CHAPTER 11

MEDICAL CONDITIONS RELATED TO COLD

W hen the body's core temperature falls below the range of 97.5 to 99.5 degrees, which is required for healthy body function and metabolism, hypothermia occurs.

There are several ways the body loses heat:

       Vapourization The body sweats, and as the sweat evaporates, the body becomes cooler.

       Radioactivity. Anytime the ambient (surrounding) temperature is lower than the body's core temperature; the body loses heat to the surroundings. If the outside temperature is 20 degrees, for instance, you will lose more heat than if it is 80 degrees.

       Conduct. When the body's surface comes into direct contact with freezing temperatures, like when someone jumps from a boat into icy water, the body loses heat. Since water is denser than air, it dissipates body heat more quickly.

The convection. For example, a cooler object moving against the body core might cause convection, a type of heat transfer. The body must expend energy to reheat the hot air that was previously present adjacent to the skin. One type of air convection is wind chill: If the outside temperature is 32 degrees, but the wind chill is 5, your body will lose heat as if the outside temperature were 5.

When the body is exposed to cold, it begins to produce heat. Shivering is the primary method of generating heat. The first sign of hypothermia is likely to be shivering, which muscles do to produce heat. If the patient is not warmed, more symptoms will surface as the illness progresses.

Other than shivering, the most obvious signs of hypothermia will be mental state-related: disorientation, lack of coordination, and lethargy. Speaking may become slurred as the disease advances, and the patient may nod or appear apathetic and uninterested in assisting themselves. This happens due to the brain's response to dropping temperatures: the brain functions more slowly when the body's core becomes colder. Although I have read of rare instances when humans (often youngsters) have survived considerably lower temperatures, brain activity stops at roughly 68 degrees.

Anticipating potential weather conditions and appropriate clothing is key to preventing hypothermia. The straightforward acronym COLD—which stands for cover, overexertion, layering, and dry—might be helpful to keep in mind:

Cover. Put on a hat to shield your head. By doing this, body heat won't be lost. Use mittens to protect your hands rather than gloves. Mittens are more beneficial than gloves because they keep your fingers in contact with one another. Thus, heat is preserved.

Overexertion. Avoid engaging in activities that make you sweat a much. You lose body heat quickly in cold conditions, and sweaty, wet clothes hasten the process. Utilize regular break periods to check for changes brought on by the cold. Layering. Pay close attention to how your group members are young, aged, or diabetic. Wearing layers of loose-fitting, lightweight clothing will keep you warm. For wind protection, wear garments composed of closely woven, water-repellent material. Cotton does not retain body heat, as well as wool or silk. A few synthetic materials are also effective.

Dry. As dry as you possibly can. As soon as you can, change out of your damp clothes. Pay close attention to your hands and feet because it's incredibly simple for snow to get into your gloves and boots.

Travelers should prepare for the weather, including windy and damp situations. If at all feasible, they should travel with a partner, prepare themselves physically for the challenge, and have enough food and water for the duration of the journey.

The impact that drinking alcohol can have in chilly weather is one thing that most people overlook. Alcohol may make you feel "warm," but in reality, it makes your blood vessels enlarge, which speeds up the rate at which heat escapes from the surface of your body. The expansion would counteract the body's efforts to stay warm because the body's response to cold is to constrict the blood vessels. Alcohol also impairs judgment, which could lead someone drunk to dress in clothing that won't keep them warm in the winter. The same is true of different "recreational" medications.

Until proven otherwise, you should always assume that a person in a chilly environment who is unconscious, disoriented, or lethargic is hypothermic.

To counteract the negative effects of hypothermia, immediate action is required. Make sure to follow these steps:

Get the person inside and warm. If you can't move the person, try to keep them as warm and wind-free as possible.

Remove soaked garments. Remove the person's damp clothing gently if they are wearing it. But many dry blankets over them, including the head (leave the face clear). Cover the ground if you're outside to prevent exposure to the chilly surface.

Watch your breathing. Severe hypothermia can render a person unconscious. Check the patient's pulse and make sure they are breathing. If required, start CPR.

