Cold Related Emergencies

1. Cold Related Emergencies

2. Factors That Promote Susceptibility To Cold • Unfit (conflicting) • >50 years and small children • Alcohol and caffeine consumption • Use of tobacco products • Previous cold related emergency • Inactivity in cold

3. Cold Factors #2 • Dehydration • Nutrition • Illness • Injury • Wind • Wet clothing (transfers heat from the body)

4. Proper Clothing • 3 layers of clothing • Purpose is to insulate by trapping layers of air • A single heavy layer is not recommended

5. Additional Considerations • Cap • 50-60% of body’s heat is lost through the head • Neck • Site of significant heat loss • Gloves / Boots

6. Cold Related Emergencies • Hypothermia • Frostbite

7. Hypothermia • Core body temperature of 95 or less • May be mild or profound (<90 degrees) • Core temperature of 80 degrees usually results in death • Can occur in temps above 32 degrees • Medical emergency • Victim may present with no heartbeat, breathing, or response to touch or pain, but may not be dead • All victims should be evaluated by a physician

8. Mild Hypothermia • Body temperature 90 to 95 degrees • (marathon) • Shivering • Slurred speech • Memory lapses • Fumbling hands • May stumble or stagger • Usually conscious and can talk • Cold abdomen and back

9. Profound Hypothermia • Body temperature below 90 degrees (AR hunter) • Shivering has ceased • Muscles stiff and rigid • Skin appears blue • No response to pain • Pulse and respirations slowed • Pupils dilate / Victim “appears dead” / 50-80% will die • Child in Canada, winter 2001, core body temp. 60

10. Hypothermia: What To Do • Stop heat loss (more on next slide) • Call EMS • RESCUEEXAMINEINSULATETRANSPORT • Check ABC’s • Take pulse for 30-45 seconds • Always try to re-warm in a hospital

11. Hypothermia: Stop Heat Loss • Remove from cold environment • Use blankets, towels, pillows, newspapers to wrap around victim • Cover head • Replace wet clothing

12. Hypothermia: Handling The Victim • Gentle handling • Roughness could cause cardiac arrest • Keep victim horizontal • Elevating legs would shunt cold blood to the core of the body • Victim should not walk or exercise - do not massage the body • These actions could drive cold blood into the torso resulting in temperature after-drop

13. Hypothermia • Controversial: • Body to body contact • Warm drinks • Do not consume un-melted snow and ice • Lowers body temperature • Sometimes, that’s your only choice

14. Hypothermia and CPR • Do not start CPR if: • Body temperature 60 degrees or below • Frozen chest • Lethal injury • Rescurer is endangered • Always take pulse for 30-45 seconds

15. Frostbite (frozen tissue) • Freezes deep into the skin • Mainly affects feet, hands, ears, nose

16. Frostbite: How Damage Occurs • Freezing of tissue • Ice crystals form between tissue cells • Obstruction of blood supply to tissues • “Sludged” blood clots form • More damaging than ice crystals

17. Frostbite: Signs and Symptoms (pre-thaw) • White, waxy or grayish-yellow skin • Pain followed by no feeling • Affected part is very cold or numb • Hard or crusty skin • Post-thaw resembles burn stages

18. First Aid: Re-warming • 1. Medical center • 2. Rapid (wet) re-warming: • Preferred re-warming method outside of hospital setting in water temperatures around 103 to 105. • 3. Slow re-warming: • involves warming body to body, arm pit, etc. • Do not re-warm with a heating-pad, stove or over a fire

19. Rapid Re-Warming • NEVER RUB FROZEN TISSUE • Place body parts in water 102 to 105 (20 to 40 minutes) • Do not re-warm if there is a chance of re-freezing