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Hypothermia: stop cold insufflating
1. Hypothermia :
stop cold insufflating !
Halte à l’insufflation froide !
Claude Hébette, Hôpital de Moûtiers 1971 - 1998
Véronique Legrand, Annecy
Lucien Cadoz, FIPS
FIPS 15th World Congress, Tignes, april 2005
2. To be read with comments pages.
A lire avec pages de commentaires.
Jean Chièze
FIPS 15th World Congress, Tignes, april 2005
3. Vital risk of hypothermia =
heart inefficiency
FIPS 15th World Congress, Tignes, april 2005
4. Heart contraction
chemical conditions
and physical conditions : minimal temperature.
FIPS 15th World Congress, Tignes, april 2005
5. During the rescue,
risk
of passing below the threshold
cardiac arrest
or ventricular fibrillation
drugs ineffective
defibrillation ineffective
FIPS 15th World Congress, Tignes, april 2005
6. Why ?
1 Cold blood
shell core
How ?
• abrupt shifts of postures
• sometimes external rewarming
FIPS 15th World Congress, Tignes, april 2005
8. cautions
DMTM Chamonix
• winch pulling up
• stretcher carrying horizontally
FIPS 15th World Congress, Tignes, april 2005
9. cautions
• external rewarming
may be dangerous
• internal rewarming is safer
FIPS 15th World Congress, Tignes, april 2005
10. cautions
• external rewarming
may be dangerous
• internal rewarming is safer
FIPS 15th World Congress, Tignes, april 2005
11. Why ? (contind.)
2 Heat loss
• through the skin
• but also through the airway
= caloric haemorrhage (Conn)
70 m²
FIPS 15th World Congress, Tignes, april 2005
12. cautions
• blankets, caps...
• but also « caloric tourniquet »
FIPS 15th World Congress, Tignes, april 2005
13. Why ? (contind.)
3 Inhalation of cold air or
oxygen lungs , near heart
especially in case of intubation
FIPS 15th World Congress, Tignes, april 2005
14. If the first responder thinks
respiratory assistance is necessary
caution
gas insufflated
must be warmed
FIPS 15th World Congress, Tignes, april 2005
15. The rescuer must know
if the core temperature
is near the critical level (28-30°C)
A special thermometer is indispensable
FIPS 15th World Congress, Tignes, april 2005
16. How to rewarm air or oxygen ?
• soda lime + CO2
• electricity
• cooking pot + water !
• « solid oxygen »
• hydrogen + oxygen ( + catalyst)
FIPS 15th World Congress, Tignes, april 2005
17. How rewarm the gas ?
Soda lime
Ca(OH)2 + CO2 CaCO2 + H2O
2NaOH + CO2 Na2CO3+ H2O
+
FIPS 15th World Congress, Tignes, april 2005
18. Lloyd Soda lime
sl
O2
CO2
FIPS 15th World Congress, Tignes, april 2005
19. Soda lime
Lloyd
FIPS 15th World Congress, Tignes, april 2005
26. hydrogen
combustion
Applinc O²
air + 0,1 % H
catalyst platinum
FIPS 15th World Congress, Tignes, april 2005
27. Available now
Little Dragon Res-Q-Air
jopo@freenetname.co.uk www.hypothermia-ca.com/res-q-air.htm
FIPS 15th World Congress, Tignes, april 2005
28. Conclusion 1
Every rescue team
possibly dealing with hypothermia
(everywhere !)
must have
- an hypothermic thermometer
- an air warmer
at one’s disposal
FIPS 15th World Congress, Tignes, april 2005