Hypothermia Without Bradycardia

Report:

Sinus rhythm 76/min

Left axis deviation – 35o

Intraventricular conduction delay (IVCD)

QRS 0.14”)

J (Osborn) waves (hypothermic humps)

Nonspecific ST/T changes

Prolonged QT interval

QTc 0.50”

Comment:

The core temperature was 31oC. The rate is faster than usual and there is no somatic tremor, making the diagnosis of brain death likely. However, the patient received Ventolin and Atrovent prior to intubation with 6 mg of vecuronium in Casualty, all 15 minutes prior to the ECG recording. There is always a differential diagnosis in medicine.

By the time he reached ICU, the temperature climbed to 33oC, with partial resolution of the hypothermic changes (153a below).

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