Rough handling of a hypothermic patient with a pulse may cause:

• A. Sinus tachycardia
• B. Ventricular fibrillation
• C. Atrial fibrillation
• D. Normal sinus rhythm

Answer: (B)

In hypothermia the heart becomes electrically unstable, so rough handling can act as a stimulus that triggers dangerous rhythms. The most feared outcome is ventricular fibrillation, a chaotic, non-pumping electrical activity of the ventricles that can occur even if a pulse is present initially. Gentle handling and careful rewarming help reduce this risk. While hypothermia can cause a fast but regular rhythm like sinus tachycardia as the body tries to generate heat, or occasional other rhythms, rough handling is not a typical precursor for those patterns; its main concern is provoking ventricular fibrillation.