Dropping temp too fast...

Burnt2 · Jul 17, 2007

I've heard of it being dangerous to let a temp go UP in the face of brain issues like strokes, but never anything about the other direction

ready4crna? · Jul 17, 2007

Elizabeth-

Dropping a patient's temp too fast from 105.8 is not possible, you may need to slow it down to prevent shivering (or maybe use a neuromuscular blockade depending on what the exact problem is with your patient). Now, there is some recent data to suggest that certain populations (MI and Traumatic brain injury) actually do better with induced HYPOthermia. There is all kinds of data to prove that sustained high fever (>103) is bad. so get that fever down as quickly as possible.

ElizabethJRN · Jul 17, 2007

Thanks for the info, we were working on dropping it fast, but one nurse said that it can cause cerebral issues...so just thought I'd ask...thanks!

Diary/Dairy, RN · Jul 17, 2007

No, for our cardiac arrests, we use the hypothermia protocol to protect cerebral function!

ElizabethJRN · Jul 17, 2007

Hi! I am aware that hypothermia is used in such cases, but I am wondering about in this situation, which was septic shock with a temp 105.8, about getting it down FAST, and how fast is allowed. Another experienced RN said to drop it about a degree an hour...?? We just dropped it...now he's got a core temp of 96.

Diary/Dairy, RN · Jul 17, 2007

Well, anytime your temp is that high, you are doing very bad things to your brain, and the temperature just needs to come down, it probably won;t happen too fast anyway, just need to get it down. We had a protocol for the entire proceedure...I will talk to someone to see about how fast we got them down.

phiposurde · Jul 17, 2007

Hey guys, anyone know what are some of the symptoms, etc. of dropping a patients temperature too fast? Nurse at work said "cerebral problems", but don't know specifics. Had a pt tonight with a temp of 105.8...docs weren't too worried about dropping too fast, but I'm just curious. Tried to do a search and came up with nothing. Thanks!

*** The only thing I could see, is you could send the patient in hypothermia. Then is to determine if your patient could tolerate it. If his a post-cardiac arrest or a isolated head injury good. But if his a multi trauma, it could increase is risk of bleeding. There is 2 kind of patient with high temperature. The one with there thermo regulator system intact and the one that is not so much. If I have someone with a temp because he as an infection, that temp is good and that patient is actually creating that temperature as a mechanism of defense, so his in control of it . There not much chance that it will hit the 41 degree or 42 degree, cause the body will compensate. The person that come with a sympathommimetic OD. That patient is loosing the battle, and you need to cool them at any mean possible. In some case in the ER, we even paralyze them. Cause if not, soon he will have a brain sunny side up!! Well that's my 2 cent!( I know is is Canadian money but right now it is not so bad) LOL

Christie RN2006 · Jul 24, 2007

When our neuro patients start to spike a temp we start acting! If you try to cool down a severe brain injury patient too fast, you can make them start seizing. You want to get their temp down fast, but slow enough that they don't start shivering. If you aren't dealing with a neuro patient, by all means get their temp down fast or else they will have brain damage!!

phiposurde · Jul 24, 2007

When our neuro patients start to spike a temp we start acting! If you try to cool down a severe brain injury patient too fast, you can make them start seizing. You want to get their temp down fast, but slow enough that they don't start shivering. If you aren't dealing with a neuro patient, by all means get their temp down fast or else they will have brain damage!!

*** What's the physiologies of the seizure??

Christie RN2006 · Jul 24, 2007

*** What's the physiologies of the seizure??

A lot of our severe neuro patients will go into seizures when you overstimulate them, something as simple as making them shiver will send them into a seizure.

Adham Ahmed · Oct 8, 2007

ready4crna thank you