1. Alton Police Department Tactical Response Team Environmental Emergencies

2. Alton Police Department Tactical Response Team Presented By Sgt. Michael Gordon Alton P. D. Tactical Response Team E-mail: gordon@altonpolice.comgordon@altonpolice.com Work: (618) 463-3505 ex. 235

3. Alton Police Department Tactical Response Team Environmental Emergencies This course will specifically identify and discuss heat and cold related injuries, or Thermoregulatory Emergencies. A Thermoregulatory Emergency is defined as: Any emergency involving a change in the temperature of the body.

4. Alton Police Department Tactical Response Team Environmental Emergencies Heat and cold related problems are very common during training and actual operations and can have a direct effect on mission success. All Medical Threat Assessments (MTA) must consider and be aware of the environment(s) to be encountered and its effect on team members.

5. Alton Police Department Tactical Response Team Environmental Emergencies Officers must be aware that these types of emergencies can occur at any time and are not necessarily weather dependent. Heat related problems can occur in a cold weather environment. Cold related problems can occur in a warm weather environment.

6. Alton Police Department Tactical Response Team Environmental Emergencies Heat and cold related problems consist of a logical progression of signs and symptoms. It is important for team members to be able to recognize the early signs and symptoms in themselves and others. Early recognition will allow early reversal of the problem before it progresses to something more serious.

7. Alton Police Department Tactical Response Team Environmental Emergencies Temperature Regulation There is a delicate balance between heat generated by the body and heat lost from it. The body is like a furnace. It takes in fuel and “burns” it to create energy, which produces heat.

8. Alton Police Department Tactical Response Team Environmental Emergencies This heat is lost to the environment in 5 different ways: 1. Conduction- The transfer of heat directly from one object to another. 2. Convection- The loss of heat thru moving air or liquid. 3. Evaporation- When a liquid changes to a gas (sweating).

9. Alton Police Department Tactical Response Team Environmental Emergencies 4. Radiation- Heat radiates constantly from the body to surround air. 5. Respiration- Air inhaled must be warmed and humidified. Exhaled air carries heat out of the body (Breathing).

10. Alton Police Department Tactical Response Team Environmental Emergencies Heat Related Emergencies Hyperthermia Anytime a person’s temperature rises above normal 37°C or 98.6°F. Humans create excess heat through exertion. This heat builds up and causes a rise in our core body temperature. The body compensates by sweating and sending blood to the skin to cool.

11. Alton Police Department Tactical Response Team Environmental Emergencies Heat Related Emergencies Emergencies arise when the body is overloaded or unprepared to deal with the environment. The body can warm itself better in the cold than cool itself in the heat. Predisposing factors Hot humid weather, vigorous activity, dehydration,obesity and fatigue.

12. Alton Police Department Tactical Response Team Environmental Emergencies Heat Related Emergencies Prevention Officers should stay well hydrated. Fluid maintenance is #1! Hydration systems, bottled water. Weather appropriate uniform Avoid fluids with diuretic properties. Coffee, tea, and soft drinks are examples

13. Alton Police Department Tactical Response Team Environmental Emergencies Heat Related Emergencies Prevention cont’d Use the buddy system to keep everyone in check. Watch each other. Provide medic with prior knowledge (medical history) of being a heat casualty in the past, as you are more susceptible.

14. Alton Police Department Tactical Response Team Environmental Emergencies Generalized Hyperthermia Develops when a team member is sweating profusely and not replacing enough fluids and electrolytes. May develop cramps and/or spasms in hands, feet and stomach area, but more commonly in the long muscles of the legs.

15. Alton Police Department Tactical Response Team Environmental Emergencies Generalized Hyperthermia Treatment Move to a shaded area or cool environment. Ingest water. Do not massage, it may cause strains or sprains. Administer Oxygen

16. Alton Police Department Tactical Response Team Environmental Emergencies Generalized Hyperthermia Caused by a greater deficit in fluids and electrolytes in the body. Not necessarily life-threatening by itself, but will quickly progress to more serious condition if not treated.

17. Alton Police Department Tactical Response Team Environmental Emergencies Generalized Hyperthermia May be preceded by fatigue and cramps. Symptoms include Pale, moist skin Feeling of “Cold Sweat” Nausea Lightheadedness

18. Alton Police Department Tactical Response Team Environmental Emergencies Generalized Hyperthermia Treatment Move to shaded area or cool environment. Gear off and loosen clothing. Ingest water/sports drink. IV Fluids Cool packs can be applied Under armpits Behind knees Around neck Administer oxygen

19. Alton Police Department Tactical Response Team Environmental Emergencies Generalized Hyperthermia Hot, red, strong-rapid pulse, and (sometimes) dry skin. Cooling system shut down Body temperature is usually above 106°F

20. Alton Police Department Tactical Response Team Environmental Emergencies Generalized Hyperthermia The most life-threatening of the heat emergencies. Body heats faster than it can cool and the cooling mechanism overloads and shuts down causing a rapid rise in core body temperature. As little as 30 minutes from on-set before death.

