MultisystemDifficulty 3/5
During rewarming of a severely hypothermic patient, why is a slow, controlled rate preferred?
- ARapid rewarming denatures circulating clotting factors and causes uncontrolled haemorrhage
- BSlow rewarming is required by policy but has no physiological rationale
- CSlow rewarming allows kidneys to excrete accumulated potassium before circulation improves
- DRapid rewarming causes vasodilation and core afterdrop with dysrhythmia risk
Show answer and rationale
Correct: D. Rapid external rewarming dilates peripheral vessels and returns cold, acidotic blood to the core, producing core temperature afterdrop, hypotension and a risk of ventricular dysrhythmia in an irritable myocardium.
- A — Coagulopathy in hypothermia relates to enzyme kinetics, not thermal denaturation during rewarming.
- B — There is a clear physiological rationale.
- C — Potassium handling is not the basis of the rewarming rate.