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Chapter13
Thermoregulatory disorders in Adults
14
Medical
Professional
09/28/2011

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Cards

Term
Definition of hyperthermia
Definition
Fever > 38.2 Celc
Term
Heat Cramps
Definition
Core body temp is normal, skin is moist and cool

Occurs in muscles following vigorous exercise in the heat

Caused by salt depletion from excess sweating combined with hypotonic fluid replacement.... dilutional hyponatremia
Term
Heat Exhaustion
Definition
Core temp is minimally increased (37-40)

Consequence of Salt and water loss
Term
Heat Stroke
Definition
Temp > 40.6

Usually during heat wave over several days, usually affects elderly of chronically sick

Can occur in athletes, workers in high heat and humidity without appropriate salt/water

Signs are dehydration, CNS dysfunction, hot & dry skin
Term
Malignant Hyperthermia
Definition
Malignant Hyperthermia

Drug induced genetic susceptibility to sustained skeletal muscle contraction after exposure to depolarizing muscle relaxants such as SUCCINLYCHOLINE, or anesthetic agents such as HALOTHANE or ISOFLURANE.

Duchenne diseases and myotonic muscular dystrophy are associated with malignant hyperthermia
Term
NMS
Definition
NMS

Drug induced reaction characterized by hyperthermia, altered mentation, muscle rigidity

Drugs implicated are most often FGAs, or withdrawal of dopaminergic agent eg levodopa..
Term
Treatment of Malignant Hyperthermia (Think what causes it)
Definition
Malignant hyperthermia caused by genetic predisposition to skeletal muscle contraction for long periods of time... Treatment would be a Muscle relaxant!

Dantrolene 2mg/kg IV q5min

can continue dantrolene in oral regimen for 2-3 days after
Term
Treatment of NMS
Definition
Bromocriptine (dopaminergic agonist) and dantrolene (muscle relaxant)
Term
Passive External Rewarming
Definition
Minimize heat loss by removing wet clothing, and keep pt dry with warm blankets. Relies on pts shivering to warm back up (this is lost below 32 C, so need to do more if that is the case)
Term
Active External Warming
Definition
Heat blanket or warm immersion... Not too hot to avoid vasodilation. Limit heating to the trunk.
Term
Active core rewarming
Definition
eg. Heated (40-43) IV NS through central line. Cannot heat blood as proteins will be destroyed.

Really any invasive procedure to warm body
Term
Hypothermia is often associated with alcohol intoxication... What supplement should be given?
Definition
Thiamine (vit B1)
Term
Muscle relaxant used to prevent shivering in hypothermia?
Definition
Cisatracurium
Term
What electrolyte should be monitored when reheating in hypothermia?
Definition
K+, hyperkalemia can be induced by rewarming
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