MOD F TECH 47 Extremes of Body Temperature

Question 1

Extremes of Body Temperature

Answer 1

•Normal body temp

–36.9°C

–

•Abnormally low body temp

–Hypothermia

–

•Abnormally high body temp

–Hyperthermia

• Heat Exhaustion
• Heat Stroke

Question 2

Hypothermia

Answer 2

•is a lowering of the body core temperature below 35°C

•

•Heat may be lost in 4 ways:

–Convection – carried by moving air

–Conduction – passing onto a solid object

–Radiation – dissipating into surrounding air

–Evaporation – through evaporation of water from skin or wet clothing

Question 3

Hypothermia

3 classifications

Answer 3

1.Acute Hypothermia = immersion hypothermia were person looses heat very quickly e.g. falling in cold water

●

2.Subacute Hypothermia = Hill walkers who becomes exhausted and unable to generate body heat.

●

3.Chronic Hypothermia = heat loss occurs slowly over days usually. Elderly or homeless

Question 4

Causes of hypothermia

Answer 4

•Cold environment - unheated room

•

•Exposure to cold weather

•

•Immersion in cold water

•

•Inadequate clothing or diet

Question 5

Hypothermia

•Risk groups:

Answer 5

–The elderly – live alone, inadequate heating & food, immobility

–Young babies - no thermal regulator especially premature –

no shivering reflex

–People involved in outdoor activities in Winter

–Water Sports even in Summer

–Alcoholics

–Chronic Illness

Question 6

Hypothermia

Answer 6

Question 7

Hypothermia in adults

Answer 7

• Slow heart rate <40 may be undetectable
• Skin ice cold to touch
• Pale, peripheral cyanosis, appears dead - moribund
• Dilated pupils, unreactive
• Breathing slow, shallow, undetectable
• Reducing LOC, slurred speech
• Visual disturbance
• Irrational behaviour
• Stumbling
• Collapse

Question 8

Hypothermia - Management

Answer 8

• ABC’s
• Handle gently!
• Administer O2 aiming for 94% - 98%
• Wrapping patient enough to prevent further heat loss and moving to a warm environment
• Allowing the body to recover gradually
• Giving hot drinks if the patient is fully conscious and uninjured
• Check blood sugars
• Remove to Hospital

DO NOT….

•

–Strip clothing unless wet and in vehicle

–Give alcohol

–Rub the patient’s skin

Wrap cold patients in foil blankets

In cardiac arrest:

•Defibrillation is not likely to be effective if the patient’s core temp. <30oC

•

•If with clinician – attempt one loop of defibrillation/drugs then BLS only

•

•DON’T STOP RESUSCITATION IN THE FIELD

Question 9

Hypothermia in babies

Answer 9

• Remember that babies have not got fully developed reflexes so may not shiver even when very cold….
• Pale, unwell appearance
• Unwell, not crying, no appetite, no interest in surroundings
• Cold to touch

Management

• Hazards ABCD
• Cover the baby to prevent further heat loss
• Warm baby gradually
• Suspect hypothermia in all cases of near drowning.
• Dilated pupils, undetectable pulse, minimal respiration.
• Commence & maintain resuscitation

Question 10

•Suspect hypothermia in all cases of near drowning.

•

•Dilated pupils, undetectable pulse, minimal respiration.

•

•Commence & maintain resuscitation

Answer 10

Resuscitation

They’re not dead until they’re warm and dead!!

Question 11

Local Cold Injury - Frostbite

Answer 11

• Can be superficial (close to surface of skin) or deep
• Normally involves exposed areas – fingers, ears, nose etc.
• Comes on slowly and is generally not painful
• Skin may be white / waxy, feels numb
• As thawing occurs, area looks mottled blue and patient experiences a hot stinging sensation
• Blisters may develop within a few hours

Question 12

Frostbite - Treatment

Answer 12

• Get out of the cold
• Rewarm the injured part with body heat
• Cover any blisters with a dry, sterile dressing

Do not

Rub or massage a frost bitten area

Rub snow on a frostbitten part

Apply ointments

Apply tight bandages

Allow a thawed extremity to refreeze

Handle a frostbitten extremity roughly

Question 13

Hyperthermia

Answer 13

• Heat Exhaustion
• Heat Stroke

Question 14

Effects of Extreme Heat

Answer 14

•In extremely hot conditions, the body’s heat loss mechanisms may fail.

•

• When the atmospheric temperature equals the body temperature, it becomes impossible for the body to lose heat by radiation. If there is also high humidity (when the air is laden with moisture), sweat does not evaporate well.
• In these circumstances, particularly during strenuous exercise when extra heat is generated by muscular activity, heat exhaustion, or the more dangerous condition, heatstroke, may develop.

Question 15

Hyperthermia

Answer 15

•Heat Exhaustion (38 °C)

–Caused by excessive sweating combined with inadequate water intake

–

•Heat Stroke (40 °C)

–Occurs as body starts to dehydrate resulting in

• Hypothalamus breaking down
• Body continuing to produce heat with no means of cooling, in effect overheating

Question 16

Heat Exhaustion & Heat Stroke

Answer 16

Overheating = loss of body fluids and salts.

Heat exhaustion progresses to heat stroke - an acute medical condition with high mortality rate.

Question 17

Heat exhaustion

Answer 17

• Usually develops gradually and is caused by loss of water and salt from the body by excessive sweating accompanied with inadequate fluid intake
• More common in people who are

unaccustomed to working or exercising in

a hot, humid environment, and in those

who are unwell, especially with

diarrhoea and vomiting.

•Heat is still being produced but the body

has no way of cooling

•Can often lead to Heat Stroke if not managed early and effectively

Question 18

People at Risk…

Answer 18

–People working in high temperature environments

–People in the sun for long periods of time

–Excessive physical exertion, for example military personnel exercising, or people who have taken Ecstacy

Question 19

Hyperthermia – S&S

Answer 19

• Unconsciousness – sudden and deepening
• Initially a rapid and weak pulse, becoming full and bounding
• Shallow breathing, becoming rapid, noisy and panting
• Headaches and dizziness developing into confusion and delirium
• Muscular cramps and twitching
• Initially pallid colour, turning flushed
• Sweating and warm skin, becoming dry and very hot

Question 20

Signs & Symptoms

Answer 20

Heat exhaustion;

May have flu-like symptoms such as:

• Headache
• Nausea
• Dizziness
• Cramps
• Tachycardia
• Sweaty

Heat stroke;

Neurological symptoms

such as:

• Decreased level of consciousness
• Ataxia
• Convulsions
• Sweating may well be absent

Question 21

Heat Exhaustion - Management

Answer 21

• ABC’s
• Move to a cool environment
• Place patient at rest
• Cool drinks in small regular quantities
• Sponging with luke warm water

Question 22

Heat Stroke - Management

Answer 22

• Remove as much clothing as possible
• Wrap in a wet sheet (if available)
• Fanning the patient vigorously
• Placing cold packs under the arms, in the groin area and around the neck
• Treat the patient accordingly if unconscious

Question 23

Dehydration
Drink before you feel thirsty!

Answer 23

Question 24

Febrile Convulsions

Answer 24

• Sudden rise in body temperature
• Caused by excessive fever
• Usually affect children up to 3 years
• Parents have usually tried ‘Calpol’ to no avail
• Hazards ABCDE
• Remove child’s clothes
• Clinicians will consider Paracetamol (Calpol)