Injuries to the heat regulating centres in a patient’s brain may cause hyperthermia, especially during the first 12 hours after an injury. When he is first admitted his temperature is usually low, and any rise over 39C is a grave sign. During the first few days a temperature fluctuation of a degree or so is unimportant, but a rise after a day or two is serious, because it may indicate renewed subarachnoid bleeding, pneumonia, or meningitis. Hyperthermia can kill a patient with a head injury who might survive otherwise, so monitor his temperature carefully, and treat him promptly. It can rise very suddenly: it may be 38C one moment and 42C half an hour later.
HYPERTHERMIA Take the patient’s temperature regularly. During times of crisis take it every 10 or 25 minutes. If his temperature rises above 39C, take off his pyjamas, cover him with a wet sheet, and turn a fan on him. Bring his temperature down to 40C or below, and keep it there. If necessary give him chlorpromazine 50 mg 6 hourly, intramuscularly or by stomach tube.