Hypothermia and Cold Weather Survival

1
Hypothermia and Cold Weather Survival

• Officer Stephen Verchinski
• New Mexico State Parks

2
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

3
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.

4
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 bodys ability to retain
  heat.
• HEAT PRODUCTION -- The bodys ability to produce
  heat

5
Your Bodys Reaction to a Cold Challenge

• 1. The Cold Response
• 2. Mild Hypothermia
• 3. Severe Hypothermia

6
The Cold Response

• The bodys 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

7
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.

8
MILD HYPOTHERMIA

• THE BODYS 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.

9
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

10
MILD HYPOTHERMIATreatment

• 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.

11
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.

12
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

13
SEVERE HYPOTHERMIATreatment

• 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.

14
SEVERE HYPOTHERMIATreatment Concerns and Upgrades

• Warmed, Humidified Oxygen (Rescue Air RES-Q-AIR
  9x3x2 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