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Cold Weather Injuries 1 PPT-084-01 Cold Weather Injuries 1 PPT-084-01

Cold Weather Injuries 1 PPT-084-01 - PowerPoint Presentation

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Cold Weather Injuries 1 PPT-084-01 - PPT Presentation

Bureau of Workers Comp PA Training for Health amp Safety PATHS Who is at Risk Anyone who works outside is subject to cold weather injuries 2 PPT08401 Who is at Risk Whether during their regular shift or during extended shifts due to emergencies ID: 911216

084 ppt frostbite cold ppt 084 cold frostbite warm skin water hypothermia foot conditions person clothing area affected dry

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Slide1

Cold Weather Injuries

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Bureau of Workers CompPA Training for Health & Safety(PATHS)

Slide2

Who is at Risk?

Anyone who works outside is subject to cold weather injuries!

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Slide3

Who is at Risk?

Whether during their regular shift or during extended shifts due to emergencies.

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Slide4

Who is at Risk?

Others at risk:

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Slide5

Who is at Risk?

Those using extremely cold liquefied gases in industry such as:Liquid Nitrogen

and

Liquid Helium5

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Slide6

Types of Cold Weather Injuries

Hypothermia

ChilblainsFrostbiteTrench Foot or Immersion Foot

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Slide7

Hypothermia

Hypothermia is a Medical Emergency

Normal body temperature (98.6

oF) drops to or below 95oF.

Fatigue

or drowsiness; uncontrolled shivering; cool bluish skin; slurred speech; clumsy movements; irritable, irrational or confused behavior.

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Slide8

Hypothermia

Symptoms

Mild

Moderate to SevereShivering Shivering will stopDizziness Lack of CoordinationHunger Clumsiness

Nausea Loss of Consciousness

Breathing/heart rate Shallow breathing/weak

increase pulse

Difficulty speaking Slurred speech/mumbling

Slight confusion Poor decision making

Fatigue Drowsiness, low energy

lack of concern

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Slide9

Causes of Hypothermia

Wearing unsuitable clothing

Working or recreation outdoors too long

Exertion leading to wet clothingFalls into water

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Slide10

Causes of Hypothermia

Risk Factors:

Elderly or very youngMental problems interfering with judgment; dementia or mental illness.

Alcohol and drug use causing blood vessels to dilateMedical conditions; poor nutrition, stroke, severe arthritis, Parkinson’s, diabetes; conditions affecting blood flow.

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Slide11

Other Conditions

Freezing body tissues-frostbiteTissue death and decay-gangrene

Diagnosis is apparent by physical signsDon’t drink alcohol

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Slide12

Hypothermia

What Should be Done? (land temperatures

)Call for emergency help (e.g. Ambulance or Call 911

).Move the person to a warm dry area.

Don’t

leave the person alone.

Remove

any wet clothing and replace with warm, dry clothing or wrap the person in blankets

.

Have the person drink warm, sweet drinks (sugar water or sports type drinks) if they are alert.

Avoid drinks with caffeine

(coffee, tea, or hot chocolate) or alcohol.

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Slide13

Hypothermia

What Should be Done? (

land temperatures)

Have the person move their arms and legs to create muscle heat. If they are unable to do this, place warm bottles or hot packs in the arm pits, groin, neck and head areas.

Do

NOT

place them in warm water bath. This may stop their heart

.

DO NOT

rub the affected area, because rubbing causes damage to the skin and tissue.

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Slide14

Hypothermia

What Should be Done? (water temperatures)

Call for emergency help (e.g. Ambulance or Call 911). Body heat is lost up to 25 times faster in water.

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Slide15

Hypothermia

What Should be Done? (water temperatures)

DO NOT remove any clothing.

Button, buckle, zip and tighten any collars, cuffs, shoes and hoods because the layer of trapped water closest to the body provides a layer of insulation that slows the loss of heat.

Keep

the head out of water and put on a hat or hood.

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Slide16

Hypothermia

What Should be Done? (Person not breathing)

If a person is not breathing or has no pulse: Call

911 for emergency medical assistance immediately.Treat the worker as per instructions for hypothermia, but be very careful and do not try to give an unconscious person fluids.

Check him/her for signs of breathing and for a pulse. Check for 60 seconds.

If after 60 seconds the affected worker is not breathing and does not have a pulse, trained workers may start rescue breaths for 3 minutes.

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Slide17

Hypothermia

What Should be Done? (Person not breathing)

Recheck

for breathing and pulse, check for 60 seconds.If the worker is still not breathing and has no pulse, continue rescue breathing.

