Recommendations on Rewarming Modality based on Temperature and Clinical picture
Prevent additional heat loss → Remove wet clothes
Heated room
Blankets - If patient still shivering, capable of rewarming 0.5°C/hr<unk>  cap
Rewarm trunk BEFORE the extremities, otherwise you cause further hypotension ("core temperature afterdrop")
Afterdrop: warmed vasodilated peripheral tissue allows cooler blood in extremities to circulate back to core
Options:
Warm water immersion (Capable of 2-4°C/Hr rewarming)
Heating blankets
Radiant heat
Forced air - e.g. Bair hugger or Arctic Sun (Up to 1-2.5°C/Hr rewarming)
Warm humidified air via facemask or endotracheal tube
Afterdrop: warmed vasodilated peripheral tissue allows cooler blood in extremities to circulate back to core
Warm water immersion (Capable of 2-4°C/Hr rewarming)
Heating blankets
Radiant heat
Forced air - e.g. Bair hugger or Arctic Sun (Up to 1-2.5°C/Hr rewarming)
Warm humidified air via facemask or endotracheal tube
Options:
Heated IV fluids: 38-42°C.
Two animal studies have showed 65°C IVF via central line warmed subjects faster without side effects, but this has not been tested in humans
If central line is placed, avoid irritating the heart
GI tract lavage
Can cause fluid and electrolyte fluctuations, also risk of pulmonary aspiration
Bladder lavage
Small surface area available for heat exchange
Thoracic lavage
Peritoneal lavage
Bypass/ECMO/AV Dialysis
Two animal studies have showed 65°C IVF via central line warmed subjects faster without side effects, but this has not been tested in humans
If central line is placed, avoid irritating the heart
Can cause fluid and electrolyte fluctuations, also risk of pulmonary aspiration
Small surface area available for heat exchange
Accidental hypothermia
Generalized
Malignant hyperthermia
Hypothermia
Traumatic asphyxia
Freezing
Lightning injuries
Frostbite