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Hypothermia Pearls:
- Lidocaine is generally ineffective in preventing ventricular arrhythmias, as is cardiac pacing or atropine to increase the heart rate.
- Should the patient fully arrest be prepared to perform CPR for a long time. If your ED does not have a automatic CPR device consider calling your local fire department or ambulance service as they might have one that can be loaned to your department.
- Warm fluids, heated blankets and heat lamps will typically increase a patients temperature about 1' C an hour.
- Gastric lavage, peritoneal lavage and heated IV fluids can warm as much as 3' an hour.
- To rewarm quickly as high as 18'C an hour requires cardiac bypass or thoracic lavage.
Finally, remember to monitor the patient closely when you first start rewarming as this can induce cardiac arrest. This is thought to occur as colder peripherial blood returns to the central circulation as peripherial veins and arteries dilated from the warm fluid.