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Hypothermic cardiac arrest — DIPIMC MCQ

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HardResuscitationHypothermic cardiac arrestDIPIMCDipIMC

A man is found collapsed in snow. He is in ventricular fibrillation and his measured core temperature is 26 degrees Celsius.

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Withhold adrenaline until the core temperature exceeds 30 degrees and limit defibrillation to three attempts until rewarmed

Explanation lettering: C = shown as A · D = shown as B · E = shown as C · A = shown as D · B = shown as E

In severe hypothermia (below 30 degrees) drug metabolism is markedly impaired, so adrenaline is withheld until the core temperature rises above 30 degrees, and defibrillation attempts are limited to three until the patient is rewarmed. Standard drug dosing (A) risks accumulation and toxicity. The dictum 'not dead until warm and dead' (against B) reflects the need to rewarm, ideally with extracorporeal support, before stopping.

Reference: Resuscitation Council UK 2025 (hypothermia)