A 27-year-old female is brought to the emergency department in the wee hours of January 1st 2015. She was found by a bystander in her skimpy New Years dress confused, laying on the lawn of a stranger’s home. She is rousable to light touch, does not know where she is, and states that, “I’m just tired and I need to sleep.” The patient reports that she drank alcohol that evening, but did not take any drugs. There are no obvious signs of trauma, the patient is protecting her airway, has appropriate respirations, pale and cold extremities with a 1+ radial pulse that you measure at 44 beats per minute. She is put in a hospital gown and a complete physical exam is performed. Rectal temperature is found to be 31.2 degrees C (88F). What are some EKG findings that you may expect? At what core body temperature do humans lose the shivering reflex?

 

answers
EKG changes are common in hypothermia. Core temperatures less than 30 degrees celsius, 86F are associated with myocardial irritability. Expect to see any and all tachy or brady dysrhythmias. Less than 30C you may also see J waves, or Osborn waves. Below 32C (90F) humans lose the ability to generate heat by shivering.  Stay warm out there this season. In the famous and nagging words of our mothers, “Don’t forget to take a sweater.”

 

 

Rivers, 7th Edition, (2014)

By: Andy Grock and Sally Bogoch

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Categories: EM Principles

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