SNOW-BLINDNESS AND CARBONMONOXIDE

Deep freezing injuries
Symptoms
•
Hard, waxlike appearance of the skin
•
The skin is NOT MOVABLE in relation to deeper tissue and bone
•
The appearance of oedema with miscoloured fluid
•
Frozen skin, dermis and possibly also frozen muscle and bone tissue
First Aid
•
Do NOT thaw the injury on the spot
( Injury is thawed in hospital )
•
Shelter patient - blankets and clothing
•
Give warm non-alcoholic beverage
•
Avoid further deterioration
•
Evacuate to hospital
Preventive measures to avoid hypothermia,
non-freezing injuries and freezing injuries
Strict control and disipline
•
Food – a MINIMUM of one warm meal a day, preferably two ( every 6th hour )
•
Water – minimum 2,5 litres a day. Warm drinks when possible
•
Sleep – minimum 4 hours a day
•
Physical activity – adjust clothing according to activity and conditions
•
Avoid tight clothing and ventilate sufficiently
•
Carry out inspection of feet minimum once daily and when conditions call for it. Must be
carried out by superiors
•
Wash/rub feet, control condition and use dry socks when possible
•
Ongoing buddy control. Keep an eye on one another
•
Avoid shaving when temperatures are extremely low. If needed, shave the day before
•
Areas with previous freezing injury must be properly protected.
•
Keep dry and warm clothing for head and hands available!
•
Avoid the use of soap in the face.
•
Ensure that you are well prepared for:
- Prevention, signs and symtom
- First Aid and treatment
REPORT IMMEDIATELY UPON SUSPICION OF FREEZING INJURIES.
BE ACTIVE AND AWARE!
SNOW-BLINDNESS AND CARBONMONOXIDE POISONING
Snow-blindness
Definition
Snow-blindness occurs as a result of the eyes being affected by excessive amounts of ultraviolet
radiation from the sun.
Symptoms
The symptoms appear 6-12 hours after a person has been exposed to the strong sunlight, often in the
evening or during the night.
•
Agonizing pain in the eyes
•
Tears
•
May be mistaken for sand or particles in the eye
•
The discomfort increases when exposed to light
•
Redness in the eyes
•
Musclespasms around the eyes
Symptoms
•
Headache, dizziness, nausea, vomiting, distortion of sight and rapid pulse, shortness of breath.
•
Reduced consciousness, possibly towards coma, cramps and circulatory collaps.
•
When the pink colour under nails/mucous membranes becomes increasingly stronger, the
condition is dramatic.
The effect of CO-poisoning occurs even before symptoms are visible. The symptoms are few and hard
to detect.
Prevention
•
Ventilation during use of cooking stove
•
Use a lid on the pot to reduce cooking time
First Aid
•
Bring the patient into fresh air
•
ABCDE
•
Avoid re-exposure to source because of long half-time!
•
Consult medical personnel.
First Aid
•
The damage is superficial and heals relatively fast. The pain is short-lasting. Improvement can
be expected within 24-48 hours of treatment.
•
The patient must rest in a dark place with eyes covered.
•
Medical personnel will often use eye drops with anaesthetics before evaluating the eyes.
Anaesthetics will help relax the muscles around the eyes.
•
Kloramfenicol (antibiotics) is recommended during the first 24 hrs of treatment. The
medication is available both as ointment and eye drops.
Prevention
•
Use of sunglasses, also in cloudy weather.
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Carbonmonoxide (CO) poisoning
Definition
CO is formed as a result of incomplete combustion of fuel in cooking stoves.
The purpose of this folder is to provide a checklist for symptoms and First Aid with
the regard to Cold Weather Injuries. The folder is meant to contribute to awareness
regarding the prevention of Cold Weather Injuries.
Proper ventilation prevents CO-poisoning. Be especially aware when melting snow on a cooking stove.
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HYPOTHERMIA, FREEZING INJURIES AND NON-FREEZING INJURIES
Temperature related injuries are categorized as HYPOTHERMIA, NON-FREEZING INJURIES
FREEZING INJURIES and HEAT INJURIES. Heat injuries are not dealt with in this folder.
HYPOTHERMIA
Definition
A general cooling of the body to core temperatures below 35° C (~rectal measure)
Mild
35 – 33 ° C
Moderate 33 – 30 ° C
Deep
< 30 ° C
Causes
Exposure to cold, humid weather and/or poor clothing. Exposure to cold water.
