Cold Induced Illness
HYPOTHERMIA
Hypothermia is the condition where the core body temperature of a person falls to 35 degreesCelsius or lower. Normal body temperature is around 37 degrees. Core body temperature is around 2 degrees higher than normal body temperature. People who are more at risk from hypothermia are
- Very young or elderly persons.
- People under the influence of alcohol or drugs.
- Sufferers of certain medical conditions e.g. hypothyroidism.
- A person who is immobilized e.g. trapped.
- Seriously injured e.g. burns, spinal cord injury.
- Unconscious person.
Hypothermia can be of the following types
- Acute: Immersion with rapid heat loss in cold water.
- Subacute: Exposure to cold over several hours. e.g. bushwalking
- Gradual: Decreased heat production
SIGNS AND SYMPTOMS
- Mild Hypothermia 35-34 Degrees
- Maximum shivering
- Pale cool skin
- Poor coordination
- Slurred speech
- Responsive but with slowed thinking and apathy
Moderate Hypothermia 33-30 Degrees
- Most shivering ceases
- Increasing muscle rigidity
- Consciousness clouded
- Pulse and respirations slow and difficult to detect
Severe Hypothermia Under 30 Degrees
- Progressive loss of consciousness
- Pupils fixed and dilated
- Abnormal heart rhythms
- May appear dead
MANAGEMENT
- Call an ambulance
- Take 30-45 seconds to confirm a heartbeat
- If the casualty is to be moved, do so very carefully to prevent bringing on Ventricular Fibrillation( a life-threatening condition of the heart rhythm)
- Prevent further heat loss by placing the casualty on an insulating material, and protecting it from Environment by wrapping in a blanket, space blanket. If conscious warm sweet drinks may be given. If medical aid is delayed or if the core temperature is below 32 degrees, active rewarming through heat packs to groin armpits and side of the body, and body to body contact may be used.
- These actions are not necessary if the casualty is shivering.
- If basic life support is initiated it should be continued until the casualty is rewarmed as there are records of recovery after prolonged hypothermia and lengthy resuscitation attempts.
- Do not give Alcohol.
- Do not rub or massage.
- Do not expose to excessive heat.
HEAT-INDUCED ILLNESS
The body temperature is normally controlled to within 0.5 degrees of 37C. Direct cell injury begins to occur at body temperatures of about 42C
Factors that affect heat balance
- Excessive physical exertion.
- Hot climatic conditions with high humidity.
- Inadequate fluid intake.
- Infections (particularly viral infections).
- Inappropriate environments.
- Inappropriate clothing.
- Use of medications that impair heat loss.
- Illnesses that impair heat loss.
- Extremes of age.
Heat-induced illness and associated dehydration may cause fatigue, dizziness, nausea, headache seizures and unconsciousness. THIRST MAY BE A LATE SYMPTOM
FEBRILE CONVULSIONS
Febrile Convulsions occur in very young children, usually up to the age of around 4. Caused by a (sometimes rapid) rise in body temperature to around 39C
MANAGEMENT
- Remove wraps and clothing
- Cool by fanning (discontinue if shivering occurs)
- Seek medical assistance
HEAT EXHAUSTION
Heat exhaustion is recognized by pallor, sweating, thirst, fainting and moderately elevated body temperature.
MANAGEMENT
- Lie casualty down
- Remove or loosen excess clothing
- Cool by fanning
- Give regular small amounts of cool water to drink if conscious
- Apply wrapped ice packs to groin and armpits
- Seek medical help
HEATSTROKE
Heat Stroke causes impaired mental function and a very high body temperature which may lead to unconsciousness and death.
All body organs are affected.
Common situations are :
- Exercising on warm humid or hot days.
- The elderly living in hot, poorly ventilated homes
- Young children in closed hot environments
- Excessive exposure in hot outback regions
MANAGEMENT
- Give regular small amounts of cool water if conscious
- Place casualty in a cool environment
- Apply ice packs to groin and armpit
- Arrange urgent medical treatment (in hospital)
- Follow DRABCD