Passive cooling
Removing a patient in the hot environment
Remove clothing turning on the AC, gentle Fanning
Active cooling
Applying anything internal or external
Tempt water
Ice to growing in armpits, never directly on the skin
Stop active cooling if
The target is 38°
Shivering start as the body temperature can cause thermogenesis, which is shivering
Heat cramps
Decrease in water and electrolytes through sweating
Cramps and fingers
Mentally alert
Skin warm, moist and pale
May pass out
Passive cooling
Heat Exhaustion
High temperature, but under 40°
Cool clan the skin
Possible altered LLC
Abdo cramps
Risks for athletes, elderly, and children, and outside workers
Passive cooling
Heat stroke
Temperature over 40°
Hot dry skin
Altered mental status
Total failure of thermal regulation
Acceptable to do active cooling
Normal body temperature
36.5to 37.5
Mild hypothermia
35
Shivering
Increase in blood pressure, heart rate, and respiratory rate
Moderate hypothermia
30-34
Shivering stops
Altered
Decrease in heart rate bp
Severe hypothermia
Anything under30
Coma
Not shivering
Undetectable pulse
Passive rewarming
Removing the patient from the cold environment
Do not rush handle and moderate or severe as this can cause cardiac arrest
Remove wet clothing, crank up the heat cover patient with a blanket
Actively warming
Heat packs
Warm drinks
Nothing to direct skin or extremities warming to quickly can lead to rewarming shock
What happens in rewarming shock?
Vasoconstriction in the extremities due to the cold and build up a metallic acidosis warming too fast, causes a peripheral reflex phase of dilation,
a.k.a. pushing cold, bad blood to the core
What is the treatment for moderate to severe
Supine
Active rewarming
Plus, all your typical things
Treatment for hypothermic cardiac arrest
Max of three shocks in hypothermic arrest, and we want no brakes and CPR
Remember kids a patient is not dead until they’re warm and dead prolong revival is expected
Frostbite superficial 1 degree /2degree
1st Freezing of the epidermal tissue
Redness, followed by blanching
Both white, and waxy swelling
2nd BLISTERS
Deep Frostbite
Freezing of the epidermis and sub
White yellow mollted blue cold and frim
No sensation
Thawing equals extremely painful and purple This is where you can get a risk of amputation gangrene.
Superficial treatment
Passive rewarming
Do not use direct heat
Do not massage
Separate toes and fingers
Dry, sterile dressing
Reduce swelling by elevating
Deep Frostbite treatment
Do not thaw
Don’t allow it to thaw then refreeze keep it frozen
Direct diving emergency
Barotrauma expansions of gases
Indirect diving emergencies
Decompression illness
Hape vs hace
Hape is high, altitude, pulmonary oedema
Hace high altitude, cerebral oedema
Number one priority is getting out of the altitude
Freshwater versus saltwater, drowning
Fresh water washes out surfactant = aveoli collapse
Saltwater draws fluids from the bloodstream and pulmonary oedema occurs
Risk Factors to drowning
Male
Under 20
Pre-existing conditions
Ineffective, safety
Hyperventilation