HOT and COLD Injuries and Illness
Hypothermia is defined as a core body temperature below 35°c.
As the temperature falls, systems and organs progressively fail until death occurs, usually from cardiac arrest. Infants and elderly people are at greater risk. [ARC 2016]
Common symptoms of include:
● MILD: shivering, pale skin, the “UMBLES”, slurred speech, apathy or confusion.
● MODERATE/SEVERE: absence of shivering, increasing muscle stiffness, progressive decrease in consciousness, slow irregular pulse, hypotension.
● In more severe cases there may be cardiac arrhythmias, cardiac arrest and fixed dilated pupils. The patient may appear dead, particularly if they have a weak slow pulse.
Causes of Hypothermia:
● ENVIRONMENTAL: cold/wet/windy conditions; cold water immersion
● TRAUMA: trauma, immobility and burns
● DRUGS: alcohol + / or sedatives
● NEUROLOGICAL: stroke and altered consciousness
● ENDOCRINE: impaired metabolism
● SYSTEMIC ILLNESS: severe infections, malnutrition
Treatment:
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Full DRSABCD assessment
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Remove from cold environment/ remove wet clothing / dry
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Hypo-wrap patient: insulate from ground (mat), create
heat (sleeping bag), capture heat (tarp)
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Active warming: luke-warm oral fluids, warm heat sources
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Replace energy used: simple sugars, then complex carbs
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Monitor!!!
Evacuation: Consider: Any patient that doesn’t respond to rewarming interventions Rapid: Persistent moderate/ severe patients
Hyperthermia is a raised core body temperature caused by excessive heat absorption from a hot environment, excessive heat production from metabolic activity or failure of the body’s cooling mechanisms. [ARC 2016]
Common symptoms of include:
● Heat Exhaustion: fatigue, headache, nausea, vomiting, malaise and dizziness. Temp= <40°C
● Heat Stroke: lack of sweating, hot skin, multiple organ involvement, collapse, seizure. Temp= >40°C
Treatment:
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Full DRSABCD assessment
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Move patient to a cool environment or in the shade
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Strip (clothes), soak (with water) or fan the patient
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Immerse in ice bath if available or cover with ice-soaked towels
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Cool water (if fully conscious) in small sips
Evacuation: Consider: Any patients that don’t respond to cooling interventions Rapid: Altered LOC or seizing patients
HYPONATRAEMIA occurs when excessive fluid consumption dilutes salt levels and creates a sodium imbalance in the body.
● Mild symptoms include nausea, vomiting, muscle cramps and spasms.
● The danger is that these are similar to the symptoms of dehydration, and if you misdiagnose yourself and start drinking more fluids, you'll make the problem more serious.
● Always try to replace electrolytes as well as fluid in hot conditions!
Below are some more useful links and downloads regarding Hot and Cold Injuries and Illness
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AUSTRALIAN RESUSCITATION COUNCIL GUIDELINE 9.3.3 HYPOTHERMIA: FIRST AID MANAGEMENT
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Wilderness Medical Society Clinical Practice Guidelines for the Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia: 2019 Update
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Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Frostbite: 2019 Update
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ANZCOR GUIDELINE 9.3.4 – HEAT INDUCED ILLNESS (HYPERTHERMIA) GUIDELINE
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Wilderness Medical Society Practice Guidelines for the Prevention and Treatment of Heat Illness: 2019 Update
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Wilderness Medical Society Practice Guidelines for Treatment of Exercise-Associated Hyponatremia: 2014 Update