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Are mobile ECMO teams necessary to treat severe accidental hypothermia?

https://arctichealth.org/en/permalink/ahliterature312200
Source
Resuscitation. 2021 01; 158:301-302
Publication Type
Letter
Comment
Date
01-2021
Author
Hermann Brugger
Peter Paal
Ken Zafren
Giacomo Strapazzon
Martin E Musi
Author Affiliation
Institute of Mountain Emergency Medicine, Eurac Research, Via Ipazia 2, Bolzano, Italy; Medical University Innsbruck, Innerkoflerstrasse 1, 6020 Innsbruck, Austria. Electronic address: hermann.brugger@eurac.edu.
Source
Resuscitation. 2021 01; 158:301-302
Date
01-2021
Language
English
Publication Type
Letter
Comment
Keywords
Denmark
Extracorporeal Membrane Oxygenation
Humans
Hypothermia - therapy
Problem Solving
Rewarming
Notes
CommentOn: Resuscitation. 2020 Nov;156:114-119 PMID 32946984
CommentIn: Resuscitation. 2021 Jan;158:303-304 PMID 33279532
PubMed ID
33278520 View in PubMed
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Clinical staging of accidental hypothermia: the Revised Swiss System: Recommendation of the International Commission for Mountain Emergency Medicine (ICAR MedCom).

https://arctichealth.org/en/permalink/ahliterature305356
Source
Resuscitation. 2021 Mar 03; :
Publication Type
Journal Article
Date
Mar-03-2021
Author
Martin E Musi
Alison Sheets
Ken Zafren
Hermann Brugger
Peter Paal
Natalie Hölzl
Mathieu Pasquier
Author Affiliation
Department of Emergency Medicine, University of Colorado, Anschutz Medical Campus, Mail Stop B-215, 12401 17th Avenue, Aurora, CO, 80045, USA; International Commission for Mountain Emergency Medicine (ICAR MedCom), Zürich, Switzerland. Electronic address: martin.musi@cuanschutz.edu.
Source
Resuscitation. 2021 Mar 03; :
Date
Mar-03-2021
Language
English
Publication Type
Journal Article
Abstract
Clinical staging of accidental hypothermia is used to guide out-of-hospital treatment and transport decisions. Most clinical systems utilize core temperature, by measurement or estimation, to stage hypothermia, despite the challenge of obtaining accurate field measurements. Recent studies have demonstrated that field estimation of core temperature is imprecise. We propose a revision of the original Swiss Staging system. The revised system uses the risk of cardiac arrest, instead of core temperature, to determine the staging level. Our revised system simplifies assessment by using the level of responsiveness, based on the AVPU scale, and by removing shivering as a stage-defining sign.
PubMed ID
33675869 View in PubMed
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Determination of Death in Mountain Rescue: Recommendations of the International Commission for Mountain Emergency Medicine (ICAR MedCom).

https://arctichealth.org/en/permalink/ahliterature304405
Source
Wilderness Environ Med. 2020 Dec; 31(4):506-520
Publication Type
Journal Article
Review
Date
Dec-2020
Author
Corinna A Schön
Les Gordon
Natalie Hölzl
Mario Milani
Peter Paal
Ken Zafren
Author Affiliation
International Commission for Mountain Emergency Medicine (ICAR MedCom), Zürich, Switzerland; Institute of Forensic Medicine, University of Bern, Bern, Switzerland. Electronic address: corinna.schoen@irm.unibe.ch.
Source
Wilderness Environ Med. 2020 Dec; 31(4):506-520
Date
Dec-2020
Language
English
Publication Type
Journal Article
Review
Keywords
Cardiopulmonary Resuscitation - methods
Death
Humans
Mountaineering
Practice Guidelines as Topic
Rescue Work - standards
Abstract
Determination of death requires specific knowledge, training, and experience in most cases. It can be particularly difficult when external conditions, such as objective hazards in mountains, prevent close physical examination of an apparently lifeless person, or when examination cannot be accomplished by an authorized person. Guidelines exist, but proper use can be difficult. In addition to the absence of vital signs, definitive signs of death must be present. Recognition of definitive signs of death can be problematic due to the variability in time course and the possibility of mimics. Only clear criteria such as decapitation or detruncation should be used to determine death from a distance or by laypersons who are not medically trained. To present criteria that allow for accurate determination of death in mountain rescue situations, the International Commission for Mountain Emergency Medicine convened a panel of mountain rescue doctors and a forensic pathologist. These recommendations are based on a nonsystematic review of the literature including articles on determination of death and related topics.
PubMed ID
33077333 View in PubMed
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Induced Hypothermia to 4.2°C with Neurologically Intact Survival: A Forgotten Case Series.

https://arctichealth.org/en/permalink/ahliterature305740
Source
Wilderness Environ Med. 2020 Sep; 31(3):367-370
Publication Type
Historical Article
Journal Article
Date
Sep-2020
Author
Ken Zafren
Peter Paal
Hermann Brugger
Raimund Lechner
Author Affiliation
Department of Emergency Medicine, Alaska Native Medical Center, Anchorage, AK; Department of Emergency Medicine, Stanford University Medical Center, Stanford, CA; International Commission for Mountain Emergency Medicine (ICAR MEDCOM), Zürich, Switzerland.
Source
Wilderness Environ Med. 2020 Sep; 31(3):367-370
Date
Sep-2020
Language
English
Publication Type
Historical Article
Journal Article
Keywords
Body temperature
Cardiopulmonary Resuscitation - history
History, 20th Century
Humans
Hypothermia, Induced - history - statistics & numerical data
Rewarming - history
Abstract
The lowest recorded core temperature from which a person with accidental hypothermia has survived neurologically intact is 11.8°C in a 2-y-old boy. The lowest recorded temperature from which an adult has been resuscitated neurologically intact is 13.7°C in a 29-y-old woman. The lowest core temperature with survival from induced hypothermia has been quoted as 9°C. We discovered a case series (n=50) from 1961 in which 5 patients with core temperatures below 11.8°C survived neurologically intact. The lowest core temperature in this group was 4.2°C. The authors also presented cardiovascular and other physiologic data at various core temperatures. The patients in the case series showed a wide variation in individual physiological responses to hypothermia. It is not known whether survival from accidental hypothermia is possible with a core temperature below 11.8°C, but this case series suggests that the lower limit for successful resuscitation may be far lower. We advise against using core temperature alone to decide whether a hypothermic patient in cardiac arrest has a chance of survival.
PubMed ID
32482520 View in PubMed
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Warm Fluid Infusion Is Not an Effective Primary Warming Method in Accidental Hypothermia.

https://arctichealth.org/en/permalink/ahliterature311660
Source
Ther Hypothermia Temp Manag. 2021 Apr 21; :
Publication Type
Journal Article
Date
Apr-21-2021
Author
Mathieu Pasquier
Les Gordon
Peter Paal
Tomasz Darocha
Ken Zafren
Author Affiliation
Department of Emergency Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Source
Ther Hypothermia Temp Manag. 2021 Apr 21; :
Date
Apr-21-2021
Language
English
Publication Type
Journal Article
PubMed ID
33887159 View in PubMed
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