Cold Related Emergencies

[Kids talking] “Are you okay? I’m going to
get help!” Now let’s cover cold emergencies. In this
situation we had two children possibly lost for a while, or played outside in bad conditions
without enough warming and insulation in their clothing, and they started to feel the effects
of hypothermia. You know, hypothermia begins when they start shivering. And once the body
drops below 95 degrees Fahrenheit at the core temp, serious side effects begin to take effect.
Dizziness, delirium, confusion, the shivering begins to stop. They become lethargic, weak,
and then lose consciousness. Now the treatment for hypothermia is that we need to insulate
their body as best we can while we wait for EMS to arrive, or remove them from the environment
into a permanent warming area. If we’re out in the field like this, obviously we need
to get help to come to us. We’re going to have to help protect them while we’re here.
And the way we do that, a really good way is to have a waterproof blanket made out of
Mylar. These are very common in first aid kits. And I’m strongly encourage you to have
them whenever you have a first aid kit or an emergency kit that you have in your vehicle
or with your rescue bag. These Mylar blankets are really designed to help reflect the heat
of the patient. They’re normally large enough that they would certainly be okay for a child
and big enough for most adults. But our whole goal here is to actually have the patient
roll towards us being extremely gentle with the child. If they have frozen parts, frostbitten
parts, we don’t want to agitate those parts anymore than we have to as we could give crystals
in their bloodstream. Make those kind of move and it could actually put them in cardiac
arrest, so we want to be careful about that. Now what I’m doing here is I’m just untucking
part of the blanket, and tucking the other half underneath the patient’s body. What we’re
gonna do is we’re gonna roll the patient then back onto this Mylar blanket. I’m gonna roll
you over a little bit. We’re gonna get you help here, honey, in just a little bit. I
know you’re super cold. Untuck the blanket on my side, and now they can lay on their
back as we pull the rest of this blanket up and around them insulating their body. Go
ahead and straighten your legs out, honey. I know it’s super cold. As we wrap this all
the way around, we’re gonna try to seal it around their feet as best we can up up under
their chin. But you can’t breathe through this stuff, so it’s gonna be vitally important
you leave room for them to be able to breathe. You don’t cover their face. Now I’m gonna
take another blanket and I’m gonna cover their body the rest of the way, over their feet
and as far up as we can, tucking it all around underneath and as best we can and then waiting
for EMS to arrive. You might notice that we have this little extra around their head.
I might even tuck it around like that. Remember we lose an immense amount of heat through
our scalp and through our head. We want to try to insulate that and keep them from losing
any more heat than they already have. This is how we’re gonna maintain this person that’s
in hypothermia until EMS or help arrives. But we’re also gonna monitor for airway, breathing
and circulation. If they stop breathing and go unconscious, we’re gonna go straight into
CPR until help arrives for as long as we possible can. Remember it’s important to protect ourselves
as well, the rescuer. I’m kneeling in cold snow. It’s lowering my body temperature. I
might need to take my gloves off for dexterity so it’ll be easy for my fingertips to start
getting frostnip or frostbite. So remember scene safety for you as well. Now let’s talk
about the next piece, and that is frostnip, frostbite, and how we recognize it and then
how we treat it. Out here in the field, we’re not gonna be rewarming any frozen parts. Frostbite
is indicated by fully frozen hard ends of their fingers, nose, cheeks, ears, toes, feet,
hands. Those are the most common parts to freeze first. They’re gonna be hard. They’re
gonna be white, and they’re not going to have much feeling. If we have a person that’s still
able to walk but they have frozen parts, especially the feet, we’re gonna try to walk them to
permanent safety for as long as we can while their feet are frozen. We don’t wanna take
the time to rewarm if there’s a chance that they’re gonna refreeze again. We don’t want
to reheat or rewarm any frozen parts of the body with water hotter than 105 degrees. That’s
the maximum temperature before we then get into burns. And in my preference, it might
even be a little cooler than that as that type of temperature can be extremely painful
once the nerve endings come back and they can start feeling again. All rewarming attempts
is extremely painful and so we sometimes will want, if at all possible in advance settings,
for some form of analgesia to be applied through the rewarming, but not to the point where
we suppress their ability to breathe on their own. It’s gonna be important that we maintain
this body temperature, rewarming, keeping their core temperature as high as we can until
help arrives, and we can get them to permanent help where we can fully rewarm them and save
their life.