Cold-Related Emergencies

1. Chapter 20 Cold-Related Emergencies

2. Cold-Related Emergencies When surrounded by air or water cooler than body temperature, body loses heat. Normal body temperature is 98.6?F. If heat escapes faster than the body produces it, the body temperature falls, and cold injuries result.

3. How Cold Affects the Body (1 of 2) The body has two internal mechanisms to maintain body temperature. Vasoconstriction Tightening of blood vessels Can cause discomfort, numbness, loss of dexterity, cold injuries Shivering Stops when core temperature falls between 86?F and 90?F

4. How Cold Affects the Body (2 of 2) Physical activity produces heat. Heat loss increases if clothes become wet with perspiration. Susceptibility can be minimized by: Proper hydration and nutrition Avoiding alcohol, caffeine, and nicotine Limiting periods of inactivity

5. Heat Loss from the Body (1 of 2)  Four mechanisms of heat loss: Conduction Direct contact with colder object Convection Loss of heat by air blowing over skin Evaporation Conversion of liquid on skin to vapor

6. Heat Loss from the Body (2 of 2) Four mechanisms of heat loss (cont�d): Radiation Heat given off to cooler air Accounts for the greatest heat loss

7. Susceptibility to Cold Injury Physically unfit Dehydration Very lean people Elderly people Alcohol, caffeine Nicotine Inadequate nutrition, illness, injury Experienced a previous cold injury

8. Effects of Altitude Air temperature drops 3.6?F every 1000 feet. Winds are more severe. More susceptible to frostbite above 8000 feet

9. Effects of Water Water can conduct heat away from the body much faster than air of the same temperature. Wet clothing accelerates heat loss.

10. Effects of Wind Wind increases heat loss from skin exposed to cold air. Windchill is the combined effect of the ambient temperature and wind speed.

11. Effects of Metal and Liquid Fuels Can conduct heat away from skin rapidly Contact can cause almost instantaneous freezing.

12. Minimizing Effects of Cold on the Body (1 of 2) Layering Undergarment removes perspiration. Wicking properties

13. Minimizing Effects of Cold on the Body (2 of 2) Middle layer insulates. Should be effective when wet Synthetics are better than natural fibers. Wool Outer layer protects against wind. Waterproof Wind resistant �Breathable� Hat

14. Nonfreezing Cold Injuries Can occur when conditions are cold and wet and hands and feet cannot be kept warm and dry

15. Chilblain Is painful Causes little or no permanent damage Can develop in 3 to 6 hours

16. Recognizing Chilblain Swollen skin Skin is tender, hot to the touch, and possibly itchy. Blisters Aching, prickly sensation, numbness

17. Care for Chilblain Get victim out of cold.

18. Trench Foot Develops when skin on the feet is exposed to moisture and cold for 12 hours or longer Caused by: Wearing wet boots and shoes Prolonged immersion of the feet in cold water Rubberized or tight-fitting boots increase risk.

19. Recognizing Trench Foot and Immersion Foot Itching, numbness, tingling pain Swollen feet and pale skin cold to touch Red or bluish blotches on the skin Sometimes open weeping or bleeding

20. Care for Trench Foot Dry the skin. Rewarm foot gradually. Care for open weeping areas. Use mild soap and water. Apply a breathable dressing.

21. Freezing Cold Injuries Occur when air temperature is below freezing Frostnip Freezing is limited to skin surface. Frostbite Freezing extends into the flesh.

22. Frostnip Frostnip is caused when water on the skin surface freezes.

23. Recognizing Frostnip Red and sometimes swollen skin Painful Repeated frostnip can dry the skin.

24. Care for Frostnip Gently warm affected area. Do not rub the affected area.

25. Frostbite Two ways of damage: Tissue freezing Obstruction of blood supply to the tissue Affects feet, hands, ears, and nose

26. Recognizing Frostbite (1 of 2) White, waxy, or grayish yellow skin Part feels cold and numb. Tingling, stinging, aching Stiff or crusty skin Underlying tissue is soft.

27. Recognizing Frostbite (2 of 2) Indications of deep frostbite: Part feels cold, hard, and solid and cannot be depressed. Blisters Pale, waxy skin Painfully cold part suddenly stops hurting.

28. Classifications of Frostbite First-degree Warm, swollen, and tender Second-degree Blisters form. Enlarges over several days

29. Care for Frostbite (1 of 2) Get victim to warm area. Remove wet clothing and constricting items. Seek medical care. If affected part is partially thawed: Place part in warm water. Maintain water temperature. 20 to 40 minutes Give pain medication. Apply warm cloths to ear or facial injuries.

30. Care for Frostbite (2 of 2) After thawing: Treat the victim as a stretcher case. Protect area from contact with clothing and bedding. Place dry gauze between toes and fingers. Slightly elevate the affected part. Apply aloe vera gel. Provide pain medication.

31. Hypothermia A life-threatening condition in which the body�s core temperature falls below 95?F Body loses more heat than it produces. Heartbeat/breathing may be undetected. Begin cardiopulmonary resuscitation (CPR) immediately. Consider whenever victim�s behavior and history and the weather conditions indicate abnormal heat loss

32. Types of Exposure Acute Usually in water 6 hours or less Subacute 6 to 24 hours Land or water

33. Hypothermia Symptoms Change in mental status Disorientation Apathy Changes in personality Shivering Cool abdomen Low core body temperature

34. Types of Hypothermia Mild to severe based on core body temperature In severe cases, shivering stops. Do not start CPR if: Core body temperature is below 60?F. Chest is frozen. Submerged in water for more than 60 minutes. A lethal injury exists. Transport will be delayed. Rescuers are endangered.

35. Recognizing Mild Hypothermia Vigorous, uncontrolled shivering Decreased mental skills Slurred speech Difficulty using fingers or hands Staggers while walking Cool or cold skin on abdomen, chest, or back Core body temperature above 90?F

36. Care for Mild Hypothermia Get victim out of cold. Handle gently. Prevent heat loss. Cover the victim with a vapor barrier. Keep the victim horizontal. Call 9-1-1. Allow the victim to shiver. Give warm, sugary drinks.

37. Recognizing Severe Hypothermia No shivering Ice cold and blue skin Stiff and rigid muscles Altered mental status Slow breathing and pulse Might appear dead. Core body temperature is below 90?F.

38. Care for Severe Hypothermia Get victim out of the cold. Handle gently. Prevent heat loss. Cover with vapor barrier. Keep victim horizontal. Call 9-1-1. When remote, warm by available heat.

39. Adding Heat Problems with rewarming: Warm water immersion requires a lot of warm water and a bathtub. Body-to-body contact in insulated sleeping bag is not better than shivering. No evidence that chemical heating pads are capable of rewarming a hypothermic victim.

40. Dehydration (1 of 2) Occurs because of unperceived fluid loss combined with inadequate fluid intake Cold weather: fluid lost through breath Drink even if not thirsty. Inactive: drink 2 quarts of water daily Color and volume of urine indicate hydration.

41. Dehydration (2 of 2) Unmelted snow and ice should not be consumed for water. Irritates the mouth Wastes body heat Lowers body temperature Be sure snow and ice are disinfected before consumption.