Transmit body heat. Take off your clothes and lie next to the person, touching the skin to warm the person's body. Then wrap blankets around both of your bodies. Although this idea can make some people shudder, it's crucial to remember that you are attempting to save a life. It could be beneficial to rub or massage gently.

Give warm liquids to drink. Give the affected person a warm, non-alcoholic, non-caffeinated beverage to help warm the body if they are conscious and able to swallow.

Utilize dry, warm compresses. Apply a dry, warm compress exclusively to the groin, chest wall, or neck. Instead of applying warm compresses to the extremities, which occasionally worsens the condition, these locations will disseminate the heat much more effectively.

Don't use direct heat. Avoid warming the person with hot water, a heating pad, or a lamp. The intense heat puts stress on the heart and can harm the skin.

Hypothermia causes numerous organ systems to fail, resulting in death. People who get hypothermic from exposure to the cold are also more prone to cold-related wounds, including frostbite and immersion foot.

 

Immersion and Frostbite (Trench) Foot

Frostbite, or the freezing of human tissues, typically affects the ears and nose in addition to the extremities. Numbness and a "pins and needles" sensation are among the initial symptoms. The hue of the skin shifts from red to white to blue. Once the color turns black, gangrene develops. Gangrene is tissue death brought on by a lack of blood flow. Typically, the damaged body part is lost as a result.

Long-term immersion in water can damage neurons and small blood vessels, leading to immersion foot (formerly known as "trench foot"). While the affected foot may appear more swollen than frostbite, this condition resembles frostbite.

The injured extremities should be soaked in warm water (no hotter than 104 degrees) as a treatment for frostbite or immersion foot. Keep the following in mind when addressing these conditions:

Keep thawed tissue from freezing up once more. The extent of the damage depends on how frequently the tissue freezes and thaws. You should wait, but no more than a day, before treating your patient if you cannot stop them from being exposed to subfreezing temperatures again.

Frozen tissue should not be rubbed or massaged. Damage to already-harmed tissue will ensue by rubbing frostbitten tissue.

Never use a fire or a heat source to cure frostbite. People who have frostbite are numb and unable to feel the tissue that has been damaged. Burns that are severe may result.

Mild frostbite can be thawed using your body heat. For example, place them beneath your arm to warm up slightly frostbitten fingertips.

 

Cold Water Protection

Hypothermia can develop even in warm water. Heat will be lost from colder water than the body's natural temperature. You could pass out from hypothermia if submerged long enough off a tropical shore. Death from exposure is a typical occurrence in boating accidents and when people fall through the ice.

To prevent hypothermia if a boat capsizes, anyone going by boat should take the following precautions:

Don a life vest. Allowing you to float without expending a lot of energy and offering some insulation can prolong your life. The greatest life jackets have whistles built into them so you can signal for help.

Wear what you have on. Keep your clothes on when you're in the water. Zip or button up. Whenever you can, cover your head. You will be more protected from the cold if there is a layer of water between your body and your clothing. Once you're out of the water safely, take off your clothes only after you've done everything you can to stay warm and dry.

Get out of the water, even just a little bit. Less of your body will be exposed to the cold, causing you to lose less heat. Even if you can only get a portion of your body out of the water, clinging to a floating object will boost your chances of survival. If you don't have a dry area to swim to, don't waste your energy swimming.

To prevent heat loss, position your body. While you wait for assistance, use the heat escape lessening position (HELP) to minimize heat loss. Simply clasp your knees to your chest to prevent heat loss from your torso (the center of your body).

Group together. Keep warm by facing each other in a close circle and holding on to each other if you and your companions have fallen into the frigid water.

What if you're out on a hike outdoors and what appears to be a snowfield is a lake's frozen surface? It makes sense to bring a change of clothes in a waterproof container whenever you are out in the wilderness so you will always have dry clothing on hand in case you become wet. Additionally, have a wet-weather fire starter on hand.

You might be able to spot weak ice spots. A narrow patch of snow-covered ice on a lake often seems darker than the surrounding area. It's interesting how lighter-colored narrow patches of bare ice without snow seem. As you go, watch out for regions of contrasting hues.

