Assessment
of Patient

Severe
Hypothermia: If the patient is cold and has any of the following
signs or symptoms, he is considered to have severe hypothermia:

a.
Temperature of 90O F (32.2O C) or less.


b.
Depressed vital signs, such as a slow pulse and/or slow respiration.


c.
Altered level of consciousness, including slurred speech, staggering
gait, decreased mental skills, or the lack of response to verbal or
painful stimuli.


d.
No shivering in spite of being very cold. (Note: This sign is
potentially unreliable and may be altered by alcohol intoxication.)
Mild Hypothermia: If the patient is cold and does not have any of the
above signs or symptoms, he is considered to have mild hypothermia.


Basic
Treatment for Hypothermia

1.
Prevent further heat loss. Insulate from the ground, protect from the
wind, eliminate evaporative heat loss by removing wet clothing or by
covering the patient with a vapor barrier (such as a plastic garbage
bag), cover the head and neck and move the patient to a warm
environment. Consider covering patient’s mouth and nose with a light
fabric to reduce heat loss through respirations.


2.
Activate the emergency medical services system to provide transport
to a medical facility.


3.
Do not give alcohol.


Treatment
for Mild Hypothermia

Treat
the patient as outlined in Basic Treatment for Hypothermia. If there
is no way to get to a medical facility, rewarm the patient gradually
by:


a.
Placing patient in as warm an environment as possible. b. Increasing
heat production through exercise and calorie/ fluid replacement. This
method of adding heat is particularly important when emergency care
is not readily available as in remote or prolonged transport
environment.


c.
Rewarming passively through the application of insulated heat packs
to high heat transfer/loss areas such as the head, neck, underarms,
sides of the chest wall, and groin, and heavy insulation to prevent
further heat loss.


d.
Considering warm showers and warm bath if the patient is alert.


e.
Placing patient in a sleeping bag and providing contact with a warm
body. The patient should not be placed a sleeping bag with another
individual who is hypothermic. This method should be considered a
last resort since it may endanger the rescuer and is less efficient
than other methods. Encourage the patient to drink warm fluids as
soon as he, or she, is capable of swallowing and protecting his or
her airway.

Treatment
for Severe Hypothermia with Signs of Life (e.g. Pulse and
Respirations Present)

Treat
the patient as for Mild Hypothermia above with the following
exceptions:

a.
Do not put severely hypothermic patients in a shower or bath.


b.
Do not give a patient oral fluids unless he or she is capable of
swallowing and protecting his or her airway. Treat patients who are
hypothermic very gently (do not rub or manipulate extremities).

Treatment
for Severe Hypothermia with No Life Signs

1.
Treat as above.


2.
If no pulse (after checking for up to 45 seconds) and no
respirations, start CPR.


3.
Use mouth-to-mask breathing.

4.
Reassess the patient’s physical status periodically. Transfer to a
medical facility as soon as possible.



From the State of Alaska Cold Injuries and Cold Water

Near
Drowning Guidelines (Rev 01/96).


Printed
in “The Eddy Line”, February 2005