Sunday, September 22, 2019

Rewarming

Q: Which of the following thermometers is most accurate during the rewarming phase in hypothermia?

A) rectal thermometers 
B) probe in lower one-third of the esophagus 
C) probe in upper one-third of the esophagus 
D) infrared tympanic thermometers 
E) bladder probes


Answer: B

Temperature probe inserted in the lower one-third of the esophagus - or to be precise - about 24 cm below the larynx) provides the best approximation of cardiac temperature. 


 Rectal temperature becomes unreliable during rewarming as it may be adjacent to cold feces, which may lag in rewarming (choice A).  Esophageal probes in the upper one-third area become unreliable due to heated humidified oxygen in endotracheal (ETT) (choice C). Similarly, infrared tympanic thermometers (temporal artery thermometers) are too superficial to be accurate (choice D). Bladder probe also lags behind during rewarming (choice E).


#hypothermia



References:


1. Danzl D. Accidental hypothermia. In: Wilderness Medicine, 6th ed, Auerbach PS (Ed), Elsevier, Philadelphia 2012. p.115.


2. Kempainen RR, Brunette DD. The evaluation and management of accidental hypothermia. Respir Care 2004; 49:192.

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