Your heart rate, blood pressure, and breathing will increase due to sudden immersion in cold water. It is crucial to take the following actions:

  1. Remain calm. Before you give in to the cold, you still have some time.
  2. Take a deep breath and stoop to lift your head out of the water.
  3. Walk on water and get rid of weighty items.
  4. Make a U-turn and head back the way you came. There, the ice was sturdy enough
  5. On the ice, extend your arms widely.
  6. To lift a leg onto the ice, kick your feet to gain propulsion.
  7. When you're on the ice, roll back the way you came. Don't get up!

By rolling, you disperse your weight rather than putting all of it on your feet. Once you are safe, crawl away and start to warm up right away.

 

ALTITUDE SICKNESS

 

We could have to move from a residence at sea level to a mountain refuge in any survival crisis. You'll probably be moving quickly when you have to do this. Some people may get altitude sickness, often known as "acute mountain sickness," due to the abrupt elevation change (AMS). This syndrome develops when someone enters an environment with less oxygen availability and lower air pressures without first acclimating themselves.

Exertion worsens AMS and occurs most frequently at altitudes near 8,000 feet above sea level. Even while the illness is typically very brief, some patients may experience problems in the form of "edema" of particular organs. Edema is the buildup of fluid, and in altitude sickness, it can affect the brain or the lungs (pulmonary edema) (cerebral edema). Both of these ailments carry the potential to be fatal.

The greatest method of combating AMS, like many disorders, is prevention. Choose your retreat's path so that the elevation is as gentle as you can make it. Never attempt to climb more than 2,000 feet in one day. Ensure your employees don't push themselves excessively while climbing and supply enough fresh water. Avoid drinking alcohol while traveling.

Some ordinary people could be more susceptible to AMS at lower elevations than others. If you have to climb quickly, you should keep a tight eye on each party member. Typically, patients will show up with symptoms like a hangover. If they're minor, they typically involve:

Rest is necessary before treating AMS if only to halt further climb and give the body more time to adapt. A portable oxygen tank will be helpful as soon as symptoms appear if one is accessible. Carbohydrate-rich diets are believed to lessen negative consequences.

Acetazolamide is a drug that is frequently prescribed for both preventing and treating AMS (DiamoxTM). It has a diuretic effect, which expedites the body's natural process of eliminating extra fluid through urination. Acetazolamide takes between 125 and 1,000 mg daily, beginning two days before the ascent.

Normally, you should let your doctor know that you're planning a vacation to a high altitude and that you'd prefer to prevent altitude sickness. In an emergency, you'll typically be given a prescription for acetazolamide.

There is some proof that ginkgo giloba may aid with natural altitude sickness prevention. It has been demonstrated that a little dose of an extract of this chemical can help the brain handle decreased oxygen levels. Native Americans have benefited from utilizing ginkgo for AMS for ages.

WILDFIRE PREPAREDNESS

 

One of nature's methods for renewing the earth is fire. For some seeds to germinate, like those of the lodge pole pine, a fire must be present. Fire is a problem that poses a hazard to the people living there, despite its long-term advantages for the forest. Although wildfires can happen at any time of the year, summer is particularly risky in areas prone to drought.

Management of vegetation is one pertinent tactic. Your objective is to keep fires from spreading to your shelter. There are a few ways to accomplish this:

       Remove any dead wood that is close to your hideaway.

       You might want to think about clearing the area around your home of living vegetation. This can need you to get rid of the prickly shrubs you put there under your windows for protection.

       Use fire-resistant materials for your shelter. A wood-frame house with wooden shingles in a wildfire will burn up like match.

So let's establish a defensible space, a zone surrounding a building where wood and plants have been treated, removed, or otherwise modified to impede the progress of wildfire toward the building. A defensible area will also allow personnel battling the fire space to work.

If you're on flat land or a steep slope, you'll need a different amount of defensive space. Fires on flat terrain spread more slowly than those on slopes. (Flames and hot air rise.) Due to tiny pieces of burning trash in the air, a fire on a steep slope with an uphill wind will spread quickly and cause spot fires, which are little fires that start vegetation before the main burn.

