Hypothermia, Frostbite, & Frostnip
Mild Hypothermia
Symptoms of mild hypothermia: body temperature is 90º to 98º, patient feels chilly, has difficulty using hands, shivering begins and may become violent, patient stumbles, loss of coordination, weakness, difficulty speaking, slow thinking, mild confusion
Treat mild hypothermia by raising the core temperature by whatever means are available. For example, rewarm the person inside a sleeping bag next to a warm fire.
Severe Hypothermia
Symptoms of severe hypothermia: body temperature is 90º or under, shivering stops, muscles become stiff, unable to stand or walk, exposed skin is blue or puffy, jerky movements, dulled senses, impaired responsiveness, dilated pupils, breathing and pulse slow down. Below 80° patient is unresponsive, rigid, breathing is very slow, cannot find a pulse, ventricular fibrillation occurs (this is when the heart stops beating normally and quivers instead of beating), and eventually death.
Treat for severe hypothermia by preventing the person from further cooling by using slow-rewarming methods (such as shivering inside sleeping bag, hot rocks placed against patient’s body, heating pads). Treat dehydration with warm fluids when patient is able to swallow. Avoid coffee and tea because the caffeine in them will make dehydration worse. Hot apple cider is best for treating a person who is cold and dehydrated. Avoid jostling the person during transport, and avoid performing CPR unless ventricular fibrillation occurs. A person who is suffering from severe hypothermia may die if moved around quickly. Only move a person who has severe hypothermia slowly and very gently.
Frostnip & Frostbite
Frostnip
Frostnip is when the skin is still soft. There is no actual freezing of tissues although there may be a few ice crystals on the skin surface. Treat frostnip by applying direct body heat to cold areas, or warm up a rice pack in the microwave to rewarm fingers and toes that have frostnip.
Frostbite
Superficial frostbite is when only the skin is frozen. Deep frostbite occurs when both the skin and underlying tissues are frozen including muscles, tendons, and bones. The skin is usually hard and has a waxy feel if it's deep frostbite. After thawing large blisters develop, and gangrene can develop if the areas are refrozen.
Treat frostbite by rapid rewarming inside a water bath with water temperature carefully controlled between 102º and 108º. Give the patient hot apple cider during rewarming (not coffee or tea). Also, warm up rest of the body to open up circulation. For deep frostbite, after thawing, dry extremity/fingers/toes, and apply thick layers of sterile dressings held in place by loosely applied roller bandages, separate digits with gauze pads, elevate to reduce swelling, wrap parts in jacket or blanket, and prevent refreezing.
Cold Weather Facts
- It only takes 1 hour for a person who falls into 40° water to become severely hypothermic.
- It takes at least 2 hours for an inadequately dressed person, who is exposed to a cold environment, to reach the severe hypothermic stage (without being wet).
- A person can get hypothermia in temperatures as warm as 60 degrees.
- Afterdrop occurs when blood
from the core perfuses the colder extremities and cools further before
returning to the core; it can set in even after rewarming efforts have begun. That is why the person may start to feel colder after being inside for awhile.
- If a person falls into cold water, remove all wet clothing and try to warm up the person by using blankets, a sleeping bag, or by sitting next to a fire. Removing the wet clothing even in cold temperatures will help prevent hypothermia from setting in quickly.