Cold Related Emergencies

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

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

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

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

Cold Related Emergencies Hypothermia Frostbite

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

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

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

Hypothermia: What To Do Stop heat loss (more on next slide) Call EMS RESCUE EXAMINE INSULATE TRANSPORT Check ABC’s – Take pulse for seconds Always try to re-warm in a hospital

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

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

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

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 seconds

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

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

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

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 Slow re-warming: – involves warming body to body, arm pit, etc. Do not re-warm with a heating-pad, stove or over a fire

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