HYPOTHERMIA What is Hypothermia - PowerPoint Presentation

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HYPOTHERMIA

What is Hypothermia

Hypothermia is a lowering of the body temperature in response to cold

Mild Hypothermia

Core temperature of 95 F (35 C)Moderate HypothermiaCore Temperature of 86 F (32 C)Severe HypothermiaCore Temperature less than 82 F (28 C)

Temperature is Difficult to Measure in the Field

Core temperature is measured rectally

Do not expose patient unnecessarily to obtain a temperature

Oral, ear, and skin thermometers are unsuitable for this purpose – inaccurate.Most conventional mercury thermometers do not register abnormally low temperaturesFor our purposes we will gauge severity by the appearance of the patient

We Lose Heat By

Evaporation

Loss of heat by vaporizing liquid from the skin or clothing

Example: sweating RadiationTransfer of heat in the form of electromagnetic energy between two objectsExample: warming hands by a fireConductionDirect transfer of heat from warmer to cooler object in direct contact

Sitting on a block of iceConvectionTransfer of heat to or from a gas or liquid that is in motionExample: standing in front of a fan

To Prevent Heat Loss

Dress in Layers

Layering

Allows removal of a layer of clothing when body heats from exertion

Wicking layer next to skin

Avoid “Rotten Cotton” the fabric of deathPolypropylene doesn’t hold water vapor and keeps us drierInsulating layerWool or fleece insulate when wetCan wear multiple layers if needed

Wind and water resistant layerGortex or similar fabric breathes and allows passage of water vapor

Wear a Hat and Gloves

Keep Your Feet Warm and Dry

Wear suitable footwear for the conditions

Don’t let your feet get wet

Wear dry socks, change if they become wetHave spare dry socks

People in Cold Climates

Have learned to thrive in winter weather

Hypothermia more likely

After an accidentStuck or stalled vehicleIf impaired by alcohol, drugs or a medical condition

In More Temperate Climates

Hypothermia is more likely the result of misadventure

Becoming lost

Delayed by an injuryPoor planningInadequate preparationUnexpected adverse weatherAccidental immersionTemperatures less than 50 F

Recognizing Hypothermia

Mental Status:

Normal mental status but “cold”:

Not hypothermicAble to care for themselves, but slow: Mild hypothermiaConscious but disoriented: Moderate hypothermiaNot shivering and unconscious: Severe hypothermiaShivering

Slowed vital signs

Vital Signs

Are difficult to obtain due clothing

Pulse is difficult to detect if the rescuer has cold hands

Check pulse and respiration for one full minute

Treatment of Hypothermia

Protect the patient from further exposure

Get them under shelter

Wind and water-resistant layerInsulate them from the groundSleeping bag Sleeping pad

Treatment of Moderate to Severe Hypothermia

Keep them horizontal

Remove all wet clothing

Cut it off rather than moving patient

Active External Rewarming

Use large heat packs on chest and back

Smaller heat packs in armpits

DO NOT use chemical heat packs due risk of burnsDO NOT put hypothermic patient in shower or water bathCause cardiovascular collapse by dilation of peripheral blood vessels

Active Rewarming

Only if patient able to swallow

Warm food and liquids

High carbohydrate content is preferred

Evacuation

Transport all hypothermic patients on a litter

Handle VERY gently

Keep the patient horizontalHelps prevent development of a lethal heart rhythm: ventricular fibrillation

Hypothermia Prevention and Management Kit

Developed by military

Commercially available

Compact and self-containedGenerate heat by internal heat packsIntegral wind and water barrier

They Ain’t Dead ‘til They’re Warm and Dead!

CPR and ventilation are appropriate in cardiac arrest

It is safe to interrupt CPR for transportation

One minute CPROne minute of movementConventional ACLS interventions; medications and defibrillation are not indicated until the patient is warmed