This is the podcast surgery in IC rounds. My name is Dr. Jeffrey Guy. I'm an associate professor of surgery and director of the Burns Center at Vanderbilt University School of Medicine. The topic that we're going to discuss today is that of hypothermia. There was a rather spectacular emergency landing or plane crashed depending on how you look at it.

Recently here in the United States where a U.S. Airlines jet on a very cold day in Manhattan landed on the Hudson River.

And all the occupants of the plane were basically unhurt and were able to evacuate into the

river on the wings. And this certainly brought up the idea of what is environmental hypothermia.

We talk a lot about hypothermia now in regards to its therapy.

And we've recently had a discussion on a podcast on the use of hypothermia for the post-cardiac

arrest patient.

And there's also a growing body of literature about the use of hypothermia in patients

who have not only brain injuries but CNS lesions and how that's applied in the neurointensive

care unit.

But the topic I want to talk today is what is the treatment and the problems associated with

environmental hypothermia, somebody who may come in as a

cold water drowning or a trauma patient or a homeless person who's perhaps found in a snowbank.

And having done my training in the northern part of the United States and treated many

patients who've come in with profound hypothermia after being passed out or found in a snowbank or being a

motor vehicle crash with a prolonged extrication or delayed and being fined.

So accidental hypothermia, what is the actual definition of it?

And hypothermia is really, by definition, as an unintentional decline in the core body temperature below 35

degrees centigrade or 95 degrees Fahrenheit.

And there are some conditions that are associated with hypothermia, and basically those

can be broken down in the two big groups.

Those conditions where the patient has an intact thermal regulation and those conditions

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