pre-hospital management of hypothermic patients according to ERC guidelines. Streszczenie Wprowadzenie: Prawidłowe postępowanie z pacjentem w hipotermii opisane w wytycznych Europejskiej Rady Resuscytacji (ERC) wymaga dokładnego pomiaru temperatury głębokiej ciała. Zgodnie z tymi wytycznymi temperatura głęboka jest punktem odcięcia dla szeregu kluczowych decyzji terapeutycznych, takich jak wstrzymanie podawania leków lub ograniczenie liczby prób defibrylacji elektrycznej. Również decyzja o transporcie pacjenta do ośrodka, który posiada ogrzewanie pozaustrojowe, ściśle zależy od temperatury. Ze względu na koszty sprzętu medycznego można się spodziewać, że służby ratownicze otrzymują wyposażenie na minimalnym poziomie wymaganym przez przepisy prawa. Cel pracy: Ocena uregulowań prawnych dotyczących wyposażenia ambulansów i uprawnień personelu medycznego w zakresie pomiaru temperatury głębokiej na etapie przedszpitalnym w krajach Unii Europejskiej. Implementation of European Resuscitation Council guidelines: measurement of core body temperature in Emergency Medical Services in Europe Medical Studies/Studia Medyczne 2020; 36/1 Materiał i metody: Przeprowadzono badanie ankietowe. Ankietą objęto ministerstwa zdrowia oraz lokalne przedstawicielstwa ERC we wszystkich krajach Unii Europejskiej. Wyniki: Odpowiedzi uzyskano z 18 spośród 28 krajów. W żadnym z państw nie ma oficjalnych wymagań dotyczących wyposażenia ambulansów w termometry przystosowane do pomiaru temperatury głębokiej. Większość krajów nie zdefiniowała uprawnień personelu medycznego do takiego...

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Section: Discussionmentioning

confidence: 99%

Implementation of European Resuscitation Council guidelines: measurement of core body temperature in Emergency Medical Services in Europe

Podsiadło¹,

Darocha²,

Kosiński³

et al. 2020

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“…Kommt es infolge einer Kälteexposition zur Unterkühlung, handelt es sich um eine primäre Hypothermie, wohingegen bei einer sekundären Hypothermie Erkrankungen und andere äußere Umstände die Unterkühlung verursachen. Zur primären, exogen bedingten, Hypothermie kommt es vor allem im Freien (Sportler und orientierungslose Personen) und in städtischen Gebieten (Obdachlose und Betrunkene/Intoxikierte), während es in häuslicher Umgebung bei alten und multimorbiden Menschen immer häufiger zu einer sekundären, endogen bedingten Hypothermie kommt [ 166 , 167 ].…”

Section: Evidenz Die In Die Leitlinien Einfließtunclassified

Kreislaufstillstand unter besonderen Umständen

Lott

Truhlář

Alfonzo

et al. 2021

Notfall Rettungsmed

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Diese Leitlinien des European Resuscitation Council (ERC) für den Kreislaufstillstand unter besonderen Umständen basieren auf dem 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. Dieses Kapitel enthält Leitlinien zu den Modifikationen der lebensrettenden Basismaßnahmen und erweiterten lebensrettenden Maßnahmen zur Vorbeugung und Behandlung von Kreislaufstillständen unter besonderen Umständen; insbesondere spezielle Ursachen (Hypoxie, Trauma, Anaphylaxie, Sepsis, Hypo‑/Hyperkaliämie und andere Elektrolytstörungen, Hypothermie, Lawinengeschehen, Hyperthermie und maligne Hyperthermie, Lungenembolie, Koronarthrombose, Herzbeuteltamponade, Spannungspneumothorax, Giftstoffe), spezielle Umstände (Operationssaal, Herzchirurgie, Herzkatheterlabor, Dialyseeinheit, Zahnkliniken, Transport während des Flugs, Kreuzfahrtschiffe, Sport, Ertrinken, Großschadensereignisse) und spezielle Patientengruppen (Asthma und chronisch obstruktive Lungenerkrankung, neurologische Erkrankungen, krankhafte Adipositas, Schwangerschaft). Zusatzmaterial online Die Online-Version dieses Beitrags (10.1007/s10049-021-00891-z) enthält das originale Zusatzmaterial aus dem Artikel in Resuscitation. Beitrag und Zusatzmaterial stehen Ihnen auf www.springermedizin.de zur Verfügung. Bitte geben Sie dort den Beitragstitel in die Suche ein, das Zusatzmaterial finden Sie beim Beitrag unter „Ergänzende Inhalte“.