Only start chest compressions per the direction of the 911 operator or emergency medical services

*

Reassess patient’s physical status periodically

.

*

Chest compression are recommended only if the patient will not receive medical care within 3 hours.

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Slide18

Hypothermia (water)

Get out of the water

quickly or climb on anything floating.

DO NOT attempt to swim unless a floating object or another person can be

reached.

S

wimming

or other

activity

uses the body’s heat and reduces survival time by about 50%.

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Slide19

Hypothermia (water)

Can’t get out of the water: Wait quietly, conserve

body heat. Fold

arms across the chest, keep thighs together, bend knees, and cross

ankles.

If

another person is in the water, huddle together with chests held closely.

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Slide20

Infants and Hypothermia

Visual cues:Skin-bright

red and coldLow energyWeak cry

 Precautions:Dress infants and young in one more layer than adults for same conditions.

If shivering-bring indoors

and rewarm

.

Babies should not sleep in a cold room.

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Slide21

Winter Driving Tips

Let your destination contact know when you’re leaving and estimated time of arrival.Keep emergency kit in car:

Blankets Matches

Clean can to melt ice for drinking First aid kit

Food

Jumper cables

Cellphone

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Slide22

If Stranded on the Road

Bring everything you’ll need from trunk

to car

Stay covered and huddleRun

car for 10 minutes hourly to warm

up

Ensure

window is down a bit and exhaust pipe is

unobstructed.

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Slide23

Chilblains

Painful inflammation of small blood vessels due

to sudden warming from cold temperatures. Symptoms:

Itching, red patches, swelling and blistering on extremities, such as on your toes, fingers, ears and nose.

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Slide24

Chilblains

In one to three weeks, condition may

clear as weather warms.

Treatments typically consist of lotions and medication. Limit

your exposure to

cold

and dress warmly.

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Slide25

Chilblains Risk Factors

Skin exposed to cold

Being female and underweight

Where DomiciledTime of year

Poor circulation

Diagnosed with Raynaud’s Phenomenon

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Raynaud’s Phenomenon

Slide26

Frostbite Hazards

Temperature + Wind Speed=Frostbite

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Slide27

Frostbite

Signs & Symptoms

At first, cold skin and a prickling feelingNumbness

Red, white, bluish-white or grayish-yellow skinHard or waxy-looking skinClumsiness due to joint and muscle stiffness

Blistering after rewarming, in severe cases

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Slide28

Frostbite Stages

Frostnip: First stage

A mild form of frostbite.

Pale or red skin and feels very cold.

This

can lead to prickling and numbness.

As skin warms, pain

and

tingling

No permanent skin damage.

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Slide29

Frostbite Stages

Superficial Frostbite: Second Stage

Reddened skin turns white or pale.

Some ice crystals may form in the tissue.

If your skin feels

warm

it is a

sign of serious skin

involvement

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Slide30

Severe Frostbite

Severe (or deep) Frostbite: Third Stage

All skin layers and underlying

tissues involved.

Numbness

, loss of all

cold

, pain or discomfort

sensation in

the affected area.

Joints or muscles may no longer work.

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Slide31

Frostbite Risk Factors

Medical conditions: dehydration

, exhaustion, diabetes and poor blood flow Alcohol or drug abuse

SmokingFear, panic or mental illness, inhibiting your ability to respond to cold

Previous frostbite or cold injury

I

nfant

or older

adult: difficulty in producing body heat

H

igh altitudes, reduce oxygen supply to your skin

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Slide32

Frostbite

Seek medical attention for frostbite if you experience:

Signs and symptoms of superficial or deep frostbite — such as white or pale skin, numbness, or blisters

Increased pain, swelling, redness or discharge in the area that was frostbitten

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Slide33

Frostbite

Seek Medical Attention if:

FeverNew, unexplained

symptoms Get emergency medical help

if

you suspect hypothermia,

a

condition in which your

body

loses heat faster than it

can be produced.

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Slide34

Frostbite

What Happens to the Body:

Freezing in deep layers of skin and tissue. Pale waxy-white skin colors. Skin becomes hard and numb; usually affects the fingers, hands, toes, feet, ears and nose.

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Slide35

Frostbite

What Should be Done?

Move the person to a warm dry area. Don’t leave the person alone.

Remove any wet or tight clothing that may cut off the blood flow to the affected areas.

DO NOT

rub the affected area, because rubbing causes damage to the skin and tissue.

