Hypothermia: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps.

In principle, an emergency examination must first be performed on persons who are unconscious:

Glasgow Coma Scale (GCS) – scale for estimating impaired consciousness.

Criterion Score
Eye opening spontaneous 4
on request 3
on pain stimulus 2
no reaction 1
Verbal communication conversational, oriented 5
conversational, disoriented (confused) 4
incoherent words 3
unintelligible sounds 2
no verbal reaction 1
Motor response Follows prompts 6
Targeted pain defense 5
untargeted pain defense 4
on pain stimulus flexion synergisms 3
on pain stimulus stretching synergisms 2
No response to pain stimulus 1

Assessment

  • Points are awarded for each category separately and then added together. The maximum score is 15, the minimum 3 points.
  • If the score is 8 or less, a very severe brain dysfunction is assumed and the there is a risk of life-threatening respiratory disorders.
  • With a GCS ≤ 8, securing the airway by endotracheal intubation (insertion of a tube (hollow probe) through the mouth or nose between the vocal folds of the larynx into the trachea) must be considered.

Subsequently, takes place:

  • General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore:
    • Inspection (viewing).
      • Skin and mucous membranes
    • Auscultation (listening) of the heart
    • Auscultation of the lungs
    • Palpation (palpation) of the abdomen (abdomen) (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, kidney bearing knocking pain?)
  • Neurological examination – including checking reflexes and cranial nerve function [due todifferential diagnoses:
    • Hypothalamic disorders, unspecified – part of the diencephalon that controls autonomic regulation.
    • Parkinson’s disease (shaking palsy).
    • Spinal cord injury, unspecified
    • Subarachnoid hemorrhage (SAB) – bleeding between the meninges and the brain]

Square brackets [ ] indicate possible pathologic (pathological) physical findings.