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but which might be providing adequate perfusion. If chest compressions cause
ventricular fibrillation, perfusion will be lost.
·
If transportation is not available within 3 hours begin ventilation (intubate of
possible), start chest compressions and perform for up to 30 minutes while
attempting to rewarm the patient. If this is unsuccessful in restoring spontaneous
circulation, discontinue CPR.
·
CPR, while litter bearing, is not effective and should not be attempted.
(Recommendation Category 1A) Reference: State of Alaska Cold Injuries Guidelines,
Revised 11/2003-1.
III. GUIDELINES FOR EVACUATION
If a patient with mild hypothermia is adequately rewarmed, with a return to normal
mental status, there is no need for evacuation. Take care to prevent a recurrence. Monitor
the patient while walking with him/her to the nearest location where treatment is
practical. Patients who do not respond to rewarming, or who obviously have moderate-
to-severe hypothermia, must be insulated for maximum heat retention, provided with
moderate heat source(s), and be evacuated as soon as possible. Evacuation of such a
patient must be as gentle as possible to prevent ventricular fibrillation. Package the
person so that rescue personnel are able to examine the patient periodically. Every 15
minutes during transport check the patient for 1) vital signs, 2) burning of the skin
underneath heat sources and 3) circulation in the feet to examine for frostbite, unless this
examination increases heat loss in which case be judicious in monitoring as often as
practical.