Thick-canopied trees should be thinned out close to your home. This includes trees within 50 feet of your retreat on flat ground or 200 feet away on downhill terrain. Trees should be spaced 10–20 feet apart; remove branches less than 10–12 feet high. Remove all shrubs that are at the base of the trunks as well.

Of course, the natural impulse is to want to defend it once you have defensible space, even against a forest fire. You must regrettably remember that a lot of heat and smoke will surround you. Except if you're wearing complete fire protection gear, this will make things challenging. That will be the best action if there's a way out.

If you're leaving, ensure your supplies, any vital documents you might need to save, and some cash are already in the car. Make sure to turn off any air-conditioning system that brings outside air inside the house if you have electricity. Lock all doors, close all windows, and turn off all appliances. Tell people where you're going.

Dress in long pants, a long-sleeved shirt, and sturdy boots if there is a remote chance that you might become trapped in a fire. Wool is relatively fire resistant; thus, using a wool blanket as an additional exterior layer is very beneficial.

Stay on the side of the building, far from the fire outside if you're inside a structure. Pick a space with the fewest windows possible. (Windows allow heat to enter the room.) Until you are forced to leave due to smoke or a building fire, remain there.

In that case, cover yourself with the blanket, exposing only your eyes. Some people believe that wetting the blanket first is a good idea. Don’t. Wet materials will result in more serious burns since they transfer heat more quicker than dry ones.

Stay low and, if necessary, crawl out of the building if you're having problems breathing due to the smoke. The lower you descend, the less heat and smoke there is. Keep your chin in and look down at the ground. It will safeguard your airway. Eyewash should be included in your kit because smoke affects the eyes.

Act promptly if you come across someone who is genuinely on fire. Keep in mind the classic saying "stop, drop, and roll" when someone's clothing is on fire:

Stop. The victim will likely be in a panic and be frantically putting out the flames. As a result, the wind is produced, which will fan the flames. Halt the victim from fleeing.

Drop. To the ground, knock the victim. Wrap them in a blanket if you can. The greatest textiles are those that are heavy.

Roll. Till the flames are put out, roll the victim on the ground. Any burned skin should be immediately cooled with water.

 

Smoke Inhalation

In addition to burns, which are covered in another section of this book, breathing too much smoke can cause serious illness or even death. Remember that burns to your skin can heal, but burns to your lungs cannot. The following are typical causes of smoke inhalation injury:

       Easy combustion Near a fire, combustion depletes the oxygen, resulting in hypoxia, a condition that can be fatal. The more oxygen is removed from the environment, especially in a closed space, the greater the fire is.

       Irritants from chemicals. When they come into touch with it, numerous substances present in smoke might irritate or injure the lungs. This results in edema and airway blockage and is analogous to a burn within the lung tissue. Chlorine gas is an illustration from World War I.

       Additional asphyxiants. The body's ability to utilize oxygen may be hampered by carbon monoxide, cyanide, and certain sulfides. The most frequent of these is carbon monoxide.

Symptoms may include the following:

       Cough

       Shortness of breath

       Hoarseness

       Upper airway spasm

       Eye irritation

       Headaches

       Pale, bluish, or even bright-red skin

       Loss of consciousness leading to coma or death

Soot around the mouth, throat, and nasal passages may be seen during your examination of the patient who has inhaled smoke. These areas could be inflamed and swollen. The victim is most likely to have a raspy voice and be out of breath.

Of course, you'll want to move your patient away from the smoke and into a fresh-air environment. You must be careful not to put yourself in a position where smoke inhalation would likely result in your death. Before entering a fire to rescue a victim, always think about wearing a mask. If CPR is required, be ready to perform it.

It's crucial to have a method for providing oxygen to your patient in case it's necessary. Portable oxygen canisters are available to deliver oxygen to the lungs fast.

Expecting a quick recovery after severe smoke exposure is unrealistic. With even the smallest movement, your patient will feel out of breath and sound very hoarse. These symptoms might go away with time or be lifelong limitations.

Your team can leave dangerous circumstances swiftly if you plan escape routes and hold regular exercises. You will gain valuable time if everyone knows what to do in advance.

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