Management of Pediatric Hypothermia and Peripheral Cold Injuries in the Emergency Department

Management of Pediatric Hypothermia and Peripheral Cold Injuries in the Emergency Department is organized by EB Medicine.

Date of Original Release: January 1, 2019
Date of most recent review:  December 15, 2018
Termination date:  January 1, 2022.
CME Expiration Date: February 1, 2022

Target Audience:
This enduring material is designed for emergency medicine physicians, physician assistants, nurse practitioners, and residents.

CME Credits:
4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAFP Prescribed Credits, 4 AOA Category 2-A or 2-B Credits.

About this Issue:
Infants, children, and adolescents are at higher risk for primary cold injuries due to a combination of physiologic and cognitive factors. This issue describes the workup and management of hypothermia, frostbite, and frostnip in pediatric patients. It provides guidance for prompt diagnosis, management strategies for stabilization, and recommendations for transfer when necessary. You will learn:
•  Why pediatric patients are more susceptible to cold injuries
•  How to determine the severity of hypothermia, based on the patient’s core body temperature and associated clinical findings
•  What types of thermometers are appropriate for use in patients with hypothermia, as well as temperature measurement strategies
•  When CPR should be initiated, and when it is appropriate to stop resuscitation efforts
•  When diagnostic studies are warranted, and which studies should be ordered for patients at different stages of hypothermia
•  Types of rewarming techniques, including passive and active rewarming methods
•  How to manage patients with mild, moderate, or severe hypothermia, as well as those with frostnip or frostbite
•  Indications and evidence for the use of extracorporeal membrane oxygenation

Goals: 
Upon completion of this activity, you should be able to: 
• demonstrate medical decision-making based on the strongest clinical evidence; 
• cost-effectively diagnose and treat the most critical ED presentations
• describe the most common medicolegal pitfalls for each topic covered.

CME Objectives:
Upon completion of this article, you should be able to:
• Identify the risk factors for cold injuries in pediatric patients
• Describe the clinical features and stages of hypothermia
• Correlate pathophysiology with clinical features and diagnostic testing in hypothermia
• Develop a general management plan for pediatric patients with mild, moderate, and severe hypothermia.