J4

HYPO-AND HYPER-THERMIA

Presenters: Kenneth Feldman

Abstract Category: Medical

Instruction Level: Beginner, Intermediate

Presentation: Click Here

Description:         

Causes and pathophysiology of cold and heat stress injuries will be discussed in relationship to child abuse.

Abstract: 

The human organism tightly regulates its temperature through hypothalamic control. However, its ability to compensate for adverse environments is limited. Children through their increased Body Surface Area to Mass ratio, limited ability to express distress and inability to change their enviroments are uniquely susceptible to these injuries. Excess cooling slows metabolism, causes hyperglycemia, lowers consciousness and eventually causes death through ventricular fibrilation. Arrythmias become common below 28 degrees C. Heat stress can result in dehydration, shock and both brain injury and rhabdomyolysis.

Rates of post-mortem cooling are also of concern in death investigation. The cooling rates correspond to body size, as modeled by an ideal cylinder. Tympanic membrane temperature corresponds well with the core brain temperature. Cooling is faster in water than air, but both follow exponential curves.