Mildly hypothermic person, that is fully awake, conscious, and is shivering actively has the ability to recover spontaneously when remover from the cold water. He/she does not need emergency treatment, but should be evaluated in a medical facility as soon as possible. Dry clothing, keep warm, give warm sugar-containing fluids. Do not give coffee, tea, alcohol.
Moderately hypothermic victims should be urgently transported to an emergency care facility. Dry clothing, keep wann, could put in a sleeping bag with a normothermic person. They can be given warm, sugar-containing liquids only if they are awake and able to swallow. Avoid coffee, tea, alcohol.
Severely hypothermic patients:
- no palpable pulse, no respirations CPR, EMS activation
- palpable carotid pulse, slow respiration no CPR, EMS activation Even 2-3 heart beats/mm and 1-2 breaths/mm may be enough to sustain life. Make sure that you check the carotid pulse for at least 1 frill minute. Starting CPR in such victim may be harmful cold heart muscle is very sensitive to mechanical insult.
- palpable pulse present, no respiration start rescue breathing, EMS activation
Keep positive attitude! Even if they appear dead, severely hypothermic victims have been successfully revived after being warmed up. Remember, a hypothermia victim is never cold and dead, only warm and dead!
Stabilization and insulation
The main goal is to stabilize the core temperature with minimal after-drop.
1. remove
victims wet clothing
2. keep
movements of the body to minimum and handle very gently
3. dry
out the skin
4. put
on dry, insulating clothing, sleeping bags, blankets
5. administer
humidified heated air or oxygen to the victim via mask if available
6. conservative
application of moderate external heat to neck, trunk, groin areas hot-water
bottles, hot packs, heating pads avoid direct contact with the skin
7. body-to-body
rewarming in a sleeping bag, lateral chest to lateral chest
8. administration
of warm-hot liquids orally only in completely conscious victim with intact
gag and cough reflexes, who is able to swallow
9. alcohol
is absolutely contraindicated! !!!
Transportation
Mildly hypothermic victims could be treated in any emergency care facility.
Moderately and severely hypothermic persons should de transported to facility equipped to handle potential complications and provide core rewarming such as cardiac bypass equipment.
Adriana Manikian, MD
NYU School of Medicine Bellevue Hospital