EMAS EMT Extremes of Body Temperature.

Causes of hypothermia

Cold environment. Exposure to cold weather. Immersion in cold water. Inadequate clothing or diet.

Treatment of frostbite.

Get out of the cold. Rewarm injured part with body heat. Cover and blisters with a dry, sterile dressing.

Chronic hypothermia

Heat loss occurs slowly over days usually. Elderly or homeless.

Abnormally high temp

Hyperthermia (Heat exhaustion, Heat stroke).

Abnormally low temp

Hypothermia - <35

How can heat be lost?

- Convection (carried by moving air) - Conduction (passing into a solid object) - Radiation (dissipating into surrounding air) - Evaporation (through evaporation Of water from skin or wet clothing)

S&S in hypothermia (adults).

- Slow HR <40 may be undetectable. - Skin ice cold to touch - Pale, peripheral cyanosis, moribund - patient may appear dead - Dilated pupils, unreactive - Breathing slow, shallow - Reduced LOC, slurred speech - Visual disturbance - Irrational behaviour - Stumbling - Collapse

Death.

24-28

Pulse absent, apparent death.

28

Unconsciousness, loss of reflexes.

30-33

Noticeable drowsiness, semi conscious.

31

Shivering ceases replaced by muscular rigidity, irregular pulse.

33

Confusion and amnesia

34-35

Shivering temp

35-36

Normal body temp

36.9

Heat exhaustion

39-40 Causes by excessive sweating combined with inadequate water intake. The body continues to warm up but unable to cool. Overheating = loss of body fluids & salts. (Sweating). Will progress to heat stroke. More common in people who are working in high temps, Sun bathers, military personnel. People who have taken ecstasy.

Heat stroke

>41. Occurs as body starts to dehydrate in hypothalamus breaking down, body continuing to produce heat with no means of cooling. High mortality rate.

Management of hypothermia

ABC's Handle gently O2 aiming for 94%-98% BM Wrap patient Move to warm environment Allow to recover gradually Hot drink if patient conscious Transport

Management of heat exhaustion.

ABC's O2 if needed. Move to cool environment Place patient at rest Measure temp. Cool drinks in small regular quantities Sponging with Luke warm water.

Frostbite

Can be superficial or deep. Normal exposed areas. Comes on slowly and is not painful. Skin may be white/wax, feels numb. As thawing occurs, area looks mottled blue and patient experiences stinging sensation. Blisters may develop within a few hours.

Management (hypothermic baby).

DRABCD Cover baby Warm them gradually

Management of febrile convulsions.

DRABCDE Remove clothes Calpol

Heat stroke S&S

Decreased level of consciousness. Ataxia. Convulsions. Sweating may be absent.

Dehydration.

Drink before you feel thirsty.

Subacute hypothermia

Hill walkers who become exhausted and unable to generate body heat.

In cardiac arrest.

If temp <30 defibrillation may not work. One loop of defibrillation/drugs then BLS only. 3 shocks.

Acute hypothermia

Immersion hypothermia. Where person looses heat very quickly. Falling into cold water.

Effects of hyperthermia.

In extremely hot conditions the body's heat loss mechanism may fail. If body temp is the same as atmosphere it is impossible to loose heat through radiation. If atmosphere is of high humidity body can not sweat properly. Heatstroke may develop in these circumstances particularly during strenuous exercise.

Heat exhaustion S&S

May have flu like symptoms. Headache. Nausea. Dizziness. Cramps. Tachycardia. Sweaty.

Hypothermia is babies

Remember they will not shiver. Pale, unwell appearance. Unwell, not crying, no appetite, no interest. Cold to touch.

Management of heat stroke.

Remove as much clothing as possible. O2 if needed. Wrap in a wet sheet. Fan the patient vigorously Place cold packs under arms, in the groin area, around the neck. Treat the patient according to consciousness.

DO NOT (Frostbite)

Rub or massage Rub snow Apply ointments Apply tight bandage Allow thawed extremity to refreeze Handle roughly.

DO NOT (hypothermia)

Strip clothing unless wet. Give alcohol Rub the patients skin Wrap cold patients in foil blanket Make them move. Apply external heat.

Febrile convulsions.

Sudden rise in temp Caused by excessive fever Usually children 0-5 Calpol normally hasn't worked.

Tips.

Suspect hypothermia is all cases of near drowning. Dilated pupils, undetected pulse, minimal resps. Commence & maintain resus. THEYRE NOT DEAD TILL THEY ARE WARM AND DEAD.

Risk groups of hypothermia

The elderly as the live alone. Young babies. People involved in outdoor winter activities. Water sports even in summer. Alcoholics. Chronic illness.

S&S of hyperthermia.

Unconsciousness (sudden and deepening) Initially a rapid pulse and weak becoming full and bounding. Shallow breathing becoming rapid, noisy and panting. Headaches and dizziness becoming confusion and delirium. Muscular cramps and twitching developing into convulsions. Initially pallid colour turning flushed. Sweating and warm skin becoming dry and very hot.