Cold injuries

First aid and treatment

 Definitions
• Normal temperature around 37° degrees
C
• Hypothermia
mild 32 -35° C
moderate 28 -32° C
severe less than 28° C
26° degrees ……
 Thermoregulation
• Peripheral receptors in the skin mostly
detect changes in the ambient
temperature
• Central receptors detect changes in the
blood and the core of the body
• Central and peripheral signals travel to the
temperature regulation control centre in
hypothalamus
 How can the body prevent
hypothermi????
• Shivering can increase heat production

• Shivering is an unsynchronised high-

frequenty muscular contraction combined
with a slow, synchronised, centrally
triggered muscular contraction
 Accidents - events
• Drowned
• Persons under influence of alcohol
• Psychiatric disorders or dementia
• Outdoor enthusiasts
in cold water
stranded or lost in cold and windy weather
injuried in cold weather
 Psychological heat loss
• Vasoconstriction in
blood vessels in hands
and feet
• The head blood vessels
are protected

Heat can escape from

the head!!!
Heat loss from
respiratory tract too.
 Drowning
• Critical watertemperature
• Metabolism
• Heat production

Unpredictable circumstances – survivers

Fear ….. breathing

Unconsciousness
Turbulent waves
Aspiration
 Wind effects
• Wind increase the risk of
hypothermia and frostbite
• Even low wind accelerate
the rate of heat loss

• Example: -10 C
combined with a wind
strengh of 15 m/sec
correspond -33 C
 What happens in the body?
• The nervous system
• The circulatory system
arrythmias
blood vessels
• The coagulation system
• The respiratory system
• Renal function and fluid
balance
 Clinical picture
• Early, vague symptoms like hunger, silence,
fatigue, bad temper, lack of co-ordination and
confusion
• The degree of consciousness gradually
declines, between 30° C -26° C people will get
unconsciousness
• The skin turns to cold an pale, especially the
extremities.
• The pulse will be faint
• Pupils become fixed
• Shivering stops at about 33° C
 Mental changes
• Early anxiety
• Poor judgement
• Neurotic behaviour
• Disturbed perception of reality
• Describe the situation in a different way
• Apathy
• Hallucinations
• Psychosis
• Receptor disturbance in the heat control centre
 First aid
• Try to get shelter
• Sweetened hot drink
• Handle the patient with care and avoid
sudden movements - think of the heart
• Remove wet clothing (depends on)
• Cover the head warmly
• Insulate with warm blankets – extra to
head an feet
 Treatment
• Warm very carefully - slowly

• Gently transportation - horizontal position

 Hospital care
• A - Airway management
• B - Breathing (ventilation)
• C – Circulation
• D – Disability (level of consciousness)
• E – Exposure and environmental control,
Degrees and Dry