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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Diagnosed with major depressive disorder and took psychotherapy and fluoxetine. Suggest the cure for hypothermia?

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Dr. Benard Shehu

Cardiologist

Practicing since :2004

Answered : 2254 Questions

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Posted on Thu, 21 Nov 2013 in Heart Attack
Question: Dear Health Care Magic, the following question is for the sake of reference. I am working on a novel and have a question related to frostbite, hypothermia, and the consequences of each. I have listed a lot of information that I hope may give you an idea of the situation, and I understand that there are many uncounted variables, but even a general idea of the consequences that are likely to happen in this case would be incredibly helpful. I have included the specific questions below the information. Thank you ---Overview--- Girl leaves home on the middle of a cold, windy night in the middle of winter. Walks approximately 1.4 miles. While walking her lower legs and boots become wet from traipsing through thick snow. Eventually she lays down at her resting spot where she remains until she is discovered several hours later and brought to an emergency room. ---Victim Information--- Age: 10 Sex: Female Height: 4'3”/129.6 cm Weight: 56 lbs BMI: 15.2 Exposure: No experience with extreme temperature over long periods of time. Grew up in a cold area and plays outside in the cold on occasion. Clothing: Merrell Winter Boots: Waterproof shell, suede/faux fur upper, side zipper, winter insulation. Nine inch high shafts No Socks Down Winter Jacket with polyester shell, waist-high with hood (worn down) and slightly long at the arms, unzipped at front Cotton underwear 100% Cotton T-shirt ---Weather Information--- Air Temperature: -18.4 degrees Fahrenheit and warms to 6 degrees Fahrenheit with sunrise Wind Speeds: 5 mph sustained wind-speed with gusts up to 15 mph Precipitation: None Sunlight: 2 days past full moon Time of Departure: 12:04 a.m. Time of Arrival: 12:35 a.m. (approximately) Time of Discovery: 10:24 a.m. ---More Information--- The girl is not in great physical condition and has been sleeping inadequately the last several weeks leading up to the incident. 1. How long would hypothermia and frostbite take to set in? 2. When would loss of consciousness be experienced? 3. Would heart stop? 4. If yes to 3, would any limb damage would occur due to exposure and circulation issues? 5. A general idea of injuries and damages in similar situations would be very helpful. Thank you VERY much! XXXX
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Answered by Dr. Benard Shehu 1 hour later
Brief Answer: Please follow the answers below.. Detailed Answer: Hi XXXXXXX 1. It would have taken up to 30 minutes after going out for hypothermia and up to 1 hour for the frostbite to set in. 2. Most probably within 30 minutes of laying down, she had lost consciousness depending on the weather condition (low temperature and humidity). 3. Her heart stopped 1 and half hour after laying down. 4. + 5. The hands, feet, face, ears, cheeks, nose have suffered ; first yellow and gray, then blister/sore, and pain. Hope it answered to your questions! If you have more concerns, can write back to me! Dr.Benard
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Benard Shehu 29 minutes later
Dr. Shehu, Thank you very much for your prompt initial responses! I greatly appreciate it. I know that cold temperatures can help prolong the possibility of revival. If the girl loses consciousness roughly an hour and a half after laying down can you give a rough estimate of time when revival would no longer be possible? Gangrene can also be a problem with hypothermia and cardiac/circulatory failure. Do you think it could become a problem in this instance, and if so, how quickly is gangrene dealt with? I've observed cases where the gangrene is surgically removed. Is tissue infected with gangrene removed immediately during emergency care or dealt with separately? Thanks again and have a wonderful day, XXXX
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Answered by Dr. Benard Shehu 51 minutes later
Brief Answer: please read the answer below... Detailed Answer: Hi XXXXXXX Thank you for writing back. It is true that hypothermia is used to prolong the possibility of revival; however, this is done only on strict medical conditions and not in such freezing temperatures. In addition, the hypothermia used for revival is considered for temperatures higher than the temp.the girl is experiencing. Next, the efforts of resuscitation could be successful within the first 30 to 60 minutes. However, trying at the 90th min could also be successful although less chances. In such emergency cases, the most important think is to start resuscitation efforts, then, the surgical intervention is set for the next steps. Hope you are happy with the answer! Dr.Benard If you need more clarifications, can write back to me! I'd be glad to assist you!
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Benard Shehu 2 hours later
Dr. Benard, I think I'm set! If I have any more related questions that come to mind I'll make sure to let you know within the time frame available. Much thanks, XXXX
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Answered by Dr. Benard Shehu 26 minutes later
Brief Answer: Happy to help you further when needed... Detailed Answer: Hi XXXXXXX Honored to help you for further questions! Dr.Benard
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Benard Shehu 38 minutes later
Dear Dr. Benard, If the girl was brought into the Emergency Room in time to be resuscitated how long would she be kept before being released by the hospital? Are patients released when they have reached a sufficient core temperature and other symptoms are no longer noticeable or do they remain under supervision for a longer period of time? Also what is the standard procedure for dealing with a patient in this condition? What I've read has pointed strongly to the use of a heart lung machine in the rewarming process. Is this the “standard” way of dealing with patients with extremely low core temperatures? Thanks, XXXX
doctor
Answered by Dr. Benard Shehu 1 hour later
Brief Answer: Please read the answer below... Detailed Answer: Hi again XXXXXXX With regards to the time before being released by the hospital, it depends on the severity of damages caused by hypothermia. Usually, release of patients is done where their temperature is back to normal together with other vital signs. Furthermore, the medical team should evaluate possible complications and get them treated accordingly The very first thing to do in the ER is to check airways, and to do endotracheal intubation if there is respiratory failure and start rewarming techniques. Yes, you are right, the heart-lung-rewarming-machine is the standard way of dealing with such patients. Hope you got your answers! Dr.Benard
Above answer was peer-reviewed by : Dr. Prasad
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