Cold Emergencies

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Section 5 -MEDICAL 5.06

COLD EMERGENCIES

FROSTBITE: INITIAL MEDICAL/TRAUMA CARE (2.01/2.02).

  • Remove wet garments and move patient to a warm environment ASAP.
  • Elevate affected part and cover with loosely applied, dry, sterile dressings.
  • If ALS required: support airway, cardiac monitoring, IV, O2 saturation and end-tidal CO2
  • Refer to ANALGESIA / SEDATION PRACTICE PARAMETERS (2.04).
    • MORPHINE SULFATE 2 mg slow IVP, IO or IN every 2 minutes until pain relief achieved Contraindicated if systolic BP <90. IM administration may also be considered.

SYSTEMIC HYPOTHERMIA:

  • Mild / moderate 95-90 degree F. Conscious or altered sensorium with shivering.

INITIAL MEDICAL CARE (2.01):

  • OXYGEN @ 100% via NRB mask.
  • Warm IV fluids using hot packs.
  • Remove wet clothing and protect patient against heat loss and wind chill.
  • Place patient in horizontal position avoiding rough movement and excess activity.
  • Completely dry patient and cover patient with insulated blanket.


SEVERE SYSTEMIC HYPOTHERMIA:

  • Temperature of 90 Degrees F or less.
  • Patient may appear uncoordinated with poor muscle control or stiff, simulating rigor mortis.
  • There will be NO shivering.
  • Sensorium: confused, withdrawn, disoriented, comatose.

INITIAL MEDICAL CARE (2.01):

  • OXYGEN @ 100% via NRB mask or assist with BVM.
    • DO NOT INTUBATE UNLESS PATIENT IS APNEIC.
  • Warm IV tubing and OXYGEN tubing with hot packs.
  • Refer to appropriate Practice Parameters.
  • Refer to Systemic Hypothermia.
  • Administer no more than 3 defibrillations until re-warmed.