Cold Weather Emergencies: Hypothermia Q4.09 – October 2009Cold Weather Emergencies © Copyright...

Cold WeatherEmergencies: Hypothermia

Health & Safety Institute

Region 8 CEMarch 2012

Learning ObjectivesCognitive 1. Describe the various emergencies as

they relate to the cold weather2. Discuss the assessment process for a

patient found in a cold environment 3. Describe the treatment for patients

who are suffering from hypothermia

Q4.09 – October 2009 Cold Weather Emergencies

Institute

Learning ObjectivesPsychomotor1. Demonstrate the appropriate

treatment for a patient suffering from a cold weather related emergency

2. Demonstrate the safety EMS providers should take when working in a cold weather environment

Health & Safety Institute

IntroductionCold weather emergencies generally occur

during certain times each year Hypothermia can occur anytime the body

temperature decreases below 98 degrees EMS providers should review and update

their knowledge to prepare for cold weather situations

2009 Health &

Safety Institute

Scene Safety Consider length of time providers and

the patients are exposed to cold weather elements

Prepare to keep warm throughout emergency

Determine resources needed to keep patient warm

Request resources to decrease time patient and crew is exposed to cold

Institute

Responder Precautions Maintain situational awareness for

personal safety Watch for early signs of hypothermia Dress for weather Prepared for extended exposure Work in shifts Have extra dry clothes

Institute

Cold Weather DangersHypothermiaFrost nipFrostbiteComplicates assessment

Safety Institute

Risk FactorsCool temperaturesWind chillAgeInjuriesChronic illness

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Risk Factors (continued)

Improper clothingMoistureFatigueDehydrationAlcoholPoisoning / overdose Medications

AntidepressantsAntipyretics, phenothiazines

Safety Institute

Assessment Check responsiveness and mental status Evaluate ABCDE

Maintain and treat any airway problems Initiate breathing adjuncts as needed Provide adequate circulatory support Determine disability Expose patient and cover to maintain

temperature

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Assessment (continued) Secondary Assessment

Assess for underlying medical conditions or injuries

Treat priority injuries Determine degree of hypothermia

Mild Moderate Severe

Safety Institute

Regulating Heat ProductionMuscular

Baseline muscular activityExertionShivering

MetabolicProcessing of food and nutrients

Carbohydrates (sugars and starches) Fats Proteins

Glycogen

EndocrineRole of hormones in basal metabolic rate

Regulating Heat LossHeat lost through skin, lungs, excretions

Skin most importantMajor sources of heat loss

Radiation Conduction Convection Evaporation Respiration

HypothermiaA condition in which an organism's

temperature drops below that required for normal metabolism and bodily functions Mild

Core temperature greater than 90° F (32° C) with s/s of hypothermia

SevereCore temperature below 90° F (32° C) with

s/s of hypothermia

Institute

Mild Hypothermia Shivering Vasoconstriction No complex actions

Institute

Moderate Hypothermia Lost fine motor skills Uncontrollable shivering Slurred speech Altered mental status Irrational behavior

Safety Institute

Severe Hypothermia Shivering stops Fetal position Muscle rigidity Pale skin Dilated pupils Decreased pulse & respiratory rates

2009 Health &

Safety Institute

Eminent Death Erratic, shallow breathing Semi-conscious Cardiac arrhythmias Ventricular Fibrillation

2009 Health &

Safety Institute

J Wave ECG

Pathognomonic J waves (Osborn waves) Eventual onset of bradycardia Ventricular fibrillation probable below 86º F

Communications

moderate hypothermia (temp 30°C)

severe hypothermia (temp < 27°C)

Frost Nip Skin turning white and waxy Top layer hard and rubbery Deeper tissue still soft Numbness

Institute

Frost Nip Care Gently re-warm with warm airPlace against bodyDO NOT rub

2009 Health &

Safety Institute

Frostbite White, wooden-feeling skin Can include freezing muscle or bone Small areas – attempt re-warming

Institute

Frostbite

Gangrenous necrosis 6 wks after frostbite injury

Frostbite Care Deep frostbite includes freezing muscle

and/or boneDeep frostbite – DO NOT re-warm Hypothermia care is first priority

Re-warm area after core is 96°No alcohol / tobaccoFollow protocols

Safety Institute

Emergency Care Identify underlying medical conditions Assess for trauma Re-warming considerations

Safety Institute

Emergency Care Patient requires re-warming to determine

mental state Remove wet clothing Move to warmer environment Apply hot packs Warmed, humidified oxygen

Stabilize injuries if needed

Safety Institute

Drug of the Month…Nitrous OxideActionIndicationContraindicationAdverse ReactionAdult DosePediatric Dose

Communications

Summary Be familiar with the subtle signs of cold

emergencies and evaluate for hypothermia

Determine if any underlying medical or traumatic situation is complicating the present condition and treat appropriately

2009 Health &

Safety Institute

Communications

Cold Weather Emergencies: Hypothermia Q4.09 – October 2009Cold Weather Emergencies © Copyright...

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