Heat and Cold Emergencies Slide Presentation prepared by Randall Benner, M.Ed., NREMT-P

Learning Objectives Explain how the body attempts to maintain normal body temperature. Explain how the body loses heat. Describe and demonstrate appropriate first aid care for heatstroke. Describe and demonstrate appropriate first aid care for heat exhaustion. Describe and demonstrate appropriate first aid care for heat cramps. © 2012 Pearson Education, Inc.

Learning Objectives Identify the signs and symptoms of hypothermia. Describe and demonstrate appropriate first aid care for hypothermia. Identify the signs and symptoms of frostbite. Describe and demonstrate appropriate first aid care for frostbite. © 2012 Pearson Education, Inc.

Introduction Heat and cold emergencies can lead to minor, and occasionally life-threatening, conditions. Understanding how the body regulates body temperature will help you anticipate and recognize these emergencies easier. Heat and cold emergencies can occur in situations where there are not extreme changes in environmental temperature. © 2012 Pearson Education, Inc.

Body Temperature Regulation The human body attempts to maintain a constant core temp of 98.6 degrees F. Heat loss must equal heat production. Body heat is created by metabolic activity, monitored by the brain, transported by the blood stream, and eliminated via the skin and by breathing. © 2012 Pearson Education, Inc.

Body Temperature Regulation The body loses heat through Radiation Conduction Convection Evaporation Respiration © 2012 Pearson Education, Inc.

Mechanisms of Heat Loss © 2012 Pearson Education, Inc.

Body Temperature Regulation The body conserves heat through Constriction of blood vessels Hairs on the skin stand erect and trap warm air next to the skin Little or no perspiration is released to the skin surface for evaporation © 2012 Pearson Education, Inc.

Temperature Regulation Clothing affects thermal equilibrium by Providing resistance to heat loss Wearing too many layers when working or two few of layers when resting (not recommended) Matching clothing to the environment and the workload (preferred) © 2012 Pearson Education, Inc.

Heat-Related Injuries Hyperthermia = Heat-Related Injuries From most life threatening to least life threatening Heatstroke Heat exhaustion Heat cramps Common with environmental temps above 90 degrees F and relative humidity above 75% © 2012 Pearson Education, Inc.

Heat-Related Injuries Groups most susceptible to heat-related emergencies Athletes Workers near furnaces or ovens Those in poor physical health Alcoholics and obese Chronically ill Not acclimated to environment Undergoing concurrent drug therapy Burn victims Very young and very old © 2012 Pearson Education, Inc.

Heat-Related Injuries Heat stroke Heat regulation mechanisms fail to cool effectively Heat in the body continues to rise out of control Brain injuries and death can easily occur Two types Classic Exertional © 2012 Pearson Education, Inc.

Mechanisms of Heat Stroke © 2012 Pearson Education, Inc.

Signs and Symptoms of Heat Stroke © 2012 Pearson Education, Inc.

First Aid Care for Heat Stroke Initiate EMS, take standard precautions. Remove the victim from heat source, if possible. Establish an airway, support breathing and circulation. Use approved cooling method, do not induce shivering. Never give the victim stimulants or hot drinks. Monitor the victim’s temperature while awaiting EMS. © 2012 Pearson Education, Inc.

Heat-Related Injuries Heat exhaustion Most common heat-related emergency Vasodilation-induced pooling of blood in the extremities Loss of body fluids from excessive sweating Greatest concern is dehydration from lack of water and blood circulation to critical body organs © 2012 Pearson Education, Inc.

Heat-Related Injuries Heat exhaustion symptoms Headache, weakness, fatigue Dizziness, fainting Profuse sweating, possible muscle cramps Pale, cool, ashen skin Normal to slightly elevated temp Thirst, nausea and/or vomiting Dilated pupils © 2012 Pearson Education, Inc.

Heat Exhaustion and Heat Stroke Symptoms © 2012 Pearson Education, Inc.

