Cold-related emergencies are typically the result of cold temperatures combined with a lack of insulation or protective clothing to deal with those temperatures.
Hypothermia begins to set in around the time the patient begins to shiver. And once the core body temperature drops below 95 degrees Fahrenheit, serious side effects ensue, including:
- Dizziness
- Delirium/confusion
- Lethargy
- Fatigue and weakness
- Loss of consciousness
How to Treat for a Cold-Related Emergency
Treatment for hypothermia is basically two-fold:
- Insulate the patient's body as best you can until help arrives.
- Move the patient to a warmer environment if possible.
Pro Tip #1: One of your best tools for helping you achieve number one above is a mylar blanket. They're common in first aid and emergency kits, and for good reason. They work by reflecting the heat of the patient and are big enough to cover most adults from head to toe.
Warning: Wrapping a patient in a mylar blanket should be done gently using the steps below. You want to make sure not to agitate any frost-bitten extremities. Plus, cardiac arrest is also a concern, as crystals in the blood stream can travel and wreak havoc.
Using a Mylar Blanket
- Carefully roll the patient onto their back and kneel beside them.
- Unwrap the blanket and tuck one end under the side of the patient's body farthest from you.
- Roll the patient away from you and onto the blanket.
- Untuck the blanket on the other side and wrap it around the patient.
Pro Tip #2: The patient may be in a fetal position to try and stay warm. Gently straighten their legs so the blanket can engulf them completely.
- Seal the blanket as best you can, but leave room for the patient to breathe, as mylar isn't breathable material.
- Put another blanket or coat over the patient. Cover the feet and tuck it in around the patient as best you can, including the top of the head.
Pro Tip #3: We lose a ton of heat through or feet, hands, and head, so make sure these areas are covered. Top and sides of head, not the face.
Keep the patient as comfortable and as warm as possible until help arrives. And continue to monitor for airway, breathing, and circulation issues.
If at any point, the patient becomes unresponsive, goes unconscious, or is not able to breathe normally, call 911 immediately and activate EMS. Then begin CPR.
Warning: Don't forget to protect yourself. When dealing with cold-related emergencies, you're likely putting yourself in the same environment that felled the patient. And since you're likely kneeling on cold pavement, in snow, and may be working with your gloves off for reasons of manual dexterity, pay extra care that you don't also become a victim.
Rewarming Body Parts in the Field
A clinical setting is the preferred location for rewarming, so don't worry about it, especially considering that frozen parts that have been warmed could freeze again. However, it pays to know that you should never rewarm using water hotter than 105 degrees Fahrenheit. Higher temperatures could burn the patient, not to mention the pain involved.
Rewarming is very painful, as the nerve endings begin to come back and the patient begins feeling again. Which is why a setting that can offer analgesics is the best option.
Recognizing Frost Nip and Frost Bite
The most common body parts to freeze first are the nose, cheeks, ears, feet, hands, and especially the ends of fingers and toes. When frost bitten, these parts will appear white, hard to the touch, and numb or nearly numb to the patient.
A Word About Cold-Related Contributing Factors
When it comes to cold-related emergencies, there are several contributing factors to be aware of, including the environment and the age of the patient.
Anyone can develop hypothermia; however, the risk factors below could put people at higher risk.
- A cold environment. Though, even if the ambient temperature isn't that low, it can quickly be made worse if the patient isn't properly protected from the cold, including the use of inappropriate clothing.
- A wet environment. The presence of moisture – perspiration, rain, snow, etc. – will increase the speed at which body heat is lost.
- Wind. Wind makes the environment a lot colder than the temperature indicates. The higher the wind chill effect, the lower the actual temperature.
- Age. The very young and very old usually have a harder time staying warm in cold conditions. Body mass, or lack thereof, is one concern, as is their ability to think clearly when it comes to removing themselves from that environment or better protect themselves with proper clothing. And in older adults, impaired circulation may also be a concern.
- Medical conditions. People with certain medical conditions, such as hypoglycemia, shock, and head injury, may be at higher risk of developing hypothermia.
- Drugs and alcohol. Alcohol and certain types of drugs can reduce a person's ability to feel the cold, or can impair judgment and impede rational thought, preventing the patient from taking proper precautions to stay warm.