EKG in Hypothermia and Hyperthermia †Free Samples to Students

Question: Discuss about the EKG in Hypothermia and Hyperthermia. Answer: Introduction: Based on the given case study it is evident that the child has developed certain altered pathophysiological symptoms that do not conform to the normal parameters of the body. His condition has been attributed to the eating of chocolate when rashes and breathlessness followed within short span of consumption. Primary assessment findings revealed on the basis of Pediatric Assessment Triangle that the 6 year old child has decreased response to the environmental stimuli along with increased work of breathing and redness on skin. Evaluation of the level of consciousness in the child further depicted that she is not fully awake and only responds to verbal commands. Further examination regarding the vital parameters demonstrated that her respiratory rate and heart rate are increased beyond the normal range suitable for school age children. Initial assessment on her state of consciousness via the reliable neurological scale of GCS exposed that her eyes are opening to voice, expressed confuse d verbal response and obey motor commands. Red and itchy rash on exposure occurred on both the arms and chest (Wilson Giddens, 2016). However, other health indicators related to systolic blood pressure, temperature, blood glucose level, pain score all have been presented within normal limits. Central capillary refill time is longer indicative of impaired blood flow. Midline trachea alongside presence of persistent cough and respiratory wheeze is found in the child coupled with increased effort and decreased level of oxygen saturation. The prevalence of asthma history in the patient further accentuated the risk of harboring chronic inflammatory disorder with recurrent attacks of breathlessness and wheezing. The swelling of the lining of the bronchial tubes cause the narrowing of the airways and cause reduction of the airflow in and out of the lungs (Oyoshi et al., 2014). Thus all the presenting symptoms imply towards the presence of a severe allergic response that triggered adverse response in the body due to altered immune sensitivity. Preliminary diagnosis of the patient on account of the symptoms presented indicates that the child must have acquired a severe allergic response due to exposure to some material which is chocolate in this case. Within 15 minutes of chocolate intake she developed shortness of breath along with presence of skin rashes. Moreover patient history shows that she has allergy towards egg, peanuts, pistachios and cashew nuts and is predisposed to asthma and subjected to medication for treating the condition. Thus assimilating all the background and current information it is likely that the child has acquired chocolate allergy. Empirical findings have shown that the main ingredient of chocolate, the cocoa beans are rarely responsible for the allergic reaction. Instead the other ingredients those constitute the chocolate are held primarily responsible for triggering the immunological response through release of certain chemical mediators in the bloodstream (Costa et al., 2015). In this case sin ce the child has already been detected to have allergy towards nuts, hence these ingredients in the chocolate based food may be identified as the root cause leading to the symptoms such as that of red and itchy skin as well as respiratory distress. Sensitivity towards these detected components may be attributed to the culmination of such allergic symptoms. In certain cases food allergies may also lead to the culmination of asthma symptoms thereby accounting for allergy induced asthma and this occurred in this particular instance with chocolate being the allergen. Thus looking into the symptoms and past history pertinent to the patient it may be opined that she has chocolate allergy that may be further confirmed through conduction of appropriate allergy tests. Moreover the presence of asthma in the child further aggravated the allergic response thereby restricting the airways immediately after consumption of chocolate due to sensitivity (Yongnam et al., 2016). Initial treatment for the patient will include amelioration of the presented symptoms with improvement in the respiratory functioning and reduction in the presence of skin rashes. In order to stop the allergic responses in the patient with reliving of symptoms related to shortness of breath, an intravenous injection of epinephrine hormone may be applied. Other medications comprising of antihistamines may be utilized to offer relief from symptoms due to chocolate allergy such as itching and rashes. In order to tackle the respiratory system associated problems those thwart the normal cardio-respiratory functioning, drugs that belong to the group of corticosteroids may be infused in the patient (Bird, Crain Varshney, 2015). Further clearance of the respiratory tract and broadening of the airways may be prompted by means of the bronchodilators that will cause release of certain chemicals that in turn will open up the breathing passage through decreasing the airflow and increasing the ai rflow by virtue of relaxing the bronchial smooth muscle. Immediate relief may be provided from the epinephrine auto-injector that will deliver the required dose of medication to abate the allergic reaction through blocking of the histamine release from the histamine 1 receptors (Sicherer and Sampson, 2014). Bronchodilators and corticosteroids may effectively address the respiratory troubles and cause relief from wheezing and difficulty breathing. The application of corticosteroid must follow the intervention of bronchodilator always thereby allowing for greater penetration to the lungs and diminishing the inflammatory response in the bronchioles and smaller airways after the opening up of the airways and are more relaxed. Additional benefits from using these medications to treat the asthma symptoms as well (Shea, 2014). Depending upon the information retrieved from the case study the presenting symptoms of the 2 year old boy it is seen that his bodily responses are not functioning properly in sync with the usual processes. Physical assessment triangle based inquiry depicted that he is anxious, irritable and lethargic with visible discomfort in breathing evident through increased effort of breathing while his skin appeared pale. Determination of the level of alertness and status of mental state by means of AVPU assessment revealed that he is