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COLD INJURIES: DESCRIPTION, TREATMENT AND PREVENTION

 

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COLD INJURIES: DESCRIPTION, TREATMENT AND PREVENTION

Introduction

Prevention of cold injuries is a Command and Individual Responsibility

ALL COLD WEATHER INJURIES ARE PREVENTABLE!!!

Outline

Susceptibility Factors

Cold Weather Injuries

description

treatment

prevention

Conclusion

Regulation of Body's Temp

Body's heat production

metabolism

exercise

shivering

Heat loss

convection

conduction

radiation

respiration

evaporation

Typical Victim of a Cold Weather Injury

Male

E-4 or below

Approximately 20 years old

From a warm climate

Less than 18 months time in service

Uses tobacco, alcohol or medications

Neglects proper foot care

Susceptibility Factors

Previous cold weather injury

Inadequate nutrition

Alcohol, caffeine, nicotine

Dehydration

Overactivity

Underactivity

Long exposure to the cold

Sick or injured

Acclimatization

Ethnic/geographic origin

Wind, cold, rain

Age

Discipline and morale

Physical stamina

Inadequate training

Poor clothing and equip

Types of Cold Injuries

Hypothermia

Frostbite

Chilblains

Immersion/Trench Foot

Dehydration

Constipation

Sunburn

Snow Blindness

Carbon Monoxide Poisoning

Hypothermia

MEDICAL EMERGENCY; life threatening condition

Severe body heat loss-body temp falls below 95oF

Occurs when:

conditions are windy, clothing is wet, and/or the individual is inactive

extended water exposure or immersion

1 hour or less when water temp is below 45oF

prolonged exposure in slightly cool water (e.g. 60oF)

thunderstorms, hail, rain and accompanying winds

Hypothermia

Initial Symptoms

shivering

dizzy, drowsy

withdrawn behavior

irritability

confusion

slowed, slurred speech

altered vision

stumbling

Severe Stages

stops shivering

desire to lie down and sleep

heartbeat and breathing is faint or undetectable

unconsciousness followed by DEATH

Hypothermia

Treatment

prevent further cold exposure

evacuate immediately if severe hypothermia

remove wet clothing

rewarm with body-to-body contact or in a warmed sleeping bag

warm, sweet liquids if conscious

give CPR if needed

Hypothermia

Prevention

eat properly and often

warm liquids (noncaffeinated) and water

wear uniform properly (layers worn loosely)

keep active

stay dry

warming tents

get plenty of rest

buddy watch/observation/NCO checks

Frostbite

Air temps below 32oF

skin freezes at 28oF

Superficial frostbite (mild)

freezing of skin surface

Deep frostbite (severe)

freezing of skin and flesh, may include bone

Hands, fingers, feet, toes, ears, chin, nose, groin area

Frostbite

Symptoms

initially redness in light skin or grayish in dark skin

tingling, stinging sensation

turns numb, yellowish, waxy or gray color

feels cold, stiff, woody

blisters may develop

Deep Frostbite

Frostbite

Treatment

remove from cold and prevent further heat loss

remove constricting clothing and jewelry

rewarm affected area evenly with body heat until pain returns

when skin thaws it hurts!!

do not rewarm a frostbite injury if it could refreeze during evacuation or if victim must walk for medical treatment

do not massage affected parts or rub with snow

evacuate for medical treatment

Frostbite

Frostbite

Prevention

wear uniform properly (layers and loosely)

keep socks and clothing dry (use poly pro/thermax liner socks and foot powder/ change insoles also)

protect yourself from wind

drink hot fluids and eat often

keep active

insulate yourself from the ground (sleeping pad/tree branches etc...)

"Buddy System"

warm with body heat

caution skin contact with super-cooled metals or fuel

seek medical aid for all suspected cases

Chilblains

Nonfreezing cold injury

Cold, wet conditions (between 32-60oF, high humidity)

Repeated, prolonged exposure of bare skin

Can develop in only a few hours

Ears, nose, cheeks, fingers, and toes

Chilblains

Symptoms:

initially pale and colorless

worsens to achy, prickly sensation then numbness

red, swollen, hot, itchy, tender skin upon rewarming

blistering in severe cases

Chilblains

Treatment

prevent further exposure

wash, dry gently

rewarm (apply body heat)

don't massage or rub

dry sterile dressing

seek medical aid

Chilblains

Prevention

keep dry and warm

cover exposed skin

wear uniform properly

use the "Buddy System"

Trench/Immersion Foot

Potentially crippling, nonfreezing injury (temps from 50oF-32oF)

Prolonged exposure of skin to moisture (12 or more hours, days)

High risk during wet weather, in wet areas, or sweat accumulated in boots or gloves

