AP IIII- hypothermia

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Author:
bgroll
ID:
224653
Filename:
AP IIII- hypothermia
Updated:
2013-06-22 11:43:46
Tags:
hypothermia aa emory
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Description:
summer ap test #2, hypothermia
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  1. Normal Core temp is ___ and elderly have a set-point ___ degree ______.
    • 37
    • 0.5
    • lower
  2. the main control center for temp is the _________.  threshold for thermoregulatory response ___________ with both general and regional anesthesia.
    • hypothalmus
    • increases
  3. Hymopthermia:
    Mild-
    Mod-
    Severe-
    • 34-36 C
    • 30-34
    • <30
  4. DHCA is what temp?
    18 C
  5. Cerebral temp is measured in the ___________.
    Nasopharynx
  6. Afferent thermal sensing:
    Cold receptor signals travel along  __ ____ ______.
    Warm receptor signals travel along  __ ____.
    • A delta fibers
    • C fibers
  7. What areas provide about 20% autonomic input for thermoreg?
    • Skin surface
    • deep abdominal/thoracic tissue
    • hypothalmus
    • other brain areas
  8. Responses to heat:
    vasodilation, sweating, temp gradient toward peripheral tissue
  9. Response to cold:
    • vasoconstriction
    • temp gradient toward core
    • shivering
  10. Most effective way to change temp:
    BEHAVIOR!
  11. Sweating can dissipate ___ times the BMR in a ______________________.
    • 10
    • dry windy area
  12. how much does shivering increase BMR?
    2-3x
  13. what is nonshivering thermogenesis in infants?
    "brown fat" metabolism increases temp.  kids lose and regain heat more quickly than adults
  14. Name the types of heat transfer in order of greatest to least.
    • Radiation-  electromagnetic radiation (BSA)
    • Convection- heat from body to surrounding air/fluid
    • Conduction-
    • Evaporation-
  15. How much heat is lost in the first hour of surgery?
    1- 1.5 C
  16. What are the phases of cooling?
    • 1- redistribution - core to periphery
    • 2- linear phase- heat loss exceeds BMR
    • 3- plateau when heat loss equals production
  17. Threshold for shivering with anesthesia?
    Nitrous-narcotic:
    propofol-nitrous:
    • 34.5 C
    • 33 C
  18. Elderly cool _______ and _____ slower.
    • faster
    • slower
  19. High risk for hypothermia:
    • old
    • short
    • low pre-op SBP
  20. Regional anesthesia fx on temp:
    peripheral nerve block prevents sweating, vasoconstriction, shivering.

    central control inhibited, core temp allowed to cool further

    *** high level of block and old age more likely to produce hypothermia than any other cause
  21. What are the consequences of hypothermia?
    MCMPCBPSW
    • Mortality in trauma
    • Cardiac problems
    • Metabolism of drugs decr
    • Plt fx decr
    • Clotting decr
    • Blood loss incr
    • Prolonged PACU
    • shivering and O2 consumption incr
    • Wound infection
  22. shivering is more likely with ______ ____________.
    faster warming
  23. a delcine of 1 - 3 provides _______ _______ __________.  more profound hypothermia provides decrease in ____ that creates prolonged ________ to _______ __________.
    • cerebral ischemia protection
    • BMR
    • tolerance
    • ischemic insult
  24. When to use deliberate hypothermia:
    • CBP
    • ARDS
    • decrease mac .5%
    • uniform cooling needed
  25. a temp of greater than _____ will cause brain injury and less than ____ will be ______________.
    • 37
    • 35
    • neuroprotective
  26. What is used an indicator of cerebral temp/
    nasopharyngeal

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