only responding to pain stimuli through opening of eyes. His oxygen saturation levels are low while the heart rate is way above normal for a toddler indicating tachycardia (Fuchs et al., 2016). Further assessments on the conscious state of mind indicated that he is opening eyes in response to pain exhibiting confused verbal response alongside localization of pain. His skin appeared to be pale, cool and diaphoretic. The systolic blood pressure, respiratory rate, blood glucose concentration are within the normal limits. Central capillary refill time is found to be longer thereby suggesting presence of dehydration and diminished blood flow. Moreover, the recording of the body temperature showed that it is far less than the normal thus indicating an altered homeostatic mechanism that might have lead to such condition. Dissipation of more heat than the absorbance accounted for reduction in the body temperature. Pupil reflexes are found to be intact as well. Auscultation assessments also demonstrated no abnormality (Gausche-Hill et al, 2014). Thus the presenting symptoms alongside the prevalence of lower body temperature with cold skin indicate that he might be suffering from hypothermia that prompted his homeostatic feedback regulation to undergo a significant change. The information gathered about the patient regarding his health history and current condition revealed that he had been suffering from cold symptoms and coughs for the past 8 days and had been diagnosed with cold only two days back. Presently he has become restless, irritable sleepy and feeling unwell. Therefore, the drop in body temperature as recorded further indicates that he has been suffering from hypothermia due to imbalance caused in heat production with respect to heat generation. Besides the symptoms of lethargy and cold skin in addition to heart arrhythmias or tachycardia are the typical attributes of hypothermia that are all presented in case of the child (Doshi Giudici, 2015). As per the temperature range based classification the 2 year old may be said to have acquired a moderate hypothermia due to accelerated rates of heat loss compared to heat production. In absence of underlying medical condition relevant to the patient, sudden exposure to the cold may be assigned as the probable reason for the development of hypothermia even in the summer season. The homeostatic mechanism and feedback control undergo a major setback under such circumstances due to inability of maintenance and regulation of body temperature. The larger body surface area in contrast to the body weight in children accounts for the faster loss of body heat compared to the adults and adolescents. Therefore in accordance to the given case study, the patient is likely to suffer from hypothermia when the core or internal body temperature falls below 95 F or 35 C. The reduction in the body temperature along with the altered heat regulation mechanism thus further confirmed the presence of hypothermia (Azzopardi et al., 2014). The treatment or management of the suspected ensuing hypothermia in case of the patient needs prompt emergency medical intervention and adequate attention. On an initial level the person must be protected from further heat loss by means of applying warm, dry clothes and blankets. Further in order to tackle the dehydration in the person warm liquids need to be given to the affected individual (Geva, Tasker Randolph, 2015). As part of the hypothermia management initiative, cardiopulmonary resuscitation must be started immediately for the patient to regain his sate of consciousness and improve his vital functioning. Warmed IV fluids may be started for the patient depending upon the case as it may occur. Heated and humidified oxygen may be administered in case of the patient. Thoracic lavage with isotonic saline may be considered as a viable treatment option for the patient. However caffeine or alcohol must be strictly avoided in case of hypothermic patient as they might further speed u p heat loss thereby worsening the condition. The ambient room temperature must be sufficiently heated to alleviate the symptom of hypothermia and keeping the body warm to an adequate level (Ducharme-Crevier Wainwright, 2017). Furthermore, strenuous muscle exertion must be abated in hypothermia as it might trigger cardiac arrest under certain situations. References Azzopardi, D., Strohm, B., Marlow, N., Brocklehurst, P., Deierl, A., Eddama, O., ... Levene, M. (2014). Effects of hypothermia for perinatal asphyxia on childhood outcomes. New England Journal of Medicine, 371(2), 140-149. Bird, J. A., Crain, M., Varshney, P. (2015). Food allergen panel testing often results in misdiagnosis of food allergy. The Journal of pediatrics, 166(1), 97-100. Costa, J., Melo, V. S., Santos, C. G., Oliveira, M. B. P., Mafra, I. (2015). Tracing tree nut allergens in chocolate: a comparison of DNA extraction protocols. Food chemistry, 187, 469-476. Doshi, H. H., Giudici, M. C. (2015). The EKG in hypothermia and hyperthermia. Journal of electrocardiology, 48(2), 203-209. Ducharme-Crevier, L., Wainwright, M. S. (2017). Therapeutic Hypothermia in Children. In Continuous EEG Monitoring (pp. 347-359). Springer International Publishing. Fuchs, S., Terry, M., Adelgais, K., Bokholdt, M., Brice, J., Brown, K. M., ... Simon, W. (2016). Definitions and assessment approaches for emergency medical services for children. Pediatrics, 138(6), e20161073. Gausche-Hill, M., Eckstein, M., Horeczko, T., McGrath, N., Kurobe, A., Ullum, L., ... Lewis, R. J. (2014). Paramedics accurately apply the pediatric assessment triangle to drive management. Prehospital Emergency Care, 18(4), 520-530. Geva, A., Tasker, R. C., Randolph, A. G. (2015). Therapeutic Hypothermia in Children. The New England journal of medicine, 373(10), 979-979. Oyoshi, M. K., Oettgen, H. C., Chatila, T. A., Geha, R. S., Bryce, P. J. (2014). Food allergy: Insights into etiology, prevention, and treatment provided by murine models. Journal of Allergy and Clinical Immunology, 133(2), 309-317. Shea, J. (2014). U.S. Patent Application No. 14/457,879. Sicherer, S.H. and Sampson, H.A., 2014. Food allergy: epidemiology, pathogenesis, diagnosis, and treatment.Journal of Allergy and Clinical Immunology,133(2), pp.291-307. Wilson, S. F., Giddens, J. F. (2016). Health assessment for nursing practice. Elsevier Health Sciences. Yongnam, L. E. E., Yoo, J. S., Shin, D. H., Ryoo, B. H., Oh, S. R., AHN, K. S., ... Song, H. H. (2016). U.S. Patent Application No. 15/261,999.