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Hypothermia

Date Last Search Run: Feb 01, 2022
Table last updated: Dec 18, 2019
Data last added: Mar 02, 2016

Recommendation RECOMMENDATION FOR INTERVENTION
STRENGTH OF EVIDENCE FOR INTERVENTION   SUPPORTIVE (Green) NEUTRAL (Yellow) AGAINST (Red) NOT YET GRADED (White)
1 (strong evidence exists)      
2 (fair evidence exists)  
3 (weak evidence exists)      


Interventions

AER (Active External Rewarming)
Level Direction Primary Outcome Patient/Process Setting Reference
I Supportive (Green) Temperature Process PH-Paramedic Kober A., Scheck T., Fulesdi B., Lieba F., Vlach W., Friedman A., et al. Effectiveness of resistive heating compared with passive warming in treating hypothermia associated with minor trauma: A randomized trial. Mayo Clin Proc 2001; 76(4):369-75. Medline
I Supportive (Green) Mean core temp Patient PH-Paramedic Lundgren P., Henriksson O., Naredi P., Bjornstig U. The effect of active warming in prehospital trauma care during road and air ambulance transportation - a clinical randomized trial. Scand J Trauma Resusc Emerg Med 2011; 19(59):7241. Medline
II Opposes (Red) Safety Patient SIM Sterba JA. Efficacy and safety of prehospital rewarming techniques to treat accidental hypothermia. Ann Emerg Med 1991; 20:896-901. Medline
III Supportive (Green) Core body temperature after rewarming Process ED-MD Bernardo LM., Gardner MJ., Lucke J., Ford H. The effects of core and peripheral warming methods on temperature and physiologic variables in injured children. Pediatr Emerg Care 2001; 17(2):138-42. Medline
III Supportive (Green) Resolution of symptoms Patient ED-MD Biem J., Koehncke N., Classen D., Dosman J. Out of the cold: management of hypothermia and frostbite. JAMC 2003; 168(3):305-11. CMAJ
III Supportive (Green) Rewarming Patient PH-Paramedic Kornberger E., Schwartz B., Linder KH., Mair P. Forced air surface re-warming in patients with severe accidental hypothermia. Resuscitation 1991; 41:105-11. Medline
III Neutral (Yellow) Survival Patient ED-MD Chochinov AH., Baydock BM., Bristow GK., Giesbrecht GG. Recovery of a 62-year-old man from prolonged cold water submersion. Ann Emerg Med 1998; 31(1):127-31. Medline
III Neutral (Yellow) Survival Patient PH-Paramedic Giesbrecht GG., Hayward JS. Problems and complications with cold-water rescue. Wilderness Environ Med 2006; 17(1):26-30. Medline
III Neutral (Yellow) Temperature monitoring Patient PH-Paramedic Owen R., Castle N. Prehospital temperature control. Emerg Med J 2008; 25(6):375-6. Medline

Inhalation Rewarming
Level Direction Primary Outcome Patient/Process Setting Reference
II Opposes (Red) Safety Patient SIM Sterba JA. Efficacy and safety of prehospital rewarming techniques to treat accidental hypothermia. Ann Emerg Med 1991; 20:896-901. Medline

Temperature Monitoring
Level Direction Primary Outcome Patient/Process Setting Reference
II Neutral (Yellow) Sensitivity and Specificity Process Niven DJ., Gaudet JE., Laupland KB., Mrklas KJ., Roberts DJ., Stelfox HT. Accuracy of Peripheral Thermometers for Estimating Temperature: A Systematic Review and Meta-analysis. Ann Intern Med 2015; 163:768-77. Medline

Warmed IV Fluids
Level Direction Primary Outcome Patient/Process Setting Reference
II Neutral (Yellow) Core Body temperature Process PH-Paramedic Cassidy ES., Adkins CR., Rayl JH., Wipfler EJ. 3rd. Evaluation of warmed intravenous fluids in the prehospital setting. Air Med J 2001; 20(5):25-6. Medline
III Supportive (Green) Core body temperature after rewarming Process ED-MD Bernardo LM., Gardner MJ., Lucke J., Ford H. The effects of core and peripheral warming methods on temperature and physiologic variables in injured children. Pediatr Emerg Care 2001; 17(2):138-42. Medline
III Neutral (Yellow) Temperature monitoring Patient PH-Paramedic Owen R., Castle N. Prehospital temperature control. Emerg Med J 2008; 25(6):375-6. Medline
X Not Yet Graded (White) - Patient Ireland AJ., Pathi VL., Crawford R., Colquhoun IW. Back from the dead: Extracorporeal rewarming of severe accidental hypothermia victims in accident and emergency. J Accid Emerg Med 1997; 14(4):255-7. Medline


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