1. Hypothermia and Cold Weather Survival
Officer Stephen Verchinski
New Mexico State Parks

2. Cold Water Near Drowning
Drowning - Lungs fill with Water (aka Pulmonary Aspiration
Near Drowning - Survival of up to 24 hours after a drowning episode. (Warm and Dead - 30 Degrees C)
Hypothermia (Hypo- Low, Therme -Heat) “A Dangerous Loss of Heat”

3. Cold Water Submersion Adults - Asphyxiation and Immediate Hypothermia
RAPID CORE COOLING - LOW BOD
Children - Cool More Rapidly
Heart to 7 BPM Epiglotis Closes
MAMMALIAN DIVING REFLEX 30 MIN.

4. FORCES IN THERMAL REGULATION IN COLD
THIS IS A BALANCE BETWEEN THE COLD CHALLENGE AND YOUR ABILITY TO PRODUCE OR RETAIN HEAT.
THE COLD CHALLENGE -- The environment working to take heat away from the body.
HEAT RETENTION -- The body’s ability to retain heat.
HEAT PRODUCTION -- The body’s ability to produce heat

5. Your Body’s Reaction to a Cold Challenge
1. The Cold Response
2. Mild Hypothermia
3. Severe Hypothermia

6. The Cold Response
The body’s normal physiological response to a cold challenge
ASSESSMENT
Blood is shunted from the periphery to the core.
Mild shivering: if exercise is not adequate for heat production
A normal level of consciousness
Fine motor function may be impaired.
Increased urination causing a loss of fluid

7. The Cold Response TREATMENT Add more clothing layers (Heat Retention)
Increase fluid/fuel intake (Heat Production)
Increase exercise (Heat Production)
THE BOTTOM LINE -- EASILY DEALT WITH IF RECOGNIZED EARLY. EMS INVOLVEMENT OR SAR IS TO EDUCATE, EDUCATE, EDUCATE.

8. MILD HYPOTHERMIA
THE BODY’S ABILITY TO COMPENSATE FOR THE COLD CHALLENGE IS OVERWHELMED
The onset of mild hypothermia is a field emergency, indicating a significant drop in core temperature has already occurred.

9. MILD HYPOTHERMIA ASSESSMENT
Mental status changes: irritable, lethargic, mild confusion (may appear drunk)
Shivering may be present
Loss of fine motor function
Shell to core shunting
Core temp. Less than 90 degrees F, 32 deg. C
Other VS within normal parameters

10. MILD HYPOTHERMIA Treatment
Shelter from wind and moisture
Remove wet clothes :replace with dry.
Body to body contact may be helpful
Insulate from the ground or snow
Use a vapor barrier over clothing to cut evaporative heat loss
Take in fluids (warm drinks)
Take in Calories
Exercise to increase heat production once above completed.

11. SEVERE HYPOTHERMIA This is a true medical emergency.
The patient has lost all ability to fight the cold challenge. Rescue efforts should be directed to gentle rapid transport and preventing further heat loss.

12. SEVERE HYPOTHERMIA ASSESSMENT Significant decrease in LOC
Shell to core effect is extreme
Core temperature less than 90 degrees F
No shivering
“Metabolic Icebox” effect. VS depressed or unobtainable. Pupils dialated with CA

13. SEVERE HYPOTHERMIA Treatment
Reduce further heat loss.
Package for rapid transport accordingly
Handle gently
Prevent exercise
Avoid shell rewarming
Evacuate flat.
Nothing by mouth
Airway to be open
Slow Mouth to Mouth
CPR Breaths/Min Comp./Min.
Primary/Secondary Injury Mgmt.

14. SEVERE HYPOTHERMIA Treatment Concerns and Upgrades
Warmed, Humidified Oxygen (Rescue Air RES-Q-AIR 9”x3”x2” weight 4.5 $1600
Flex Disks Thermo Pads. CORE AREA ONLY
No Drugs -- Pooling Shock
Protocols EMS Academy Kyle Thornton State of Alaska EMT I,II,III JAMA October 28, 1992