What is Hypothermia? The failure to maintain the vital organs at normal temperature

Hypothermia is a “Fuzzy Thinking” Problem It comes on gradually – may not even notice It comes on gradually – may not even notice Patient is not motivated to their own rescue Patient is not motivated to their own rescue Affects ability to make good decisions Affects ability to make good decisions Group may go into hypothermia together Group may go into hypothermia together Hypothermia robs you of your ability to help yourself

Hypothermia: What do you see? Mild : Shivering, “Umbles” fumbles – inability to do complex tasks grumbles – confusion, apathy, sluggish thinking mumbles – slurred speech stumbles – altered gait Mild : Shivering, “Umbles” fumbles – inability to do complex tasks grumbles – confusion, apathy, sluggish thinking mumbles – slurred speech stumbles – altered gait Moderate: worsening of “umbles” and uncontrollable, violent shivering Moderate: worsening of “umbles” and uncontrollable, violent shivering Severe: shivering stops, increasing muscular rigidity, stupor progressing to coma,  HR and Resp Severe: shivering stops, increasing muscular rigidity, stupor progressing to coma,  HR and Resp Useful hint – differentiator between mild and severe is ability to swallow

Mild Hypothermia – what do you do? Mild Hypothermia – Patient still trying to warm up internally Stop the heat loss – Get them out of cold and out of wet clothes Cover head and neck Simple warm, sweet fluid to “stoke the fire” - if they can swallow Encourage movement, if possible Use chemical heaters, etc to warm them up

Severe Hypothermia – what do you do? Severe Hypothermia – Patient is unconscious or semi-conscious; lost ability to rewarm Danger – high probability of ventricular fibrillation if handled roughly Not much you can do – stabilize core temperature – heat packs, blankets, wrap in tarp, get quickly into hands of EMS

Hypothermia Don’ts: Don’t lose time - call EMS ASAP but don’t rush to treatment Don’t lose time - call EMS ASAP but don’t rush to treatment Don’t handle roughly Don’t handle roughly Don’t use fast rewarming Don’t use fast rewarming Don’t do body to body re-warming - rescuer risk Don’t do body to body re-warming - rescuer risk Don’t rush to do CPR – HR and Resp may be very slow; normal for cold; search for ~ 3 mins; But if needed, do it! Don’t rush to do CPR – HR and Resp may be very slow; normal for cold; search for ~ 3 mins; But if needed, do it! A person is not dead until they are warm and dead

AED Avoid using AED  Cold tissue does not conduct electricity well Avoid using AED  Cold tissue does not conduct electricity well

PRECAUTIONS DURING TRANSPORT Even minor bumps or jolts can precipitate ventricular fibrillation. Do the best you can. Few of these patients survive Even minor bumps or jolts can precipitate ventricular fibrillation. Do the best you can. Few of these patients survive If the victim is breathing, oxygen administration at a generous flow rate prior to transport may reduce the risk of fibrillation. If the victim is breathing, oxygen administration at a generous flow rate prior to transport may reduce the risk of fibrillation.