Adventist Youth Honors Answer Book/First aid/Hypothermia

Hypothermia is caused by continued exposure to low or rapidly falling temperatures, cold moisture, snow, or ice. Those exposed to low temperatures for extended periods may suffer ill effects, even if they are well protected by clothing, because cold affects the body systems slowly, almost without notice. As the body cools, there are several stages of progressive discomfort and disability. The first symptom is shivering, which is an attempt to generate  heat by repeated contractions of surface muscles. This is followed by a feeling of listlessness, indifference, and drowsiness. Unconsciousness can follow quickly. Shock becomes evident as the victim’s eyes assume a glassy stare, respiration becomes slow and shallow, and the pulse is weak or absent. As the body temperature drops even lower,  peripheral circulation decreases and the extremities become susceptible  to  freezing. Finally, death results as the core temperature of the body approaches 80 °F (27 °C). The steps  for treatment of hypothermia are as follows:
 * 1) Carefully  observe  respiratory  effort  and  heart beat; CPR may be required while the warming process is underway.
 * 2) Rewarm the victim as soon as possible.  It may be  necessary to treat other injuries  before the victim can be moved to a warmer place.  Severe bleeding must be controlled and   fractures splinted over clothing before the victim is moved.
 * 3) Replace wet or frozen clothing and remove anything that constricts the victim’s arms, legs, or fingers, interfering with circulation.
 * 4) If the victim is inside a warm  place and is conscious, the most effective method of warming is immersion in a tub of warm (100° to 105 °F or 38° to 41 °C) water.  The water should be warm to the elbow - never hot.  Observe closely for signs of respiratory failure and cardiac arrest (rewarming shock).   Rewarming shock can be minimized by warming the body trunk before the limbs to prevent vasodilation in the  extremities  with  subsequent  shock  due to blood volume shifts.
 * 5) If a tub is not available, apply external heat to both sides of the victim. Natural body heat (skin to skin) from two rescuers is the best method. This is called “buddy warming.”   If this is not practical, use hot water bottles or an electric rewarming blanket.  Do not place the blanket or bottles next to bare skin, however, and be careful to monitor the temperature of the artificial heat source, since the victim is very susceptible to burn injury. Because the victim is unable to generate adequate body heat, placement under a blanket or in a sleeping bag is not sufficient treatment.
 * 6) If the victim is conscious, give warm liquids to drink.  Never give alcoholic beverages or allow the victim to smoke.
 * 7) Dry the victim thoroughly if water is used for rewarming.
 * 8) As  soon  as  possible,  transfer  the  victim  to  a definitive care facility.  Be alert for the signs of respiratory  and  cardiac  arrest  during  transfer, and keep the victim warm.

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