C & C Apr/18 – Accidental Hypothermia

Hi guys,

First, huge thanks to Dr Malin Zachau for her time and effort in sharing her knowledge.
May be a cliché comment, but I found Malin’s passion for the research and her energy to do the right thing was very infectious and inspirational.

The session started out with Malin asking us questions around AH, and some interesting stats she made us realise.
It was also our privilege to preview her posters she is presenting at the NZ Resus Council conference next week.


Malin talked about the analysis of coronial data of Accidental Hypothermia in NZ as well as changes called for NZ to be managing accidental hypothermia in line with the current best evidence.
A huge amount of work has been done and Malin gave us very interesting and relevant message for the paramedic practice here in NZ.

You really need to check out her ariticle but some of the take-home points for me include:

  • The rate of people dying from hypothermia indoor is higher in the countries with a warmer climate than cold countries.
  • The rate of a younger population of Kiwis dying from AH indoor is exceptionally high in comparison.
  • The very high rate of neurologically intact survival can be expected based on the evidence in Europe. 40 to even 70%!
  • Some patients have survived and fully recovered after receiving prolonged >6 hrs CPR having extremely cold core body temperature.

Go and check out Malin’s research via her website or her article can be downloaded from the following link.




Here is also a quick reference to our current CPG for cardiac arrest secondary to hypothermia.



Thanks for the ongoing support for our C & C.
We will have a practical session (scenario/skill lab) next month. Our practical sessions are very casual and a good place to make mistakes so come along!




Other interesting read include;

Durrer, B., Brugger, H., & Syme, D. (2003). The medical on-site treatment of hypothermia: ICAR-MEDCOM recommendation. High Altitude Medicine & Biology4(1), 99–103. https://doi.org/10.1089/152702903321489031

Gordon, L., Paal, P., Ellerton, J. A., Brugger, H., Peek, G. J., & Zafren, K. (n.d.). Delayed and intermittent CPR for severe accidental hypothermia. Resuscitation90, 46–49. https://doi.org/10.1016/j.resuscitation.2015.02.017

Paal, P., Gordon, L., Strapazzon, G., Brodmann Maeder, M., Putzer, G., Walpoth, B., … Brugger, H. (2016). Accidental hypothermia-an update : The content of this review is endorsed by the  International Commission for Mountain Emergency Medicine (ICAR MEDCOM). Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine24(1), 111. https://doi.org/10.1186/s13049-016-0303-7

Zafren, K., Giesbrecht, G. G., Danzl, D. F., Brugger, H., Sagalyn, E. B., Walpoth, B., … Grissom, C. K. (n.d.). Wilderness Medical Society Practice Guidelines for the Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia. Wilderness & Environmental Medicine25(4), 425–445. https://doi.org/10.1016/j.wem.2014.09.002



Dr Malin  Zachau has a 25 year career in emergency, prehospital and general practice behind her. Due to a rare muscle channelopathy that means sometimes she is unable to walk, talk or think she has been unable to practice since 2010.
Instead of being beaten by this condition, she enjoys research and shares her knowledge by updating aspects of Outdoor Pre Hospital Emergency Care courses in New Zealand through volunteering.
– ran an avalanche patient rescue workshop at NZ Mountain Safety council SHAC 2017 conference
-facilitated and took part in a NZRA webinar on PTSD in Outdoor recreation staff
-presented at PAIC2016 “How do NZ outdoor instructors manage death of adventure activity participants?”
– has recently attended the  critical care conference in Zermatt “Big Sick18”  by invitation due to her  keen interest in the management of accidental hypothermia
-is a non-hunting member of the  Mountain Safety Council  “Alpine Hunter Falls Prevention issue specific advisory group”

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