How to Use an AED on a Person With Hypothermia
Hypothermia exists when core body temperature drops below 95 degrees Fahrenheit, and is caused by exposure to wet or cold environments, which rob the body's ability to maintain heat. If left untreated, hypothermia becomes severe, resulting in cardiac failure and death. Emergency personnel can use basic life support skills to manage patients with severe hypothermia; however, key steps must be followed before attempting to restore circulation with an automated external defibrillator (AED) on a hypothermic patient.
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Instructions
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Remove the patient from the cold or wet environment and immediately move him to a warm, dry location. Preferably, the patient should be placed in the back of an ambulance or other emergency vehicle where medical treatment and immediate transport can take place.
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Remove all wet or cold clothing from the patient immediately and completely dry him. Garments that are moist or cold will continue to lower the patient's body temperature. Cover the patient with blankets to assist with gentle re-warming. Advanced re-warming techniques, such as the use of heating blankets, should not be used unless advised by a physician.
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Assess the patient's vital signs for a full 30 to 45 seconds. This includes checking for the carotid pulse and assessing respirations carefully. While a pulse and breathing may be present, both may become more difficult to assess as hypothermia slows down the circulatory system. If after 30 to 45 seconds, pulse and breathing are not noted, begin cardiopulmonary resuscitation (CPR) and provide high-flow oxygen by mask.
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Place the AED on the patient and stand clear as an initial rhythm is determined. If a shockable rhythm is detected, ensure no one is touching the patient, and deliver a shock. Repeat for a total of three shocks as needed. If defibrillation does not produce a pulse, continue CPR. Do not provide additional shocks unless advised to do so by a physician or medical control unit.
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Tips & Warnings
Be sure the patient is completely dry before placing the AED pads and delivering shocks.
The patient does not need to be warm before an AED can be used, and care should not be delayed while warming attempts are taking place.
Determine the patient's core body temperature, if possible, with either an ear (tympanic) or rectal probe thermometer for the most accurate reading.
Place hypothermic patients in a horizontal position and handle them carefully. Rough handling can facilitate cardiac failure in hypothermic patients who have a faint pulse, or who have regained a pulse after defibrillation.
