CHAPTER SIX: Medical Emergencies
“To avoid cold-related illnesses: Keep warm and hydrated, stay dry, and
dress in layers.”
- James W. Buchanan
Section B: Cold-related Illnesses
“October extinguished itself in a
rush of howling winds and driving rain and November arrived, cold as frozen
iron, with hard frosts every morning and icy drafts that bit at exposed hands
and faces.”
- J.K. Rowling, Harry Potter and
the Order of the Phoenix
Hypothermia
Formerly known as exposure, hypothermia kills several thousand American lives
each year, making it one of the most common killers of outdoor recreationists,
who succumb to the effects of low temperature, high wind, and unexpected
precipitation. Hypothermia can occur inside a building as well as
outside. Elderly people who sometimes suffer from the effects of
malnutrition and dehydration and also reside in cold apartments are often prone
to hypothermia.
Hypothermia occurs when the body loses heat faster than it can be
produced. The first symptoms of hypothermia are uncontrollable shivering,
drowsiness, confusion, and physical weakness.
Second symptoms include fumbling hands, memory loss, along with slurred
speech. Hypothermia becomes life
threatening when your body’s inner core temperature is lowered to the point
where it can no longer supply enough oxygenated blood to maintain vital organ
functions. In a matter of two or three hours, death can occur from
respiratory failure or cardiac arrest.
“Let me be the first to tell you,
drinking alcohol is the worst thing to do in cold weather. Hot soup is the best because the process of
digesting food helps to warm you up.”
- Morgan Freeman
Many people mistakenly believe that hypothermia can only happen during winter
at sub-zero temperatures.
However, according to the records, the majority of hypothermia deaths in the
United States occur in the spring and fall seasons with air temperatures
ranging between 30 and 50 degrees above zero. These are the two seasons
when many people are likely to be outdoors dressed in clothing that is more
appropriate for the daylight hours of a midsummer day.
Although important, air temperature is not the only factor in hypothermia
deaths. The other factors are wind (wind chill kills), precipitation
(rain, snow, or fog), perspiration, exhaustion, and dehydration.
The most common cause of hypothermia deaths is cold water next to the
skin. Cold water drains away body heat at a very rapid rate. They
estimate that a person in wet clothing loses body heat about 25 times faster
than someone whose clothing is dry. Clothing can be dampened from
perspiration as well as precipitation.
This is why hypothermia victims are often tired, hungry, dehydrated, or
improperly dressed recreationists. During spring or fall, frequently hypothermia
deaths happen below the timberline in fog or rainstorms. During the
summer, hypothermia is more common in the higher elevations. For example,
Rocky Mountain storms can dump several inches of cold water or several feet of
snow in a few hours. Always take along extra clothing while on long
wilderness outings, so if your clothing does get wet, you can change into dry
clothing. When venturing above the timberline of mountains, always pack
winter clothing.
“Take some time to learn first aid
and CPR. It saves lives, and it works.”
- Bobby Sherman
First aid for hypothermia
First is to get the victim into a warm and dry area, then check for breathing
and pulse rate, and treat for shock if necessary. Second, provide the
victim with additional sources of heat: hot showers, hot drinks, a warming
fire, or a warm animal or human body.
Three hunters walked back to their cabin at the end of a chilly autumn
day. All three were aware that they were suffering mild
hypothermia. The first hunter went directly to bed without drinking or
eating anything. The second hunter stayed awake long enough to eat
doughnuts and drink hot tea. The third hunter took a warm shower before
retiring. The next morning, the first hunter was discovered dead.
His body continued to lose heat, despite being under several blankets in a
heated cabin. His energy reserves were too low to reverse the lethal
effects of his mild hypothermia.
“The first principle of aid is
respect.”
- Ernesto Sirolli
Mild Hypothermia
This form of hypothermia occurs when people are exposed to moderately cold
temperatures and then enter a warm shelter. When this happens, the body
re-warms the skin surface at the expense of the body’s inner core, which
results in a mild case of hypothermia.
One hour after entering a warm room, the body’s inner core temperature can
still be dropping. As a result, victims have often reported that they felt
quite warm, while their body’s inner core was still losing heat.
While usually not life threatening, mild hypothermia can cause drowsiness and
loss of judgment that could result in an accident. Consequently, if you
think that you have mild hypothermia do not re-expose yourself to the cold
until your inner core has enough time to rise to its normal temperature of
98.6; a process that could take several hours.
“Prepare yourselves, everypony!
Winter is coming!”
- Twilight Sparkle in the My Little Pony: Friendship Is Magic episode,
Tanks for the Memories (3)
Heat Loss
Radiation is the leading cause of heat loss in the human body. Various
body parts radiate heat at different rates at different air temperatures.
As an example, an unprotected head may lose up to 40 percent of the body’s
total heat production when the air temperature is plus forty degrees Fahrenheit
and can lose 75 percent of the body’s heat production when the air temperature
falls to plus five degrees Fahrenheit. If your feet are cold, cover your
head with an insulated cap. If that is not enough, pull a parka hood over
your cap.
We define conduction as heat passing from one object to another. Contact
with anything cooler than the temperature of your skin, such as water, snow,
metal, or air, can cause heat loss. If you need to sit or lie down on a
cold surface, place an insulating pad between you and that surface.