Mild hypothermia 35 – 33 ° C
Symptoms
• Decrease in consciousness – lethargy, confusion, apathy
• Cold hands and feet
• Shivering (a natural reaction)
• Normal to rapid puls and respiration rate
First Aid by mild hypothermia
The person is able to activate him/herself if necessary with assistance by:
• Seeking shelter, put on warm clothes, wrap up
• Warm non-alcoholic beverages
• Physical activity
• Speed march, activate large muscle groups to produce body heat
The extremities of the body are
susceptible to heat loss in cold
conditions
Moderate hypothermia 33 – 30 ° C
Symptoms
• Further decrease in consciousness increased lethargy, confusion and apathy
• Stiffness of the muscles
• Slow pulse and respiration rate
• Irrational behavior – paradoxical undressing
First Aid by moderate hypothermia
The patient is incapable of regaining body heat on his/her own and has become dependant on care:
• Seek shelter, put on warm clothes, wrap up
• Share body heat, lie undressed next to patient
• Provide warm non-alcoholic beverages
• Wrap the patient in blankets/survival sheets/sleeping bag
• Monitor the patient
• Further treatment in hospital
NON-FREEZING INJURIES
FREEZING INJURIES
Definition
A local injury occurring in temperatures ranging from 0 to +10 degrees Celsius. The injury occurs
with a persistent skin temperature of +8 degrees Celsius or lower.Non-freezing injuries are a result
of prolonged exposure to low temperatures, in combination with humidity. By prolonged period one
refers to 10 hours or more. Non-freezing injuries may, however, occur after shorter periods of time.
The blood vessels will constrict as a result of a lowering of the core temperature, blood circulation is
impaired and as a result oxygen and energy are prevented from reaching the cells.
Definition
A local freezing injury is tissue damaged by ice crystals forming in the cells and puncturing or
bursting cell membranes. This, in turn, often leads to the retention of fluid after thawing of the damaged area. For a freezing injury to occur, hence, temperatures need to sink below 0 degrees Celsius.
Deep hypothermia < 30 ° C
Symptoms
• Unconsciousness or coma
• White, cold skin
• Expanded and rigid eye pupils
• Slow pulse rate – hard to detect
• Slow respiration rate – hard to detect
• Vital signs may seem absent, but the patient must not be declared dead
Symptoms
• Numbness and prickling sensation in the skin
• Reddish skin – developing into white/bluegray skin
• Oedema – blisters
• Bleeding
First Aid by deep hypothermia
Implement ABCDE-principles
• Careful treatment
• CPR preparedness
Avoid further loss of body temperature
• Avoid further exposure to
cold and shelter the
patient
• Remove wet clothing, dress the
patient in dry clothes. If no dry
clothes are available,
– wrap the patient
in plastic
Temperature
calm air
Gentle breeze
5 m/sek
-0o
- 10o
- 20o
- 30o
- 40o
- 50o
- 60o
Fresh breeze
10 m/sek
First Aid
• Dry, rub and warm the injured area
• Avoid straining of the injured area
• Transport the patient on a stretcher
Near Gale
15 m/sek
Prevention
• Dry boots and socks. Change socks frequently
• Ensure dry feet during rest / sleep
• If core temperature is low, the feet get cold
We distinguish between superficial and deep freezing injuries.
Superficial freezing injuries
Symptoms
• Superficial freezing injuries are revealed by white/grey spots as the skin gets a waxlike appearance but is still movable in relation to deeper tissue and bone.
• There are two stages of development:
- White skin that, when warmed up, turns normal after 15 minutes.
The skin is red, not white, after treatment.
- A superficial freezing injury reaching deeper into the skin will typically result in oedema and blisters with translucent fluid after thawing of the injured area.
First Aid
• Skin against skin – palm against ear, nose, cheek or place injured area in armpit
• Cover the area
• General rewarming
• DO NOT rub or massage
If no improvement after 15 minutes, bring the patient to a warmer place, as for example a tent,
a vehicle or a house. Seek professional medical treatment.
When thawing injury be aware of the risk of burns. Thaw injured area at normal room or body
temperature.
Unconscious patients to be put in recovery position.
Gentle, but rapid, evacuation to hospital.
HUMIDITY AND WIND INCREASE LOSS OF BODY TEMPERATURE!
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