Cold

Question 1

Mild hypothermia - sxs

Answer 1

skin pale to the touch
shivering
loss of fine coordination of movement
normal mental status

Question 2

Mild hypothermia - tx

Answer 2

replace wet clothes with dry, cover head/neck
protect from wind/cold, insulate from the ground
wrap hot water bottles or heat packs in dry clothing & apply to chest, armpits, back
if they can swallow without difficulty, give warm sweet nonalcoholic drink; cold fluid better than no fluid
after initial tx, if they can walk have them walk to warm up

Question 3

Mild hypothermia - evac

Answer 3

Usually not needed

Question 4

Moderate hypothermia - sxs

Answer 4

uncontrollable shivering
can’t perform complex tasks
confusion, apathy, sluggish thinking
slurred speech
altered gait
umbles: fumbling, grumbling, mumbling, stumbling

Question 5

Moderate hypothermia - tx

Answer 5

same as tx for mild, plus:
move them slowly - rapid movement of cool blood from extremities back into core can cause arrhythmias
hypothermia wrap
don’t let them stand/walk for at least 30 min and only if mental status is normal - movement of cool blood from extremities can lower core temp again

Question 6

Moderate hypothermia - evac

Answer 6

If they’re acting/feeling normal: Evac not needed

If normal mental status doesn’t return: Fast evac

Question 7

Severe hypothermia - sxs

Answer 7

shivering has stopped
muscle rigidity
stupor progressing to coma
decreasing HR
decreasing RR

Question 8

Severe hypothermia - tx

Answer 8

basically same as for moderate hypothermia
CPR if needed

Question 9

non-freezing cold injury
aka frostnip
sxs

Answer 9

pins & needles sensation
tingling, throbbing
skin cold to the touch & maybe very pale or very red

Question 10

non-freezing cold injury tx

Answer 10

protect area from further damage, get pt to warmer place, remove jewelry & wet clothing
skin to skin contact, e.g. holding affected part in warm hand or putting hand in armpit
avoid direct heat sources (can cause burns)

Question 11

frostbite signs

Answer 11

blotchy skin; skin turns from red to white or pale
skin firm/hard
numbness or pain

Question 12

frostbite tx

Answer 12

same as frostnip, plus:
don’t rub the affected area - can cause tissue damage

if far from professional medical care + no chance of refreezing, rewarm:
- put affected area in warm (just above normal body temp) water for 20-30 min
- severe burning pain, swelling, blistering color changes can occur
- don’t use chemical warmers - too hot

after rewarming, protect affected area for evac:
- clean pads between frostbitten fingers/toes
- wrap area in clothing
- pt should not use affected part after thawing - keep it still during evac

if risk of refreezing: don’t rewarm
- wrap/insulate to prevent accidental thawing & protect from injury

Question 13

how to create hypothermia wrap

Answer 13

prepare wrap:
- foam pad on ground (for insulation)
- then waterproof sheet (as vapor barrier)
- then blankets/sleeping bags/clothing (for insulation)

position affected person:
- make sure pt is dry
- pt should be wearing a wicking layer of clothing
- use something absorbent covered by garbage bag as diaper (so urine doesn’t soak insulation)
- lay pt on wrap

add heat:
- wrap hot water bottles, warm rocks, or chemical heat packs in clothing and apply to neck, armpit, groin

wrap pt:
- add more insulation
- wrap em up

give pt warm sugar water