1. Heat and Cold Emergencies
Slide Presentation prepared by
Randall Benner, M.Ed., NREMT-P

2. Learning Objectives
Explain how the body attempts to maintain normal body temperature.
Explain how the body loses heat.
Describe and demonstrate appropriate first aid care for heatstroke.
Describe and demonstrate appropriate first aid care for heat exhaustion.
Describe and demonstrate appropriate first aid care for heat cramps.
© 2012 Pearson Education, Inc.

3. Learning Objectives Identify the signs and symptoms of hypothermia.
Describe and demonstrate appropriate first aid care for hypothermia.
Identify the signs and symptoms of frostbite.
Describe and demonstrate appropriate first aid care for frostbite.
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4. Introduction
Heat and cold emergencies can lead to minor, and occasionally life-threatening, conditions.
Understanding how the body regulates body temperature will help you anticipate and recognize these emergencies easier.
Heat and cold emergencies can occur in situations where there are not extreme changes in environmental temperature.
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5. Body Temperature Regulation
The human body attempts to maintain a constant core temp of 98.6 degrees F.
Heat loss must equal heat production.
Body heat is created by metabolic activity, monitored by the brain, transported by the blood stream, and eliminated via the skin and by breathing.
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6. Body Temperature Regulation
The body loses heat through
Radiation
Conduction
Convection
Evaporation
Respiration
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7. Mechanisms of Heat Loss
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8. Body Temperature Regulation
The body conserves heat through
Constriction of blood vessels
Hairs on the skin stand erect and trap warm air next to the skin
Little or no perspiration is released to the skin surface for evaporation
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9. Temperature Regulation
Clothing affects thermal equilibrium by
Providing resistance to heat loss
Wearing too many layers when working or two few of layers when resting (not recommended)
Matching clothing to the environment and the workload (preferred)
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10. Heat-Related Injuries
Hyperthermia = Heat-Related Injuries
From most life threatening to least life threatening
Heatstroke
Heat exhaustion
Heat cramps
Common with environmental temps above 90 degrees F and relative humidity above 75%
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11. Heat-Related Injuries
Groups most susceptible to heat-related emergencies
Athletes
Workers near furnaces or ovens
Those in poor physical health
Alcoholics and obese
Chronically ill
Not acclimated to environment
Undergoing concurrent drug therapy
Burn victims
Very young and very old
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12. Heat-Related Injuries
Heat stroke
Heat regulation mechanisms fail to cool effectively
Heat in the body continues to rise out of control
Brain injuries and death can easily occur
Two types
Classic
Exertional
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13. Mechanisms of Heat Stroke
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14. Signs and Symptoms of Heat Stroke
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15. First Aid Care for Heat Stroke
Initiate EMS, take standard precautions.
Remove the victim from heat source, if possible.
Establish an airway, support breathing and circulation.
Use approved cooling method, do not induce shivering.
Never give the victim stimulants or hot drinks.
Monitor the victim’s temperature while awaiting EMS.
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16. Heat-Related Injuries
Heat exhaustion
Most common heat-related emergency
Vasodilation-induced pooling of blood in the extremities
Loss of body fluids from excessive sweating
Greatest concern is dehydration from lack of water and blood circulation to critical body organs
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17. Heat-Related Injuries
Heat exhaustion symptoms
Headache, weakness, fatigue
Dizziness, fainting
Profuse sweating, possible muscle cramps
Pale, cool, ashen skin
Normal to slightly elevated temp
Thirst, nausea and/or vomiting
Dilated pupils
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18. Heat Exhaustion and Heat Stroke Symptoms
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19. First Aid Care for Heat Exhaustion
Activate EMS.
If heat stroke develops, take standard precautions.
Move the victim to a cool place.
Remove outer clothing.
Place patient supine, raise feet 8–12 inches.
If conscious, provide cool water or sports drink.
½ glass every ten minutes for one hour
Monitor temperature every 10–15 minutes.
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20. Heat-Related Injuries
Heat cramps
Least serious heat emergency
Results from disturbances to salt, calcium, electrolytes, or fluid levels
Muscles tend to cramp but not relax
Hot weather is not a prerequisite.
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21. Signs and Symptoms of Heat Cramps
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22. First Aid Care for Heat Cramps
Remove the victim from hot environment, if possible.
Instruct victim to rest.
Administer sips of water or sports drink.
½ glass every fifteen minutes
Place moist towels to forehead and cramping muscles.
Stretching muscles may help relieve pain.
Activate EMS if victim does not respond or deteriorates.
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23. Cold-Related Injuries
Hypothermia = Cold-Related Injuries
Heat loss exceeds heat gain
Types
General hypothermia
Immersion hypothermia
Frostbite
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24. Cold-Related Injuries
General hypothermia
The most life threatening cold-induced injury
Core body temperature drops below 95 degrees F
Factors that contribute to hypothermia
Certain drug therapies
Surgery
Water activities
Pre-existing disease
Trauma and massive blood loss
Age extremes
Immobility
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25. Stages of Hypothermia
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26. Hypothermia Signs and Symptoms
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27. First Aid Care for Hypothermia
Activate EMS, take standard precautions, handle the victim gently.
Remove the victim from cold environment if possible.
Manage airway, breathing, and circulation.
Assess vital signs for one full minute.
Prevent further heat loss, but do not rewarm the victim if severely hypothermic.
Never rub or manipulate the arms or legs.
Administer nothing by mouth.
Reassess and maintain care until EMS arrives.
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28. Cold-Related Injuries
Immersion hypothermia
Heat loss due to immersion in cold water
Heat loss extremely rapid, can occur within minutes
Factors increasing heat loss
Water temperature
Body size
Clothing
Physical activity
Use of alcohol
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29. First Aid Care for Immersion Hypothermia
Activate EMS, take standard precautions.
Remove victim from water if can be done safely.
Assess and maintain the victim’s airway, breathing, and circulation.
Keep the victim quiet and still.
Follow insulating and rewarming guidelines for general hypothermia.
If victim cannot be rescued from water, instruct them to exert as little effort as possible.
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30. Immersion Hypothermia Strategies
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31. Cold-Related Injuries
Frostbite
Frostbite is freezing of body tissues, frost nip is freezing of the skin surface
Most commonly affects exposed surfaces
Hands, feet, ears, nose, cheeks
Factors influencing frostbite
Trauma, blood loss, age extremes, use of alcohol, wet clothing, high altitudes
Three stages
First degree (frost nip, skin surface only)
Second degree (impacts skin tissues just below surface)
Third degree (damages skin tissues at all depths)
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32. Three Stages of Frostbite
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33. First Aid Care for Frostbite
Activate EMS, take standard precautions.
Remove the victim from the cold environment.
Keep tissue frozen until care can be initiated.
Protect injured tissue from friction or pressure.
Thaw frostbitten tissue in warm water bath (98–104ºF).
Rewarm until skin color no longer improves.
Cover with loose, dry, sterile dressing.
Elevate the injured tissue.
Monitor vital signs until medical care arrives.
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34. Summary
Heat or cold emergencies can occur without extreme changes in environmental conditions.
In most instances, EMS should be activated.
Care provided to the victim by the First Aider may help decrease the overall severity of the injury.
Never place yourself in danger during patient rescue or care.
© 2012 Pearson Education, Inc.