Ch. 9 COLD INJURIES

Question 1

What is normal body temperature?

Answer 1

98.6F

37 C

Question 2

The three main physiological means for producing heat

Answer 2

• Resting metabolism (increases slightly when exposed to cold for long periods of time. Is not enough to satisfy heat requirements in winter)
• Exercise (muscles produce 73% of heat generated in work)
• Shivering ( Our first defense against cold. a random quivering of muscles creates heat 5x greater than basal metabolic rate)

Question 3

Name the 4 mechanisms of heat loss

Answer 3

primary heat loss is through the skin

• conduction, transfer of heat through direct contact with cold object
• convection, heat loss to moving air or water
• radiation, transfer of heat from hot object to cold without direct contact
• evaporation, through sweat/breathing

Question 4

What is Hypothermia?

Answer 4

Core temp drops below 95 degrees F

Body is losing more heat than it can produce

Question 5

1. Shivering numb skin with gooses bumps
2. Stiff and clumsy fingers (muscle impairment)
3. poor decisions, slow and sluggish thinking (mental deterioration)

Answer 5

Mild hypothermia

Begin warming techniques

Question 6

1. Stumbling, Apathy(lack of interest), lethargy(lack of energy)
2. complaining (Obvious mental changes)
3. stumbling/fall, clumsy hands (Obvious muscular incarnation)

Answer 6

Moderate Hypothermia

rapid evacuation

Question 7

1. Shivering stops (Energy reserves are depleted)
2. Irrational behavior, Incoherence, Disorientation (Obvious Mental Deterioration)
3. Heart Rate and blood pressure Fall
4. severe muscular rigidity
5. Undetectable Pulse/Respiratory Rate

Answer 7

Severe Hypothermia

rapid evacuation

Question 8

Warming techniques for Mild/Moderate hypothermia

Answer 8

Determine cause of hypothermia 
Replace wet cloths with warm dry ones
Shield from wind
Give patient Hot food and drink
Encourage patient to move
Place in sleeping bag
Build a shelter/fire
Hypothermia Wrap

Question 9

What causes Hypothermia?

Answer 9

Heat loss is > than heat gain causes or sudden loss of heat

Question 10

Describe a Hypothermia Wrap

Answer 10

1. Lay out a tarp on the ground.
2. Place 1 or 2 pads down on top of the tarp.
3. Stack three sleeping bags on top of the pads.
4. Place the victim inside the sleeping bag in the middle.
5. Provide the victim with hot water bottles.
   A. Hold in hands on Chest
   B Place by feet to prevent Frost-Bite
6. Wrap the victim in the tarp.

Question 11

What causes frostbite?

Answer 11

Cold Stress
Low temps
Moisture
Poor insulation
Contact with cold metal/Gasoline
Tight clothing(restricting blood flow)
Dehydration

Question 12

What is frostbite

Answer 12

Freezing of tissue

This freezing draws water out of the cells, causing blood flow to stop further damaging cells.

Question 13

what happens to cells during the thawing of frostbite

Answer 13

the frozen cells release clotting chemicals

Question 14

What are the 3 stages of frostbite

Answer 14

Superficial (Frost Nip)
Skin appears grey and mottled
after warming skin turn red and peel off

Partial Thickness
Progresses to inner tissues may appear hard on surface and resilient below
during thawing blisters will occur

Deep or full Thickness
extends from skin to underlying tissues and muscle appears like partial thickness and frost nip but is complete hard
after thawing blood filled blisters, may or may not blister

Question 15

cold, waxy, hard, or mottled skin

Answer 15

signs of Frostbite

Question 16

how to thaw frost nip?

Answer 16

Frost nip can be warmed by sticking fingers in armpits feet on bellies

This process is painful ibuprofen, and Aspirin help with pain
Do not Rub

Question 17

How to thaw Partial/Deep thickness frostbite

Answer 17

Treated with rapid warming in submerged in warm water between 99-102 degrees F, Skin to skin maybe more practical (armpits for hands and bellies for feet) do not allow for slow warming!

This process is painful ibuprofen, and Aspirin help with pain.
Do not Rub

Question 18

Post Thaw care for frostbite/nip

Answer 18

Do not rub 
Air dry
Do not pop blisters
gause between fingers and toes
Ibuprofen can help with pain and swelling
Do not allow refreeze

Question 19

describe these non freezing cold injuries?

Immersion foot (Trench foot)

Chill Blane

Pernio

Answer 19

Immersion foot (Trench foot)
Happens in the cold and wet conditions
Lack of blood and nutrients to the extremity

Chill Blane
Nodular bumps
inflammation from exposure to cold non freezing air

Pernio
Severe Chill Blains that may result in blisters

Question 20

Skin is cold swollen mottled grey waxy and pale
tingling numbness and pain
slow capillary refill time
after warming skin maybe warm red swollen and painful
sever cases blisters and gang green

Answer 20

Signs and symptoms of non freezing cold injury

Question 21

treatment of non freezing cold injury

Answer 21

slowly at room temp
elevate to reduce swelling
Ibuprofen to help with pain and swelling

Question 22

Preventing Non freezing injuries

Answer 22

Military
well fitting boots with thick warm wool socks
keeping body warm/dry
keep feet out of water and mud
reacting quickly to numbness and tingling
Massaging feet twice per day
sleep with dry feet

NOLS instructors
Dry your socks
Sleep with warm dry feet
Travel early keep time to tend feet
Stay out of slushy snow conditions (midday)
look at feet twice a day
Model good foot care
use proper equipment
Do not over tighten equipment on feet

Question 23

Evacuation Hypothermia

Answer 23

Mild can be created in field

Severe must gently and rapidly evacuated for hospital warming

Question 24

Evacuation for Frostbite

Answer 24

Isolated less than a quarter can be left in the field if you can prevent refreezing

larger than quarter evacuate

Question 25

Evacuation for Non freezing

Answer 25

Pain dictates