First Aid Management of Hypothermia
Hypothermia will occur when the core temperature of the body falls below 35°C. If the casualty is suffering from the mildest form of hypothermia, they will usually make a full recovery with professional treatment. Should the casualty’s core body temperature fall below 26°C, it will most likely be fatal. However, there have been cases of successful resuscitation of casualties with body temperatures of as low as 10°C, so it’s always worth the attempt.
The usual cause of hypothermia is over exposure to cold temperatures, but the different types of casualty and condition may have an effect on the risk:
· The hypothalamus of a baby or young child is underdeveloped, which can lead to hypothermia from as little as a cold room.
· The elderly or infirm tend not to generate as much body heat so any prolonged time in the cold will lower their core temperature.
· Wet clothes or submersion in cold water results in the body cooling much faster than when dry, as water conducts heat away from the body.
· Inadequate clothing in windy weather will result in cold air in continuous contact with skin, resulting in the body cooling faster.
Signs and symptoms:
· Skin appears pale and cold to the touch.
· Initial shivering, with the body stiffening as the body cools further.
· Bodily functions slow, including pulse, speech, breathing and thought.
· Appears to be drunk –lethargic, confused, disorientated.
· Lowered levels of response leading to unconsciousness and finally death.
The ideal temperature for the body to work at is 37°C (98.6°F). The temperature is maintained by an area of the brain known as the ‘hypothalamus’. If the body should become too hot we start to sweat, which evaporates from the skin cooling it down. Blood vessels near the surface of the skin dilate (which causes skin to flush) and the cooled blood is then circulated around the body.
If the body should become too cold we start to shiver, which creates heat from our muscles moving. Blood vessels near the surface of the skin constrict (which causes skin to appear pale), keeping the blood closer to the warmer core of the body. The hair on the skin stands up, trapping warm air (better known as goose pimples).
Injuries that result from exposure to extremes of temperature can be ‘localised’ (for example sunburn and frostbite), or ‘generalised’ (for example hypothermia and heat stroke).
Treatment of hypothermia:
If the casualty is unconscious:
· Clear the airway and check the casualty is breathing. If not, commence CPR.
· Dial 999 for an ambulance immediately.
· If the casualty is breathing, carefully place them in the recovery position. Do not move the casualty unnecessarily as the slightest jolt may cause the heart to stop.
· Place insulating materials, such as blankets, under and around the casualty making sure to cover the head.
· Remember to monitor the casualty’s breathing. Their pulse may be hard to locate, but it is safe to assume the casualty’s heart is beating if they are breathing.
If the casualty is conscious:
· Try to get the casualty to shelter if possible, remove any wet clothing and replace with dry, warm clothing. Cover the head, as a lot of heat is lost here.
· If the casualty is young, fit and able then ask them to get into a warm bath (40°C / 104°F). Do not allow an elderly casualty to do this.
· If the option of a bath is not viable, wrap them in warm blankets, heat the room to a warm temperature (25°C / 77°F).
· If the casualty is outdoors, try to insulate them from the environment as much as possible. Use a survival bag and shelter if you have them. Also share your body heat with them.
· Give the casualty something warm to drink and eat.
· Seek medical advice if the casualty is a child, elderly or you are unsure about their condition.
· If their condition appears severe, dial 999 for an ambulance immediately.
It is vital to NEVER:
· Give the casualty alcohol, as it dilates blood vessels which will cool the casualty further.
· Place a heat source directly on or near the casualty, this will draw the blood to the skin causing the blood pressure to fall and place stress on the heart.
· Try to warm a baby or elderly person quickly by placing them in a warm bath.
A hypothermia casualty’s heart is in grave danger of ‘ventricular fibrillation’, which causes cardiac arrest. Always handle a hypothermic casualty with care as the slightest jolt can induce the condition.