Wednesday, January 13, 2010

EKG Changes With Hypothermia


When one succumbs to hypothermia as this poor gentleman did here, the heart's conduction system changes in such a way that distinctive EKG changes are produced. When these are seen in the course of taking care of a hypothermic patient they should prompt aggressive rewarming techniques, but also, should prompt the treatment team to be gentle, as cold hearts are particularly susceptible to dangerous arrhythmias. "J" or "Osborne waves" are present here right on the heels of the QRS. These disappear with rewarming. Welcome to Miami.

9 comments:

  1. Ummm, yeah, it has been colder than a witches tit down here for over a week. Where's Al Gore when you need him??

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  2. Not to mention the head injuries caused by those falling lizards!

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  3. This looks exactly like the Earth's temperature history. Up, down, cooling and warming. If you zoom in on a tiny segment, Hockey Stick!!

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  4. This has been a question for me for a while. What is the actual cause of death in hypothermia? Arrhythmia?

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  5. What is really fun is when you are cooling them down for hypothermia post arrest, and you get the Osborne waves. You just know the patient is going to keep you busy the whole time you are cooling him down,

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  6. Bum-cicles beware. Osborne waves here you come. Anybody else cooling people intentionally after cardiac arrest?

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  7. Thanks 9-11 for reminding me of one of the most ignominous moments of my medical career...
    Some Bum,I mean, HOMELESS dude somehow managed to get Hypothermic in Mobile, Alabama...
    Presenting the case to our Cardiologist Attending, I proudly pointed out the....................
    "OSWALD" Waves...
    I think it was one of those Freudian things...
    and I got a whole additional 12 weeks of Internal Medicine to get it right.

    Frank

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  8. So, Frank, that more ragged, secondary peak is a grassy knoll?

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