Shock 4 : Handling Public Cause Hipertermi, Heat Stroke, and Hipotermi

Hypertermi

• Patogenesis: due to brain damage in the central termoregulator so that failure occurs other organs.
• Symptoms and Sign:
- Temperature> 40o C
- Convulsions, coma
- A history of systemic

Handling:
1. ABC
2. - Go clothes, Rinse with water, or alcohol
- Put the ice bag or tub of water to enter the ice
- Enema? ice water if necessary
3. - Infus appropriate degree of dehydration
- Anti piretik, anti konvulsi
- Antibiotics
- Steroid if necessary
4. Kateter, look at urine output

Heat Stroke

• Patogenesis: termoregulator failure in the brain hipotalamus
• Symptoms and Sign:
- Temperature> 40o C
- History: sports, exposure to hot temperatures
- Eat histamin anti drug / anti kolinergik
- Dizziness, weakness, blurred eyes
- Nausea, vomiting, delirium, convulsions
- Skin hot, dry
- Hiperventilasi

Handling:
1. ABC
2. Open clothes, wipe cold water 15o C, if need, you can use fan.
3. Compress es, strived temperature in 1 hour max. 39o C
4. Infus with appropriate degrees D5% dehydration
5. - Anti konvulsan
- May not be antipiretik!
6. Kateter, look at urine output

Hipotermi

• Patofisiologi:
The decline in organ function; oksigenasi down; heart slow polarization
• Symptoms and Alerts
- Temperature> 35 C
- Pale, sianosis
- History: - in the cold environment
- Alcoholism's
- Hypothyroid
- Not cooperative
- Poliuri,shock
- Tremor
- Hipotensi, bradikardi
- Breath slowly
- EKG: A wave is at the end of the QRS

Handling:
1. ABC, Keep out of it. O2 warm (<46.6 o C)
2. Warming
- Pasif: life jackets, warm room
- Internal: Infuse Na Cl 0.9% with a temperature of 37.7 - 40o C
o 15 minutes: 300cc (20cc / minute)
o the next 60 minutes: 700cc (11.67 cc / min)
o give:
- When both B1 100mg plus 50cc glucose + 50%
- When worsened: dialysis peritoneal fluid with a potassium-free temperature 40 C
- When there is heavy VES, lidokain IV
- When acidosis Na bicarbonate 1 Meg / kg iv BB
3. Catheter,look at urine output