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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


  1. Full DRSABCD assessment

  2. Remove from cold environment/ remove wet clothing / dry

  3. Hypo-wrap patient: insulate from ground (mat), create

    heat (sleeping bag), capture heat (tarp)

  4. Active warming: luke-warm oral fluids, warm heat sources

  5. Replace energy used: simple sugars, then complex carbs

  6. Monitor!!!

Evacuation: Consider: Any patient that doesn’t respond to rewarming interventions Rapid: Persistent moderate/ severe patients

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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


  1. Full DRSABCD assessment

  2. Move patient to a cool environment or in the shade

  3. Strip (clothes), soak (with water) or fan the patient

  4. Immerse in ice bath if available or cover with ice-soaked towels

  5. 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!

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