Hypothermia and Cold Weather Survival Officer Stephen Verchinski New Mexico State Parks

Cold Water Near Drowning Drowning - Lungs fill with Water (aka Pulmonary Aspiration Near Drowning - Survival of up to 24 hours after a drowning episode. (Warm and Dead - 30 Degrees C) Hypothermia (Hypo- Low, Therme -Heat) “A Dangerous Loss of Heat”

Cold Water Submersion Adults - Asphyxiation and Immediate Hypothermia RAPID CORE COOLING - LOW BOD Children - Cool More Rapidly Heart to 7 BPM Epiglotis Closes MAMMALIAN DIVING REFLEX 30 MIN.

FORCES IN THERMAL REGULATION IN COLD THIS IS A BALANCE BETWEEN THE COLD CHALLENGE AND YOUR ABILITY TO PRODUCE OR RETAIN HEAT. THE COLD CHALLENGE -- The environment working to take heat away from the body. HEAT RETENTION -- The body’s ability to retain heat. HEAT PRODUCTION -- The body’s ability to produce heat

Your Body’s Reaction to a Cold Challenge 1. The Cold Response 2. Mild Hypothermia 3. Severe Hypothermia

The Cold Response The body’s normal physiological response to a cold challenge ASSESSMENT Blood is shunted from the periphery to the core. Mild shivering: if exercise is not adequate for heat production A normal level of consciousness Fine motor function may be impaired. Increased urination causing a loss of fluid

The Cold Response TREATMENT Add more clothing layers (Heat Retention) Increase fluid/fuel intake (Heat Production) Increase exercise (Heat Production) THE BOTTOM LINE -- EASILY DEALT WITH IF RECOGNIZED EARLY. EMS INVOLVEMENT OR SAR IS TO EDUCATE, EDUCATE, EDUCATE.

MILD HYPOTHERMIA THE BODY’S ABILITY TO COMPENSATE FOR THE COLD CHALLENGE IS OVERWHELMED The onset of mild hypothermia is a field emergency, indicating a significant drop in core temperature has already occurred.

MILD HYPOTHERMIA ASSESSMENT Mental status changes: irritable, lethargic, mild confusion (may appear drunk) Shivering may be present Loss of fine motor function Shell to core shunting Core temp. Less than 90 degrees F, 32 deg. C Other VS within normal parameters

MILD HYPOTHERMIA Treatment Shelter from wind and moisture Remove wet clothes :replace with dry. Body to body contact may be helpful Insulate from the ground or snow Use a vapor barrier over clothing to cut evaporative heat loss Take in fluids (warm drinks) Take in Calories Exercise to increase heat production once above completed.

SEVERE HYPOTHERMIA This is a true medical emergency. The patient has lost all ability to fight the cold challenge. Rescue efforts should be directed to gentle rapid transport and preventing further heat loss.

SEVERE HYPOTHERMIA ASSESSMENT Significant decrease in LOC Shell to core effect is extreme Core temperature less than 90 degrees F No shivering “Metabolic Icebox” effect. VS depressed or unobtainable. Pupils dialated with CA

SEVERE HYPOTHERMIA Treatment Reduce further heat loss. Package for rapid transport accordingly Handle gently Prevent exercise Avoid shell rewarming Evacuate flat. Nothing by mouth Airway to be open Slow Mouth to Mouth CPR 6-12 Breaths/Min. 40-60 Comp./Min. Primary/Secondary Injury Mgmt.

SEVERE HYPOTHERMIA Treatment Concerns and Upgrades Warmed, Humidified Oxygen (Rescue Air RES-Q-AIR 9”x3”x2” weight 4.5 $1600 Flex Disks Thermo Pads. CORE AREA ONLY No Drugs -- Pooling Shock Protocols EMS Academy Kyle Thornton State of Alaska EMT I,II,III JAMA October 28, 1992