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hypothermia in C6 Spinal injury

CCU   (183 Views 3 Comments)
by kataraang kataraang (Member)

kataraang has 2 years experience and works as a Registered Nurse.

2,191 Visitors; 123 Posts

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Patient with C6 spinal injury from 10 years ago with autonomic dysreflexia. MAPs ranging from 40s to 80s, HR as low as 45.

His documented temps had been normal but when I came on shift it was 32.7. I tried it oral, axillary, rectal (though he has flexiseal). I had another nurse double check with me, used 2 thermometers. I only went to those lengths to check because this was the first documented temp this low. His skin felt cool/cold. I gave extra blankets and turned his room temp up.

My instinct was bair hugger so I asked the resident and he said no. He said it was normal for his autonomic dysfunction and not to treat.

Isn't it still necessary to treat, regardless of cause? I'll see if the intensivist had any input from rounds today (since I'm on nights). Just curious of your experiences.

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1 Follower; 11,866 Visitors; 1,319 Posts

Was the patient symptomatic for any of this?

The hypothermia could certainly superimpose it's own cardiovascular effect on to what ever autonomic dysfunction was going on, not the least of which is bradycardia and hypotension. 

Why was the guy in the unit in the first place?

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kataraang has 2 years experience and works as a Registered Nurse.

2,191 Visitors; 123 Posts

Altered mental status. He had infected wounds needing debridement and IV antibiotics.

He was a little altered during this time, not as responsive as baseline, HR dropping to 40s occasionally. The next day after rewarming he was more interactive.

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