Heat & Cold Injuries

Generalized Cold Emergencies Heat loss methods include: Heat loss methods include: –Conduction –Convection –Evaporation –Respiration

Cold Weather Injury Hypothermia Hypothermia –Early stage –Later stage Frostbite Frostbite –Early stage –Later stage

Predisposing factors of hypothermia Injuries Injuries Chronic illness Chronic illness Shock Shock Burns Burns Head and spinal cord injuries Head and spinal cord injuries Generalized infection Generalized infection Diabetes Diabetes Unconscious patient Unconscious patient Aged people Aged people

S & S Shivering in early stages Shivering in early stages Reduced sensation Reduced sensation Stiff or rigid posture Stiff or rigid posture Drowsiness Drowsiness Rapid breathing and rapid pulse Rapid breathing and rapid pulse Loss of motor coordination Loss of motor coordination Joint \ muscle stiffness Joint \ muscle stiffness Decreased level of consciousness Decreased level of consciousness Red skin appearance Red skin appearance

Emergency Medical Care Passive rewarming Passive rewarming Active rewarming Active rewarming

Patient Care – Alert Remove all wet clothing Remove all wet clothing Actively rewarm patient Actively rewarm patient Care for shock, give oxygen Care for shock, give oxygen Warm liquids slowly Warm liquids slowly Transport patient to hosp. except in mild cases Transport patient to hosp. except in mild cases

Patient Care – Unresponsive Assure open airway Assure open airway High oxygen concentration High oxygen concentration Warm patient in blankets Warm patient in blankets Transport immediately Transport immediately

Patent Care – Extreme Hypothermia Assess carotid pulse Assess carotid pulse Continue as unresponsive patient Continue as unresponsive patient

Localized Cold Injuries S & S include: S & S include: –Red skin dark skin whiten whiten –Skin numbness

Patient Care – Early (superficial) Get patient out of cold environment Get patient out of cold environment Warm affected area Warm affected area Splint & cover extremity Splint & cover extremity Do nor rub or message Do nor rub or message

Frostbite S & S: Waxy, white skin gray blue swelling and blistering S & S: Waxy, white skin gray blue swelling and blistering Rx: high O2 concentration, transport, warming Rx: high O2 concentration, transport, warming

Heat Injuries Patient with Moist, Pale, Normal to Cool Skin Patient with Moist, Pale, Normal to Cool Skin Patient with Hot and Dry or Moist Skin Patient with Hot and Dry or Moist Skin

Progression of Heat Injuries Heat Cramps Heat Cramps Heat Exhaustion Heat Exhaustion Heat Stroke Heat Stroke

Patient with Moist, Pale, Normal to Cool Skin / S & S Muscle cramps (legs, abdomen) Muscle cramps (legs, abdomen) Weakness or Exhaustion Weakness or Exhaustion Dizziness or faintness Dizziness or faintness Rapid shallow breathing Rapid shallow breathing Weak pulse Weak pulse Heavy perspiration Heavy perspiration Loss of consciousness Loss of consciousness

Patient with Moist, Pale, Normal to Cool Skin / Care Remove from hot environment Remove from hot environment Administer Oxygen Administer Oxygen Loosen or remove clothes Loosen or remove clothes Supine position with elevated legs (rest) Supine position with elevated legs (rest) Small sips of water (conscious) Small sips of water (conscious) Apply moist towel over cramped areas Apply moist towel over cramped areas Transport Transport

Patient with Hot and Dry or Moist Skin / S & S Rapid shallow breathing Rapid shallow breathing Full and rapid pulse Full and rapid pulse Generalized weakness Generalized weakness Little or no perspiration Little or no perspiration Altered mental state (loss of consciousness) Altered mental state (loss of consciousness) Dilated pupils Dilated pupils Seizures present but no cramps Seizures present but no cramps

Patient with Hot and Dry or Moist Skin / Care Remove patient from hot environment Remove patient from hot environment Remove clothing Remove clothing Administer Oxygen Administer Oxygen Transport immediately Transport immediately

Prevention of cold weather & heat injuries Think of the acronym COLD Think of the acronym COLD C-Clean clothes C-Clean clothes O-Avoid Overheating O-Avoid Overheating L-Loose Layers of clothing L-Loose Layers of clothing D-Keep Dry D-Keep Dry Change your socks