Specialties MICU
Published Jul 17, 2007
ElizabethJRN
113 Posts
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!
Burnt2
281 Posts
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?
218 Posts
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.
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
1,785 Posts
No, for our cardiac arrests, we use the hypothermia protocol to protect cerebral function!
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.
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
120 Posts
Christie RN2006
572 Posts
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??
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
42 Posts