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Slide36

Frostbite

What Should be Done?

Gently place the affected area in a warm (105o

F) water bath and monitor the water temperature to slowly warm the tissue. Don’t

pour warm water directly on the affected area because it will warm the tissue too fast causing tissue damage. Warming takes about 25-40 minutes.

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Slide37

Frostbite

After the affected area has been warmed, it may become puffy and blister.

The affected area may have a burning feeling or numbness.

When normal feeling, movement and skin color have returned, the affected area should be dried and wrapped to keep it warm.

NOTE

:

If there is a change the area may get cold again, do not warm the skin. If the skin is warmed and then becomes cold again, it will cause severe tissue damage

.

Seek medical attention as soon as possible.

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Slide38

Frostbite Treatment

Medical treatment may involve:

Rewarming of skinPain medicine

Protection of injury locationDebridement of damaged tissueWhirlpool and wound therapy

Anti-infection and

clot-

removing drugs

Surgery or amputation

Hyperbaric oxygen therapy in a pressurized room

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Slide39

Frostbite Complications

Increased sensitivity to cold

Risk of recurring frostbite

Long-term numbness in the affected areaChanges in the cartilage between the joints (frostbite arthritis)Growth defects in children, if frostbite damages a bone's growth

plate

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Slide40

Frostbite Complications

Infection

Tetanus

Gangrene — decay and death of tissue resulting from an interruption of blood flow to the affected area — which can result in amputation

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Slide41

Trench Foot or Immersion Foot

First noted in the trench warfare where soldiers suffer from this disease after having their feet exposed to prolonged moisture.

 This disease is most prevalent during rainy days especially in places where

flooding is usual.

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Slide42

Trench Foot or Immersion Foot

Characterized by

irritation, rash formation, and foot ulceration.

It results from a prolonged exposure of the feet to damp, wet, unsanitary and cold

conditions.

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Slide43

Trench Foot

Usually evidenced with a tingling or itching sensation then pain, swelling and numbness usually felt right after removing the foot from being soaked for a very long time.

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Slide44

Trench Foot Cause

While encountered during World War I, this was also an issue during subsequent wars; World War II, Korea and Viet Nam.

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Slide45

Trench Foot Treatment

Prevention first!

Constant change to dry socks.

Keep feet dry and clean.

Do not wear

constrictive

footwear.

C

lean

the foot using mild cleansers.

Dry carefully using a clean towel.

After drying the feet, keep them elevated and gently warm them.

45

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Slide46

Trench Foot Treatment

Elevating the affected area promotes increased blood circulation which reduces inflammation.

After elevating the feet, carefully warm them by immersing in warm circulating water, about 104F to 107

F, for 15 to 30 minutes.

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Slide47

Trench Foot

See a physician:

Contact your podiatrist regarding the cure of the disease.

Cover the foot with adequate amounts of clean

cloth

to prevent

the

recurring of cold injury.

47

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Slide48

Other Conditions

Other conditions due to cold environments would also include:

Dehydration

Cold DiuresisConstipation

Sunburn

Snow Blindness

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Slide49

Dehydration

When you’re wearing multiple layers of clothing, you may not be aware of body moisture loss.You must drink water to replace fluid loss.

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Slide50

Cold Diuresis & Constipation

Cold Diuresis is the increased output of urine during cold weather. Replace fluids.

Constipation may result due to putting off relieving yourself in the cold.

Eating dehydrated foods.Drinking too little liquid.

Irregular eating habits may contribute.

Eat fruits and increase fluid intake to at least 2 quarts a day.

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Slide51

Sunburn

This is due to the sun’s reflection off many surfaces and striking sensitive skin:

SnowIce

WaterThe application of sunburncream and lip salve willh

elp.

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Slide52

Snow Blindness

Sun’s ultraviolet rays are reflected off snow.Symptoms may include:

Feeling of grit in eyes,Pain in and over eyes which may increase with eyeball movement,

Watering eyes; becoming redA headache which intensifies

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Slide53

Snow Blindness

Treatment is required since prolonged exposure may result in permanent eye damage.Bandage eyes until symptoms disappear.

Wear sunglasses.You can improvise sunglasses by cutting slits in cardboard.

Put soot on cheeks under eyes to reduce glare.

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Slide54

MSD Risk Factors

Cold Temperatures

Cold environments compromise muscle efficiency.

Possible vascular and neurological damage.

Workers with cold-desensitized fingers may grasp loads with more force than necessary: exposes muscles, soft tissues, and joints to increased force.

