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Normal Core temp is ___ and elderly have a set-point ___ degree ______.
the main control center for temp is the _________. threshold for thermoregulatory response ___________ with both general and regional anesthesia.
Cerebral temp is measured in the ___________.
Afferent thermal sensing:
Cold receptor signals travel along __ ____ ______.
Warm receptor signals travel along __ ____.
What areas provide about 20% autonomic input for thermoreg?
- Skin surface
- deep abdominal/thoracic tissue
- other brain areas
Responses to heat:
vasodilation, sweating, temp gradient toward peripheral tissue
Response to cold:
- temp gradient toward core
Most effective way to change temp:
Sweating can dissipate ___ times the BMR in a ______________________.
how much does shivering increase BMR?
what is nonshivering thermogenesis in infants?
"brown fat" metabolism increases temp. kids lose and regain heat more quickly than adults
Name the types of heat transfer in order of greatest to least.
- Radiation- electromagnetic radiation (BSA)
- Convection- heat from body to surrounding air/fluid
How much heat is lost in the first hour of surgery?
1- 1.5 C
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
Threshold for shivering with anesthesia?
Elderly cool _______ and _____ slower.
High risk for hypothermia:
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
What are the consequences of hypothermia?
- 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
shivering is more likely with ______ ____________.
a delcine of 1 - 3 provides _______ _______ __________. more profound hypothermia provides decrease in ____ that creates prolonged ________ to _______ __________.
- cerebral ischemia protection
- ischemic insult
When to use deliberate hypothermia:
- decrease mac .5%
- uniform cooling needed
a temp of greater than _____ will cause brain injury and less than ____ will be ______________.
What is used an indicator of cerebral temp/