Trench/Immersion Foot

Symptoms

initially appears wet, soggy, white, shriveled

sensations of pins and needles, tingling, numbness, and then pain

skin discoloration-red, bluish, or black

becomes cold, swollen, and waxy appearance

may develop blisters, open weeping or bleeding

in extreme cases, flesh dies

Trench/Immersion Foot

Trench/Immersion Foot

Treatment

prevent further exposure

dry carefully

DO NOT break blisters, apply lotions, massage, expose to heat, or allow to walk on injury

rewarm with body heat

clean and wrap loosely

elevate feet to reduce swelling

evacuate for medical treatment

Trench/Immersion Foot

Prevention

keep feet dry

change socks at least every 8 hours or whenever wet and apply foot powder

bring extra boots to field

no blousing bands

report all suspected cases to leadership

Dehydration

A loss of body fluids to the point of slowing or preventing normal body functions

Increases chance of becoming a cold weather casualty, esp hypothermia

Can lead to heat cramps or heat exhaustion

Dehydration

Symptoms

dark urine

headache

dizziness, nausea

weakness

dry mouth, tongue, throat, lips

lack of appetite

stomach cramps or vomiting

irritability

decreased amount of urine being produced

mental sluggishness

increased or rapid heartbeat

lethargic

unconsciousness

Dehydration

Treatment

drink WATER or other warm liquids

avoid caffeinated liquids (sodas, coffee, tea)

do not eat snow

rest

Dehydration

Prevention

drink minimum of 3 canteens of water daily for inactivity and 5-6 quarts for activity

monitor urine color

do not wait until you are thirsty

drink hot liquids for warmth (non-caffeine)

Constipation

Infrequent or difficult passage of solid human waste

Symptoms

loss of appetite

headache

cramping

painful defecation

Constipation

Treatment

water consumption

medical treatment may be necessary

Prevention

drink 4-6 quarts water daily

available latrine facilities protected from the elements

eating properly, esp high fiber foods such as fruits, vegetables, whole grain breads

Sunburn

Burning of the skin due to overexposure to the sun and UV light

Contributing factors

fair skin, light hair

exposed skin

reflective qualities of the snow

high altitudes

Symptoms

redness of skin, slight swelling (1st deg)

prolonged exposure (2nd deg)

pain and blistering

chills, fever, headache

Sunburn

Treatment

soothing skin creams in mild cases

in severe cases, seek medical attention

aspirin for pain

Prevention

cover exposed skin with clothing

sunscreen, lip balm

limit exposure of skin to the environment

Carbon Monoxide Poisoning

When oxygen in the body is replaced by carbon monoxide

colorless, odorless, tasteless gas resulting from incomplete combustion

Inadequate ventilation from engines, stoves, heaters

Carbon Monoxide Poisoning

Symptoms

headache

dizziness

weakness

excessive yawning

ringing in ears

confusion

nausea

bright red lips, eyelids

drowsiness

unconsciousness

possibly death

Carbon Monoxide Poisoning

Treatment

move to fresh air immediately

seek medical aid promptly

provide mouth-to-mouth resuscitation if victim is not breathing

Carbon Monoxide Poisoning

Prevention

ensure proper ventilation

don't use unvented heaters or engines

ensure heaters are regularly serviced

turn heaters off when not needed (during sleep)

never sleep in vehicle with engine running

never wrap poncho around vehicle exhaust to collect heat

Snow Blindness

Inflammation and sensitivity of the eyes caused by ultraviolet rays of the sun reflected by the snow or ice

Symptoms

gritty feeling in eyes

redness and tearing

eye movement will cause pain

headache

Snow Blindness

Treatment

remove from sunlight

blindfold both eyes or cover with cool, wet bandages

seek medical attention

recovery may take 2-3 days

Prevention

eye protection

dark, UV protective glasses

field expedient-cut narrow slits in MRE cardboard and tie around head

do not wait for discomfort to begin

Conclusion

Dress properly

Drink plenty of fluids

Eat right

Keep in shape

Get plenty of rest

Minimize periods of inactivity

Maintain a positive attitude

Reference Materials

Center for Army Lessons Learned Newsletter No. 97-5 Winning in the Winter

Technical Note No. 92-2 Sustaining Health and Performance in the Cold: Environmental Medicine Guidance for Cold-Weather Operations

TC 21-3 Soldier's Handbook for Individual Operations and Survival in Cold-Weather Areas

FM 31-70 Basic Cold Weather Manual

FM 21-10 Field Hygiene and Sanitation

FM 21-11 First Aid for Soldiers

TB MED 81 Cold Injury

FD Pam 40-5 Win in the Heat and Cold: Climatic Injury Prevention Guide

QUESTIONS?