COLD INJURIES: DESCRIPTION, TREATMENT AND PREVENTION
Click here to download the presentation.
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withdrawn behavior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?