21. Alton Police Department Tactical Response Team Environmental Emergencies Generalized Hyperthermia Treatment Move to shaded area or cool environment May become unconscious, ensure airway. RAPIDLY cooling the patient. Remove gear and loosen/remove clothing. Cold packs in armpit, behind knee, around neck. Wet patient’s skin with water and fan aggressively. IV Fluids Rapid transport to hospital.

22. Alton Police Department Tactical Response Team Environmental Emergencies Cold Relate Emergencies Training or operations in cold environments create their own unique set of problems. Cold+Wet environments increase the probability for problems. Hypothermia Body temperature falls below 37°C or 98.6°F.

23. Alton Police Department Tactical Response Team Environmental Emergencies Cold Relate Emergencies The body loses heat in five different ways: 1. Conduction- loss of heat thru contact with objects. 2. Convection- Loss of heat thru wind/air movement. (wind chill) 3. Evaporation- Loss of heat thru sweating. 4. Radiation- Loss of heat thru the body actually radiating heat off the skin into the atmosphere. 5. Respiration- Heat loss thru Breathing

24. Alton Police Department Tactical Response Team Environmental Emergencies Cold Relate Emergencies Prevention Recognize signs and symptoms Proper dress Proper cold weather or wet weather gear. Dress in layers Provides greater warmth with less clothing. Facilitates removal to avoid heat emergencies during exertion. Cover as much exposed skin as possible. Proper eating and hydration Food is fuel for body (heat) Dehydration is common in dry cold climates.

25. Alton Police Department Tactical Response Team Environmental Emergencies Localized Cold Injuries Freezing of the skin. Occurs in gradual progression Normally effects ears, nose, hands, feet. Areas the body considers least essential in maintaining heat at its core. It can be superficial or deep depending on the temperature and amount of exposure.

26. Alton Police Department Tactical Response Team Environmental Emergencies Localized Cold Injuries Early (Superficial) signs Pale skin w/ delayed cap refill. Loss of sensation & feeling. Skin still soft Tingling when re-warmed

27. Alton Police Department Tactical Response Team Environmental Emergencies Localized Cold Injuries Late signs (deep damage). Skin will appear bluish white and waxy. Will may be hard to the touch (frozen). Swelling and blisters. Loss of sensation If partially thawed, skin may appear flushed with areas that are purple, pale, mottled, or cyanotic.

28. Alton Police Department Tactical Response Team Environmental Emergencies Localized Cold Injuries Treatment Remove from cold environment. Protect cold extremity from further injury. Administer oxygen. Remove wet or restrictive clothing and jewelry. Splint the extremity and cover w/dry sterile dressing. Contact EMS and transport.

29. Alton Police Department Tactical Response Team Environmental Emergencies Localized Cold Injuries Things to avoid: Do Not re-expose to cold. Do Not rub or massage. Do Not heat or re-warm. Do Not break blisters. Do Not allow to walk on affected extremity.

30. Alton Police Department Tactical Response Team Environmental Emergencies Hypothermia Hypothermia is a drop in the body’s core temperature below 98.6ºF. Hypothermia is Mission-Ending and Life-Threatening! It routinely kills even experience outdoorsmen, soldiers, ect...

31. Alton Police Department Tactical Response Team Environmental Emergencies Hypothermia Early detection is the key to survivability and treatment! Use the buddy system. Know the signs and symptoms and notify medic/Chain of Command if noticed in self or teammate.

32. Alton Police Department Tactical Response Team Environmental Emergencies Hypothermia Predisposing factors Cold environment, immersion in water, shock, head or spinal injury, burns, hypoglycemia. Always look for signs of hypothermia in major trauma, outdoor resuscitation and poisonings.

33. Alton Police Department Tactical Response Team Environmental Emergencies Hypothermia Mildly Hypothermic Shivering Urinating frequently Stumbling/lagging behind Loss of fine motor skills Severely Hypothermic Inability to walk in a straight line Lack of shivering Slurred speech Decreased level of consciousness

34. Alton Police Department Tactical Response Team Environmental Emergencies Hypothermia Treatment for Hypothermia with a responding alert patient: Cover w/ blankets move to heated area. Place heat packs (30-39°C/120-104°F) in/around groin, armpits, neck, and head. Do not allow to walk or become active. Contac EMS and transport.

35. Alton Police Department Tactical Response Team Environmental Emergencies Hypothermia Treatment for hypothermia patient with decreased level of responsiveness: Indicates Possible Severe Hypothermia! Do Not Actively Re-warm! Move to warm area and cover w/blankets. Do not allow to walk or become active. Contact EMS and transport.

36. Alton Police Department Tactical Response Team Environmental Emergencies Hypothermia Treatment for hypothermia patient with no signs of life: Do Not Actively Re-warm! Ensure airway/ventilate as required. Give 100% oxygen, if available. Heart rate and blood pressure may be so low that they appear dead. Must check pulse for 30-45 seconds. If no pulse, begin CPR Move to a warm area. Cover w/blankets. Immediate transport to hospital.

37. Alton Police Department Tactical Response Team Environmental Emergencies Discussion? Questions? Comments?