Alcohol, nicotine, caffeine, and some medication increases MSD risks from cold temperatures.

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Slide55

Preventive Hygiene

Washing areas where moisture develops can help prevent rashes to preclude more severe problems.

Wash where moisture and sweat accumulate:

Under armsBetween legs

Wipe dry and then periodically wipe in the same areas to remove moisture

Wash feet daily and put on dry socks.

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Slide56

Protecting Workers

Recognize the environmental and workplace conditions that lead to potential cold-induced illnesses and injuries

.Learn the signs and symptoms of cold-induced illnesses/injuries and what to do to help the worker

.Train the workforce about cold-induced illnesses and injuries.

Select proper clothing for cold, wet and windy conditions. Layer clothing to adjust to changing temperatures. Wear a hat and gloves, in addition to underwear that will keep water away from the skin (polypropylene).

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Slide57

Protecting Workers

Take frequent short breaks in warm dry shelters to allow the body to warm up.

Perform work during the warmest part of the day

.

Avoid exhaustion or fatigue because energy is needed to keep muscles warm

.

Use the buddy system (work in pairs

).

Drink warm, sweet beverages (sugar water or sports type drinks).

Avoid drinks with caffeine

(coffee, tea, or hot chocolate) or alcohol

.

Eat warm, high-calorie foods like hot pasta dishes.

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Slide58

Protecting Workers

Workers Are at Increased Risk When…

They have predisposing health condition such as cardiovascular disease, diabetes, and hypertension.

They take certain medication (check with your doctor, nurse, or pharmacy and ask if any medicines you are taking affect you while working in cold environments).

They are in poor physical condition, have a poor diet, or are older.

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Slide59

Protective Measures

The National Safety Council recommends:

General Controls to promote personal protection:

TrainingHygiene practices

Medical Surveillance

Specific Controls

advanced:

Engineering controls

Administrative measures

Person Protection (PPE)

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Slide60

Wear Proper Clothing

Clothing should protect you from cold, wind, and precipitation and should also provide ventilation—be "breathable

".

Protect head, feet, hands, and face.

Keep

dry

.

Cover your head.

Up

to 40 percent of body heat can be

lost when the head is exposed

.Footgear should be insulated to protect against cold and dampness.

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Slide61

Wear Proper Clothing

Dress in layers, wearing warm, waterproof/resistant clothing.

An outer layer to break the wind and allow some ventilation (like Gore-Tex® or nylon).

A middle layer of wool or synthetic fabric (Qualofil or Pile) to absorb sweat and retain insulation in a damp environment. Down is a useful lightweight insulator; however, it is ineffective once it becomes wet.

An inner layer of synthetic weave to allow ventilation. Synthetic materials such as

supplex

and

coolmax

are ideal because they keep you warm and dry.

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Slide62

Employee’s Responsibilities

Dress for conditions

RehydrateKnow signs and symptoms of exposure

Keep clothing dryRewarm at station when requiredMaintain periodic communications with supervisor to apprise of team’s condition

Have an additional set of dry clothing on-hand

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Slide63

Supervisor’s Responsibility

Brief all teams of their job duties and precautions for cold weather injuries

Check on team’s condition on periodic basis (by radio or field observations)Inform team of anticipated weather changes and impact

Provide periodic rest breaks in a warm shelterProvide hot beverages

Know signs and symptoms of exposure

Have provisions for First Aid and Advanced Care if required

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Slide64

With Cold - Take No Chances

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Slide65

Bibliography

Fundamentals of Industrial Hygiene, Barbara A. Plog, MPH, CIH, CSP, Editor in Chief, National Safety Council, Itasca, IL, 2012

FM 21-76, US Army Survival Manual, Headquarters, Department of the Army

www.mayoclinic.org/diseases-conditions/chilblains/basics/...

http://www.safetybok.org/osha_quick_card__cold_stress/

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Slide66

Bibliography

http://www.mayoclinic.org/diseases-conditions/hypothermia/basics/prevention/con-20020453

http://www.mayoclinic.org/diseases-conditions/frostbite/basics/complications/con-20034608

http://gudhealth.com/trench-foot.htmlhttps://www.osha.gov/SLTC/emergencypreparedness/guides/cold.html

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Slide67

Contact Information

Health & Safety Training Specialists1171 South Cameron Street, Room 324

Harrisburg, PA 17104-2501(717) 772-1635RA-LI-BWC-PATHS@pa.gov

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Like us on Facebook!

-

https://www.facebook.com/BWCPATHS

Slide68

Questions

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