2. What is cold injury?
Cold injury is a tissue trauma produced by
exposure to freezing temperatures and even
brief exposure to a severely cold and windy
environment.
3. Characteristics of cold region
• Low humidity in Ladakh region
• High Humidity in Sikkim, Kashmir & Arunanchal
Pradesh
• Temp may go below -20 degree C to -40 degree C
• Less vegetation
• Wind Chill factor
• Summer – Avalanches (Glaciers)
• Sun (UV Radiation) - Snow blindness
4. WIND-CHILL FACTOR
Wind Chill factor (at -1 degree C with wind velocity
at50 Kmph effective temp becomes minus 10 degree C
The felt air temperature on exposed skin due to wind
7. Hypothermia
BODY CORE
- Heart
- Brain
- Lungs
- Liver
- Kidneys
EXTREMITIES
- Legs & feet
- Arms & hands
Normal
core body
temperature:
98.6°F
8. CLINICAL FEATURES
• Effects
– Mental processes are slowed, Shivering becomes violent
– Later on, Ability to shiver lost,
– Coma supervenes
Lethal temperature can be highly variable, and survival has
been recorded at deep body temperature as low as 20`C
9. TREATMENT
• EXTERNAL REWARMING
– Apply warm packs at axillae, groin and neck
– ‘Insulatory wrap’ (4 inches)
– Give warm sweetened tea, coffee or milk
– DON’T WARM EXTREMITIES
– DON’T massage the limbs
– No physical activity
– No alcohol & tobacco
10. 5 % IV Dextrose warmed upto 37- 41 degree C
500ml to 1 ltr in half to one hr
Oxygen inhalation by face mask
Catheterize, monitor urine output
Monitoring temp
CPR if no carotid pulse
CORE REWARMING
11. Declare DEAD only after re-warming to 36
degrees C of core temp
DICTUM : “A patient of hypothermia, in finality, is
never “Cold and Dead” but is
“WARM AND DEAD”
13. COMMONLY AFFECTED AREAS
Fingers
Toes
Ear lobes
Nose
Cheeks
Chin
Soles, heel
Dorsal surface of foot
Male genitalia
Buttocks
14. CHILLBLAINS
- Nonfreezing cold injury
- Cold, wet conditions (high humidity)
- Repeated, prolonged exposure of bare skin
- Can develop in only a few hours
- Ears, nose, cheeks, fingers, and toes
15. CHILLBLAINS
SYMPTOMS:
– Initially pale and colorless
– worsens to achy, prickly sensation then
numbness
– red, swollen, hot, itchy, tender skin upon
rewarming
– Blistering in severe cases
16. TRENCH FOOT
• Potentially crippling,
nonfreezing injury
• Prolonged exposure of
skin to moisture (12 or
more hours, days)
• High risk during wet
weather, in wet areas, or
sweat accumulated in
boots or gloves
18. TRENCH FOOT
SYMPTOMS:
– Initially appears wet, soggy, white, shriveled
– Sensations of pins and needles, tingling,
numbness and then pain
– Skin discoloration - red, bluish, or black
– Becomes cold, swollen and waxy appearance
– May develop blisters, open weeping or bleeding
19. FROSTBITE
• Exposure to below freezing
temperatures
• Can occur in above freezing
temperatures due to wind
chill factors and wetness
• Contact with extremely
cold objects (especially
metal)
30. DO’S & DON’T’S
DO’S
- Remove tight shoes, socks etc.
- Warm the injured parts (Not by direct heat)
- Cover the body with blankets
- Provide hot drinks and rest
- Cover blisters with dry dressing
- Treat as a stretcher patients
DON’T’S
- Don’t massage or rub the parts
- Don’t smoke or drink