Convection happens when cooler air removes the protective warm air around your
body. The faster the wind velocity (the exchange of air) the greater the
body heat loss. We define this as the wind chill factor. Layered
clothing acts to stop this by keeping warm air trapped in between the clothing
layers. To protect yourself from the effects of wind velocity,
precipitation and temperature always carry instant body shelters, such as a
wind parka and pants or a tent. If these are not enough to maintain
normal body temperatures, try to find shelter out of the wind.
Knowing the current air temperature and wind velocity is your first line of
defense. If these add up to a wind chill factor of minus 20 degrees F, or
colder, even the best dressed person should stay indoors. No recreational
goal is worth risking hypothermia or frostbite. Save your competitive
running races for indoor tracks during winter.
Evaporation of perspiration from the skin also contributes to heat
loss. To avoid perspiration wear just enough clothing so that you are on
the cool side of comfort. When necessary, remove a layer of clothing to
avoid overheating. While walking, slow down your pace, and take it easy
while above all ‑ don’t overexert and become overheated and end up with
perspiration dampened clothing.
Inhaling cold air and exhaling warm air also accounts for significant heat
loss. In extreme cold weather, army cool weather experts recommend a face
mask.
Blood loss resulting from trauma reduces the body’s ability to produce
heat. Any traumatic injury may require you to abort the outing and seek
medical treatment.
Wet clothing can extract body heat twenty‑five times faster than dry
clothing. During rainy weather, protect your clothing with a full rain
suit, top and bottom. By themselves, ponchos do not provide enough
protection from the lethal effect of long exposure to the combination of cold temperature,
wind velocity, and precipitation.
“Comrade, if we can’t bring you to Russian
Siberia, we can bring the weather of Russian Siberia to you.”
- A joke told among Duluth residents
between the months of November to March.
Avoiding Hypothermia
Hypothermia is more likely to affect children, slender people, dieters,
alcoholics, and the elderly, as well as those others who are tired, hungry,
dehydrated, poorly dressed, using illegal drugs, or in poor physical or mental
health. Many outdoor hypothermia victims are uninformed weekend
recreationists who underestimate the dangers of prolonged exposure to rain,
wind, and cold.
To avoid hypothermia while on an outing, one should eat an adequate meal the
night before. Have a good night’s rest, as well as a full breakfast in
the morning. Drink plenty of plain water and snack continuously on
calorie dense food while on the trail. Both water and nutrition provides
fuel for the body and becomes the second line of defense against
hypothermia. Do not drink beverages that contain alcohol or caffeine as
these are diuretics that cause excessive urination which can lead to dehydration:
A major doorway to hypothermia.
The third line of defense against hypothermia is proper clothing. Dress
in layers of clothing that are lightweight and loose. The layer system
allows you to remove or put on clothing to maintain normal body temperature
while you are resting, as well as when you are moving.
According to an experienced Alaskan brush pilot, if you can’t sit down and fall
asleep any time you’re outdoors, you are not properly dressed. You
shouldn’t have to keep moving to stay comfortable.
The right clothing acts to cover the parts of the body that allow the greatest
loss of body heat. The most important of these is the head, which in
moderate temperature range radiates about 40 percent of the body’s heat.
The hands and wrists can lose 20 percent. Ten percent can be lost from
the feet, and the torso and legs can lose about 30 percent of the body’s
heat. The lower the temperatures the higher the percentage of body heat
that is lost through the head.
To retain heat and stay dry, wear a combination of clothing that works to wick
perspiration away from the skin and provides insulation and protection against
the effects of rain, snow, and wind.
Because wind driven rain is often a major factor in the loss of body heat, it
is very important to have rain gear that covers the head, neck, torso, arms,
and legs. A good test of your rain gear is to wear it under a running
shower before venturing out.
If you’re caught in a rainstorm, put on your rain gear before you become
wet. Don your insulated clothing before you start to shiver. A good
rule is to have enough clothing with you to allow you to survive a night in the
open. For any season of the year in the northern United States, Canada,
and mountainous areas above the timberline, you should have a sleeping bag and
tent.
If you encounter falling temperatures and/or rain or snow with a strong wind ‑
stop. Get under cover, even if it means turning back to a safe place or
setting up a shelter on the trail. You should rest before you become
fatigued. Eat and drink enough to keep the body’s furnace functioning,
which will in turn continue feeding oxygenated blood to the vital organs.
“Nothing burns like the cold.”
- George R.R. Martin, A Game of
Thrones
Frostbite
Frostbite is the freezing of the skin or deeper tissues by exposure of
unprotected skin to extreme cold temperatures, or the exposure to the
combination of cool temperatures and high winds, called wind chill.
To avoid frostbite, keep vulnerable body parts such as the head, neck, and the
extremities protected by clothing, and watch for indications of frostbite such
as white spots on the surface of the skin. If frostbite develops, the
best treatment is to slowly re-warm the injured tissue by immersing it in a
container of lukewarm water. Prepare the injured body part by gently
removing clothing and jewelry prior to immersion. Do not allow the
frostbitten area to contact the bottom or walls of the container.
During the rewarming process the victim may experience mild to extreme pain;
this is a sign of successfully re-warming. After rewarming, the skin
should be a red or blue color. Gently dry the area and apply sterile
dressing. Pad the areas between fingers and toes. Keep the victim
at rest. Never let the victim walk on frostbitten feet. Never rub a
frostbitten area of skin to warm it. Small ice particles may have formed
in the affected cells, and rubbing the skin can damage these cells. When
outdoors in a group, ask someone to check you over for any signs of frostbite
or hypothermia and then return the service.
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