1. Major Ken Wishaw FANZCA
Royal Australian Army Medical Corps

2. Hypothermia
Awareness
Detection
Management

3. Complications of Mild
Hypothermia (35°C)
 wound healing is delayed
 wound infections are increased threefold
 platelets do not work
 coagulation fails
 blood loss increases 30 ‐100%
 need for transfusion increases 30%
 Myocardial events occur in 50% with IHD

4. Core Temperature below 35.0o C
quadruples mortality in severe trauma.

5. Core Temperature below 35.0o C
quadruples mortality in severe trauma.
Is this a problem in Australia?

6. Core Temperature below 35.0o C
quadruples mortality in severe trauma.
Qld Trauma Registry
13% < 35°C

7. Core Temperature below 35.0o C
quadruples mortality in severe trauma.
Qld Trauma Registry
Over half the cases happen after hospital
admission.

8. ADF Anaesthesia Craft Group Position
paper
“Hypothermia and the Battle Casualty”
April 2010.

9. Why we don’t detect the
problem

10. Heat distribution
vs
environment temperature

11. Heat distribution
vs
environment temperature

12. Redistribution Hypothermia
Hypovolaemic
Shock
Resuscitation
Awake Anaesthesia

13. •Core temperature does NOT measure
heat loss
•Peripheral temperature more reliable
indicator

15. Detecting hypothermia
A F2010 H
Commonsense, version 1.1.1

16. warm legs = warm heart

17. •Passive warming is minimally effective
•Warm cotton blankets do not work
•Active warming techniques must be
used

18. •Remove casualty from cold wet and windy environment.
•Remove and replace wet clothing.
•Insulate head and neck with beanie or balaclava if appropriate.
•Cover patient.
•Insulate underneath patient to protect from cold ground.
•Insulate underneath stretcher e.g. using camping mat or second
sleeping bag.
•Apply active warming devices if available.
•Warm IV fluids.
•Do not use ad hoc warming techniques directly against casualty’s
skin. This may result in burns.

20. NSN: 6515-01-532-8056
Cost: $93.00