Cold Emergencies

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• Sensorium: confused, withdrawn, disoriented, comatose.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.