First Aid Care for Heat Exhaustion Activate EMS. If heat stroke develops, take standard precautions. Move the victim to a cool place. Remove outer clothing. Place patient supine, raise feet 8–12 inches. If conscious, provide cool water or sports drink. ½ glass every ten minutes for one hour Monitor temperature every 10–15 minutes. © 2012 Pearson Education, Inc.

Heat-Related Injuries Heat cramps Least serious heat emergency Results from disturbances to salt, calcium, electrolytes, or fluid levels Muscles tend to cramp but not relax Hot weather is not a prerequisite. © 2012 Pearson Education, Inc.

Signs and Symptoms of Heat Cramps © 2012 Pearson Education, Inc.

First Aid Care for Heat Cramps Remove the victim from hot environment, if possible. Instruct victim to rest. Administer sips of water or sports drink. ½ glass every fifteen minutes Place moist towels to forehead and cramping muscles. Stretching muscles may help relieve pain. Activate EMS if victim does not respond or deteriorates. © 2012 Pearson Education, Inc.

Cold-Related Injuries Hypothermia = Cold-Related Injuries Heat loss exceeds heat gain Types General hypothermia Immersion hypothermia Frostbite © 2012 Pearson Education, Inc.

Cold-Related Injuries General hypothermia The most life threatening cold-induced injury Core body temperature drops below 95 degrees F Factors that contribute to hypothermia Certain drug therapies Surgery Water activities Pre-existing disease Trauma and massive blood loss Age extremes Immobility © 2012 Pearson Education, Inc.

Stages of Hypothermia © 2012 Pearson Education, Inc.

Hypothermia Signs and Symptoms © 2012 Pearson Education, Inc.

First Aid Care for Hypothermia Activate EMS, take standard precautions, handle the victim gently. Remove the victim from cold environment if possible. Manage airway, breathing, and circulation. Assess vital signs for one full minute. Prevent further heat loss, but do not rewarm the victim if severely hypothermic. Never rub or manipulate the arms or legs. Administer nothing by mouth. Reassess and maintain care until EMS arrives. © 2012 Pearson Education, Inc.

Cold-Related Injuries Immersion hypothermia Heat loss due to immersion in cold water Heat loss extremely rapid, can occur within minutes Factors increasing heat loss Water temperature Body size Clothing Physical activity Use of alcohol © 2012 Pearson Education, Inc.

First Aid Care for Immersion Hypothermia Activate EMS, take standard precautions. Remove victim from water if can be done safely. Assess and maintain the victim’s airway, breathing, and circulation. Keep the victim quiet and still. Follow insulating and rewarming guidelines for general hypothermia. If victim cannot be rescued from water, instruct them to exert as little effort as possible. © 2012 Pearson Education, Inc.

Immersion Hypothermia Strategies © 2012 Pearson Education, Inc.

Cold-Related Injuries Frostbite Frostbite is freezing of body tissues, frost nip is freezing of the skin surface Most commonly affects exposed surfaces Hands, feet, ears, nose, cheeks Factors influencing frostbite Trauma, blood loss, age extremes, use of alcohol, wet clothing, high altitudes Three stages First degree (frost nip, skin surface only) Second degree (impacts skin tissues just below surface) Third degree (damages skin tissues at all depths) © 2012 Pearson Education, Inc.

Three Stages of Frostbite © 2012 Pearson Education, Inc.

First Aid Care for Frostbite Activate EMS, take standard precautions. Remove the victim from the cold environment. Keep tissue frozen until care can be initiated. Protect injured tissue from friction or pressure. Thaw frostbitten tissue in warm water bath (98–104ºF). Rewarm until skin color no longer improves. Cover with loose, dry, sterile dressing. Elevate the injured tissue. Monitor vital signs until medical care arrives. © 2012 Pearson Education, Inc.

Summary Heat or cold emergencies can occur without extreme changes in environmental conditions. In most instances, EMS should be activated. Care provided to the victim by the First Aider may help decrease the overall severity of the injury. Never place yourself in danger during patient rescue or care. © 2012 Pearson Education, Inc.