Hypothermia and Cold Weather Survival

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

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. MILD HYPOTHERMIATreatment

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

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

SEVERE HYPOTHERMIATreatment 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

Hypothermia and Cold Weather Survival