Wilderness Medicine Updates Ep. 4 - HOPE Score for Severe Hypothermia
Feb 23, 2023
Discover the critical HOPE score, a lifesaving tool that helps identify severely hypothermic patients who may benefit from advanced rewarming techniques. Listen as a gripping case of a young man's near-fatal encounter with hypothermia is shared, highlighting the intense emergency response. The discussion also focuses on the HOPE score's significance, its practical applications, and essential considerations for managing both adult and pediatric patients. Engage with the complexities of hypothermia management while learning about recent studies that validate this crucial scoring system.
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High-Stakes Survival Case
- Dr. Patrick Fink opens with the case of Tayyab Jafar, a 22-year-old who survived profound hypothermia after bypass and ECMO but suffered major complications.
- Jafar ultimately recovered most function and overcame his suicidal state, illustrating high-stakes outcomes of extracorporeal rewarming.
HOPE Score Purpose
- The HOPE score predicts survival after extracorporeal rewarming in severe hypothermia to guide resource use.
- It helps decide which profoundly hypothermic patients may benefit from ECLS and which attempts may be futile.
Physiology And Best Rewarming Method
- Below ~32°C shivering fails and external heat is required; below ~28°C patients may be unconscious with absent signs.
- Extracorporeal life support (bypass or VA-ECMO) is the best method to rewarm these patients.