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“…Patofizološke posljedice pothlađenosti su sljedeće: stvaraju se kristali leda između stanica, koji ometaju funkciju natrijeve crpke, puca stanična stijenka, stvaraju se konglomerati eritrocita, agregacija trombocita dovodi do stvaranja tromboza, neurovaskularni impulsi skreću tokove krvi. Opći metabolički učinci pothlađenosti imaju za posljedicu hipoksiju i nekroze tkiva (11)(12)(13)(14)(15)(16).…”

Section: Pothlađivanjeunclassified

“…Loše grijane prostorije u zimskom vremenu i izlaganje hladnoći u boravku osoba starije dobi, čija je temperatura okoline niža od 18°C (dakle, to se ne odnosi samo na zimsko vrijeme) tijekom više sati ili više dana, može imati za posljedicu pothlađenost. Oštećenja organizma imaju za posljedicu ustrojne i funkcijske promjene malih krvnih žila, stanica, živaca i kože hladnoćom (12)(13)(14)(15)(16).…”

Section: Termogeneza U Pothlađivanjuunclassified

“…Simptomi i klinički znaci pothlađivanja mogu biti: umor, opća slabost, nekoordinacija, bezvoljnost, konfuzno stanje, pospanost, halucinacije, agresivnost, neprihvaćanje pomoći, akutna stanja konfuzije, napose kada je rektalna tjelesna temperatura niža od 32°C, što sve progredira do stupora i komatoznog stanja (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Teško pothlađenog bolesnika treba liječiti u bolničkim uvjetima.…”

Section: Termogeneza U Pothlađivanjuunclassified

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Promjene Termoregulacije U Starijoj Dobi

Duraković¹,

Ostojić²,

Mišıgoj-Duraković³

et al. 2020

Neurogerijatrija/ Neurologija Starijeg Životnog Doba

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Navedeni su štetni učinci pregrijavanja (hipertermije) i pothlađivanja (hipotermije) u starijoj dobi. Opasnost smrtnog ishoda u pregrijavanju ovisi više o težini pridružene bolesti nego o težini stresa zbog toga stanja. Štetni učinci stresa su lokalna krvarenja, degeneracija stanica parenhimnih organa cijelog tijela, a napose središnjeg živčanog sustava, oštećenje stanica jetre, bubrega i drugih organa. Letalni ishod može se dogoditi i nekoliko dana nakon hipertermije napose u bolesnika koji boluju od šećerne bolesti, kronične opstrukcijske bolesti pluća, bolesti povišena krvnog tlaka u kojih je 50% viši. Liječenje pregrijavanja treba provoditi u bolničkim uvjetima uz trajno praćenje kliničkih i laboratorijskih parametara. Treba uspostaviti normalnu tjelesnu temperaturu što je prije moguće. Pothlađivanje se može podijeliti u 3 skupine: blago (rektalna temperatura 35–32°C), umjereno (rektalna temperatura 32–28°C); teško (rektalna temperatura niža od 28°C). U tom stanju u starijoj dobi visoka je opasnost letalnog ishoda koji može izgledati kao moždani udar ili kao metaboličke promjene. Oštećenja organizma posebno se događaju u ustrojnim i funkcijskim promjenama malih krvnih žila, stanica, živaca i kože. Neki čimbenici opasnosti za pothlađivanje su smanjenje stvaranja topline, promjene termoregulacije, smanjenje tjelesne aktivnosti. Svako stanje pothlađivanja, pa i blago, treba liječiti u Jedinici intenzivnog liječenja, dok se ne uspostavi potpuni oporavak. Dva su puta u liječenju: primarno je liječenje utopljavanjem, a sekundarno je liječenje komplikacija. Cilj liječenja je sporo povisivanje rektalne temperature, ne brže od 0,6°C na sat. U teškom pothlađivanju postupci reanimacije trebaju biti agresivni i produženi. Ne treba proglasiti smrtni ishod dok se ne ustanovi da je kardio-pulmonalno-cerebralna resuscitacija neučinkovita, no tek nakon što se povisi rektalna tjelesna temperatura na najmanje 35,8°C.

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Indoor accidental hypothermia in the elderly: an emerging lethal entity in the 21st century

Cited by 7 publications

References 14 publications

Implementation of European Resuscitation Council guidelines: measurement of core body temperature in Emergency Medical Services in Europe

Implementation of European Resuscitation Council guidelines: measurement of core body temperature in Emergency Medical Services in Europe

Kreislaufstillstand unter besonderen Umständen

Promjene Termoregulacije U Starijoj Dobi

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