13.2 Hypothermia and frostbite recognition and treatment

Cold-related emergencies can be life-threatening. Hypothermia occurs when body temperature drops below 95°F, causing shivering and vasoconstriction. Frostbite is the freezing of skin and tissues, progressing from frostnip to severe tissue damage.

Quick action is crucial for both conditions. Rewarming techniques, like moving to a warm environment and using warm blankets, help restore body temperature. Avoid rubbing affected areas or using direct heat sources, as these can worsen damage.

Hypothermia Recognition and Treatment

Core Temperature Drop and Body's Response

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• Hypothermia occurs when the body's core temperature drops below 95°F (35°C) due to prolonged exposure to cold temperatures
• Core temperature refers to the internal temperature of the body's vital organs, which is normally maintained around 98.6°F (37°C)
• As the core temperature drops, the body initiates shivering, involuntary muscle contractions that generate heat to warm the body
• Peripheral vasoconstriction, narrowing of blood vessels in the extremities, occurs to reduce heat loss and redirect blood flow to vital organs
• Immersion hypothermia can develop rapidly when a person is submerged in cold water, as water conducts heat away from the body 25 times faster than air

Afterdrop Phenomenon

• Afterdrop is a continued decrease in core temperature even after removal from the cold environment
• Occurs when cold blood from the extremities returns to the body's core, further lowering the core temperature
• Can be life-threatening if not properly managed during the rewarming process (gradual rewarming, close monitoring of vital signs)

Frostbite Recognition and Stages

Frostnip: Early Stage of Frostbite

• Frostnip is the earliest stage of frostbite, characterized by numbness and tingling in the affected area
• Skin appears red and feels cold to the touch, but tissue damage is minimal and reversible
• Commonly affects exposed skin, such as the nose, ears, cheeks, fingers, and toes

Progression to Frostbite and Tissue Damage

• If exposure to cold continues, frostnip can progress to frostbite, a more severe condition involving the freezing of skin and underlying tissues
• Frostbite causes skin to become pale, waxy, and hard, with a loss of sensation in the affected area
• As frostbite progresses, tissue damage becomes more extensive, potentially leading to blisters, skin necrosis (death), and gangrene (tissue death) in severe cases
• Depth of tissue damage depends on the duration and severity of cold exposure (superficial frostbite vs. deep frostbite)

Rewarming Techniques

Passive and Active Rewarming Methods

• Passive rewarming involves moving the person to a warm environment, removing wet clothing, and allowing the body to rewarm naturally
• Active rewarming techniques are used for more severe cases of hypothermia and frostbite to help restore normal body temperature
• Examples of active rewarming include warm water immersion (104-108°F or 40-42°C), warm blankets, and heated intravenous fluids

Precautions and Considerations

• Rewarming should be done gradually to prevent further tissue damage and complications, such as afterdrop
• Avoid massaging or rubbing the affected area, as this can cause additional damage to the skin and tissues
• Do not use direct heat sources (fire, heating pad) as they can cause burns and worsen tissue damage
• Seek medical attention for severe cases of hypothermia and frostbite to ensure proper treatment and monitoring