Rewarming

Treatment of hypothermia can be by spontaneous rewarming, or the treatment can be more aggressive, for example:

• active external rewarming - using heaters or immersion
• internal rewarming - infusing warm i.v. fluids

There are arguments which suggest the more aggressive approaches are better for the young and fit, and indeed it may be true that the hazards of rapidly rewarming the elderly are not outweighed by any advantages.

Problems of rewarming include:

• ventricular dysrhythmias, which may be fatal and precipitated by any interference with the patient
• hypotension, as a result of vasodilation in the peripheries - beware of placing the hypothermic patient in a hot bath as cerebral blood flow may be compromised