Monitoring

Monitor temperature regularly by measuring rectal temperature.[1] In practice, use an oesophageal probe in intubated patients.

In practice, order serial bloods and monitor laboratory tests at least once daily (particularly potassium levels, renal function, arterial blood gases, clotting profile, and creatine kinase; see the Diagnosis section). If the patient is critically unwell or there is evidence of organ failure, consider repeating bloods more frequently.

Be vigilant for complications that may develop at a later stage (even after return to normothermia) including rhabdomyolysis, acute kidney injury, disseminated intravascular coagulation, and acute liver failure.[1][2] See the Complications section.

Practical tip

Be cautious of falsely elevated rectal temperature measurements in the recovery phase resulting from the insulating effect of body mass.[1]

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