How to Reduce the Risk of Cardiac Arrest in Hypothermic Victims

Hypothermic victims have a severely low body temperature, usually caused by exposure to extremely cold conditions. With hypothermia, you are at great risk for cardiac arrhythmias (irregular heartbeats) and full cardiac arrest (heart stops). When treating someone for hypothermia, you must try to reduce the risk of cardiac arrests as much as possible.

Difficulty: Challenging

Instructions

Things You'll Need:

• Blankets

Reduce the Risk of Cardiac Arrest in Victims that are Hypothermic

1. Minimize all disturbances until the victim is warmed. Control any shock to the body, including sending cold blood rushing towards the heart due to the movement of the arms and legs. Ideally, the person should be kept as still as possible, after being moved in a horizontal position to reduce the chance of aggravating a heart condition.

2. Try to avoid rubbing, massaging or jostling victims. Since hypothermic individuals are at great risk for cardiac arrest, they should be handled gently.

3. Remove all of the victim's wet clothing to reduce further lowering of body temperature. The patient should then be insulated with warm clothing or blankets, shielded from the wind and ventilated with warm oxygen.

4. Begin CPR immediately after determining the victim has no pulse. Usually about 30 to 45 seconds is all that is needed to determine if there is a pulse. An apparatus that can ventilate the patient with 100 percent heated, humidified oxygen is ideal. However, mouth-to-mouth breathing during CPR is sufficient due to the warm, humidified air provided to the patient.

5. Initiate cardiac monitoring as quickly as possible, while trying to determine the core temperature. In the field, you should not delay transferring the victims to a hospital, even if you cannot get accurate cardiac monitoring started.

Tips & Warnings

• Hypothermic victims are not considered dead until their bodies are externaly warm. Recovery after prolonged lapses of cardiac arrest is possible as long as the body remains cold. The lower temperature may slow the cellular damage caused by loss of oxygen and blood flow.
• Management of cardiac arrest in hypothermic victims is different than in cardiac arrest regular patients. The hypothermic victim may be unresponsive to cardioactive drugs, pacemaker stimulation and defibrillation.
• Avoid repeated defibrillation attempts or additional injections of medicine, until the core temperature rises above 86 degrees F. The heart can be damaged by repeated defibrillatory shocks, and since drugs will metabolize at a different rate during hypothermia, it is easy to build up a toxic dose of any given medication.

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