Guidelines for management of accidental hypothermia in a university hospital in Northern Norway

Accidental hypothermia is defined as a trauma. Collaboration on the treatment of victims of accidental hypothermia shouldfollow a communication protocol for the seriously injured. Aim is to establish earliest possible contact with the doctor on duty at the regional University hospital to enable participation in the further communication and decision making process with relevance to technical and logistical issues. Victims of accidental hypothermia with adequate circulation and core temperature < 35⁰C can be treated with active remote heating (hot air blanket) at all hospitals providing emergency surgical care; active external warming should be started during transport to the nearest hospital. Hypothermic patients showing no signs of life, patients with inadequate circulation or hypothermia-induced circulatory arrest with core temperature < 32⁰C and serum K⁺ < 12 mmol-l⁻' should be transported directly to University hospital. Advanced life support in all these cases should be started immediately and continued without interruption during transportation until the patient is connected to a heart-lung machine for rewarming. If core temperature is < 28⁰C and/or the patient has inadequate circulation contact should be taken with the regional University hospital to discuss extracorporeal rewarming.