Two of the most dangerous conditions that
can result from cold weather are hypothermia and frostbite. Here's what
you should know to protect yourself this winter.
Hypothermia occurs when your internal body temperature drops lower than
normal as a result of being in a cold environment — indoors or out.
Babies, people in poor health and the elderly can easily become
hypothermic.
Symptoms can range from constant shivering, urge to urinate, confusion and
sleepiness to muscle stiffness, slurred speech and trouble seeing.
You can help a victim of hypothermia by taking the person to a dry, warm
place and warming the person with blankets or your own body heat.
Frostbite occurs when the skin freezes as a result of low temperatures,
wet clothes, or even forceful winds. Fingers, toes, earlobes, cheeks and
nose have the greatest exposure to cold and are most likely to be
affected.
Frostbite ranges from white or yellowish skin accompanied by an itching or
burning sensation, to numbness and reddened or swollen skin. Severe
frostbite symptoms include blistering and hardened skin.
To help a frostbite victim, get the person to a warm, dry place and remove
constrictive clothing. Raise affected areas and apply warm moist
compresses to these areas. Do not rub frostbitten areas or apply direct
heat.
With hypothermia and frostbite, medical attention should be sought as soon
as possible.
Dr. Elaine Josephson of the American College of Emergency Physicians wants
you to stay warm in the colder months with these tips:
Limit your exposure to cold and go indoors
if there's any doubt you're too cold.
Eat plenty of food and stay as active as possible.
Be careful of things that restrict your circulation — smoking, tight
clothing and fatigue. Ask your doctor if medication you're taking can
affect your circulation, and limit your hot toddies! Alcohol also affects
your circulation.
Dress in multiple layers of clothing to trap warm air between layers.
Wear a hat outside. It can prevent up to 20 percent of total body heat
loss.
To Treat Mild to Moderate Hypothermia:
Add layers of dry clothing.
Increase physical activity.
Find shelter.
Keep the hypothermic person fed and hydrated. Carbohydrates, with five
calories per gram, are released quickly in the bloodstream, creating a
momentary heat surge. Proteins, with four calories per gram, and fats,
containing nine calories per gram, are slowly released into the
bloodstream. These types of food supply a heat source over a longer period
of time. Hot liquids and sugars are also good. Avoid caffeine,
tobacco/nicotine, and alcohol.
Add heat (light a fire or use some other external heat source). Try
body-to-body contact (the hypothermic person should be in dry clothing, in
a sleeping bag, and the normothermic
(Normothermic - This refers to the normal
state of the core body temperature) person should be in dry,
lightweight clothing).
To Treat Severe Hypothermia:
Try a hypothermia wrap. Be sure
that the hypothermic person is dry and has a layer of clothing to minimize
sweating. Use multiple sleeping bags, wool blankets, wool clothing, and an
aluminum "space" blanket to create at least four inches of insulation
around the person, especially between the person and the ground. Wrap this
entire ensemble in plastic to prevent wind or water intrusion.
Keep the hypothermic person hydrated and fueled. A severely hypothermic
person will be unable to digest solid food because the stomach may have
shut down. Try warm sugar-water or diluted Jello (TM).
The hypothermic person will have to urinate from
cold diuresis; (Cold
Diuresis - A condition where the surface blood vessels constrict in
response to cold. This constriction causes greater volume pressure in the
bloodstream which is detected by the kidneys. The kidneys will "pull off"
the excess fluid to reduce the pressure. The kidneys then excrete the
fluid, causing the bladder to fill. This is one way in which the body
protects the amount of heat lost at the surface) a full bladder
can mean additional heat loss. Urinating will conserve some heat. You will
have to help the hypothermic person do this. Be careful to wrap him/her
back up tightly in the hypothermia wrap when finished.
Add heat using chemical heat packs, hot water bottles, warm rocks, or
compresses. Rescue breathing for the severely hypothermic person can
increase oxygen and provide internal heat.
It is important not to re-warm the peripheral areas of any hypothermic
victim! The core area of the body should be re-warmed to prevent a
situation called afterdrop
(Afterdrop - A condition where cold blood
from the peripheral areas of the body, such as the arms and legs, is
returned to the core, causing a drop in the core temperature. The cold
blood returning to the heart may also cause a frenzied and irregular heart
rhythm disturbance (ventricular fibrillation). This condition can be
avoided by not re-warming peripheral areas of the body before the core has
been warmed) Afterdrop can occur when very cold blood from a
peripheral area, such as the legs or arms, returns to the core of the body
and lowers the core temperature even further! This blood may be
acetic, (Acetic
- This refers to the acid waste products from cell metabolism in the
peripheral areas of the body. If the peripheral areas of the body are
re-warmed, this acetic blood may return to the heart and may cause cardiac
arrest) as well, and letting it return to the core of the body
can cause cardiac arrhythmias
(Arrhythmia - Abnormalities of the heartbeat
and the absence of cardiac rhythm. Any disturbance in the normal cardiac
rhythm or any markedly irregular rhythm, block, or the presence of
premature contraction. This includes functional abnormalities such as
tachycardia, bradycardia, premature ventricular beats, ventricular
fibrillation, atrial fibrillation, flutter, and heart block.)
and death.
Although a hypothermic victim may exhibit all the signs of being
clinically dead, such as blue skin, fixed and dilated pupils, rigid
muscles, and no noticeable breathing, he or she may still be alive! The
victim may be in a state of "metabolic icebox," which occurs when the body
temperature drops to 86 degrees Fahrenheit or lower. If this is the case,
it is necessary to rewarm the victim and possibly perform CPR. DO NOT
perform CPR if a heartbeat is detectable, even at a rate of 2-3 beats per
minute. The heart is beating slowly, but it is still distributing blood.
The heart is hyperexcitable during severe hypothermia and stimulation
through CPR, or simply moving a victim, can cause
fibrillation (Fibrillation
- A type of cardiac arrhythmia characterized by rapid, unsynchronized
quivering of atria or ventricles. Atrial fibrillation may be asymptomatic,
but ventricular fibrillation is typically fatal if not corrected within
minutes. A disorder of heart rate and rhythm in which the upper heart
chambers (atria) are stimulated to contract in a very rapid and/or
disorganized manner; this usually also affects contraction of the
ventricles) leading to death.
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there is no substitute
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