Environmental Medical Emergencies – Hypothermia

Environmental Medical Emergencies – Hypothermia

Hypothermia: Causes, Symptoms and Treatments

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Download Hypothermia Poster

Hypothermia, or abnormally low body temperature, is a dangerous condition that can occur when a person is exposed to extremely cold temperatures.

Stay safe this winter by learning more about hypothermia, including who is most at risk, signs and symptoms, and what to do if someone develops hypothermia.

What is Hypothermia?

  • Hypothermia is caused by prolonged exposures to very cold temperatures. When exposed to cold temperatures, your body begins to lose heat faster than it’s produced. Lengthy exposures will eventually use up your body’s stored energy, which leads to lower body temperature.
  • Body temperature that is too low affects the brain, making the victim unable to think clearly or move well. This makes hypothermia especially dangerous, because a person may not know that it’s happening and won’t be able to do anything about it.
  • While hypothermia is most likely at very cold temperatures, it can occur even at cool temperatures (above 40°F) if a person becomes chilled from rain, sweat, or submersion in cold water.

Who’s Most at Risk?

Victims of hypothermia are often:

  • Older adults with inadequate food, clothing, or heating
  • Babies sleeping in cold bedrooms
  • People who remain outdoors for long periods—the homeless, hikers, hunters, etc.
  • People who drink alcohol or use illicit drugs.

Recognizing Hypothermia

Warnings signs of hypothermia:

Adults:

  • shivering, exhaustion
  • confusion, fumbling hands
  • memory loss, slurred speech drowsiness

Infants:

  • bright red, cold skin
  • very low energy

Don’t Wait- Take Action

If you notice any of these signs, take the person’s temperature. If it is below 95° F, the situation is an emergency—get medical attention immediately.

If medical care is not available, begin warming the person, as follows:

  • Get the victim into a warm room or shelter.
  • If the victim has on any wet clothing, remove it.
  • Warm the center of the body first—chest, neck, head, and groin—using an electric blanket, if available. You can also use skin-to-skin contact under loose, dry layers of blankets, clothing, towels, or sheets.
  • Warm beverages can help increase body temperature, but do not give alcoholic beverages. Do not try to give beverages to an unconscious person.
  • After body temperature has increased, keep the person dry and wrapped in a warm blanket, including the head and neck.
  • Get medical attention as soon as possible.

A person with severe hypothermia may be unconscious and may not seem to have a pulse or to be breathing. In this case, handle the victim gently, and get emergency assistance immediately.

Do not Rapidly Rewarm a Severely Hypothermic Person:

  • Even if the victim appears dead, CPR should be provided. CPR should continue while the victim is being warmed, until the victim responds or medical aid becomes available. In some cases, hypothermia victims who appear to be dead can be successfully resuscitated.

Be Prepared

Taking a first aid and emergency resuscitation (CPR) course is a good way to prepare for cold-weather health problems. Knowing what to do is an important part of protecting your health and the health of others.

Taking preventive action is your best defense against having to deal with extreme cold-weather conditions. By preparing your home and car in advance for winter emergencies, and by observing safety precautions during times of extremely cold weather, you can reduce the risk of weather-related health problems.

From the CDC

Dr. Heimlich Performs Heimlich

Dr. Heimlich Performs Heimlich

Dr. Heimlich’s, Heimlich Save

Dr. Henry Heimlich, 96, performed the lifesaving technique he invented for the FIRST TIME when a woman choked on her hamburger in the seat beside him.

By  in New York For The Guardian

The surgeon who gave his name to the simple but dramatic procedure used to rescue people from choking saved someone’s life with the Heimlich Manoeuvre for the first time this week aged 96.

Dr Henry Heimlich’s technique for dislodging food or objects caught in people’s throats has been credited with saving untold thousands of lives around the world since he invented it in 1974 – but he had never once had cause to use it in an emergency situation himself.

Last Monday, however, the retired chest surgeon encountered a female resident at his retirement home in Cincinnati who was choking at the dinner table.

Without hesitation, Heimlich spun her around in her chair so he could get behind her and administered several upward thrusts with a fist below the chest until the piece of meat she was choking on popped out of her throat and she could breathe again.

Dr. Henry Heimlich and Patty Gill Ris

Dr. Henry Heimlich and Patty Gill Ris.

Heimlich told the Guardian by telephone from Cincinnati.

“That moment was very important to me. I knew about all the lives my manoeuvre has saved over the years and I have demonstrated it so many times but here, for the first time, was someone sitting right next to me who was about to die.”

Heimlich and his son Philip declared this was the first time the retired surgeon had used his technique to treat someone who was choking. Philip stated that he had no knowledge of his father using the technique in any prior emergency.

How to perform the Heimlich Manouvre

  1. Stand behind the victim with your legs separated, to form a ‘tripod’ shape. If the victim faints or becomes unconscious, this will help you to catch them.
  2.  Reach around the victim from behind. Circle your hands around the victim’s abdomen (stomach).
  3. Make a fist with your dominant hand. The thumb of this fist should point into the fist. Place this fist just above the victim’s belly button and under the breastbone.
  4. Wrap your other hand firmly around this fist. Be sure to keep your thumb away from the victim’s body, to prevent injury to the victim.
  5. Pull inward and upward, pressing into the victim’s abdomen with quick upward thrusts, using force.
  6. Perform abdominal thrusts in quick succession.
  7. Repeat the series of thrusts until the object is dislodged and expelled.

Heimlich lived in Deupree House, a senior assisted living centre in the city, where he and other residents had their own apartments but got together for meals in a communal dining room.

Fellow resident 87-year-old Patty Ris, who was quite new to the facility, sat down near Heimlich for dinner when she suddenly began choking on a piece of hamburger meat. A member of staff was heading over to attend to the emergency, when Heimlich calmly stepped in.

“I did the Heimlich Manoeuvre – of course,” Heimlich said. “She was going to die if she wasn’t treated. I did it, and a piece of food with some bone in it flew out of her mouth.”

Heimlich demonstrates the manoeuvre on Johnny Carson in 1979. Photograph: NBC/NBC via Getty Images

Heimlich demonstrates the manoeuvre on Johnny Carson in 1979. Photograph: NBC/NBC via Getty Images

Heimlich said that the woman never lost consciousness, but after being able to breathe again she was so startled she was unable to talk at first.

“I, however, just sat there absolutely smiling as big as I could,” Heimlich said.

The two had dinner together the following night in celebration.

“She told me how wonderful and fortunate she felt,” he said.

Standard practice for dealing with choking prior to 1974 was to thump the afflicted person on the back. But Heimlich argued that that can force the obstruction further into the gullet, not dislodge it.

He worked on various theories until he finally came up with the procedure in 1974, designed for use by the general public, not just medical personnel, of putting one’s arms around the casualty and exerting upward abdominal thrusts, just above the navel and below the ribs, with the linked hands in a fist, until the obstruction is dislodged.

In June 1974 Heimlich published preliminary findings from his experiments with anti-choking techniques in a US medical journal. Newspapers around the US quickly began picking up on examples where readers, including restaurant owners, had caught word of Heimlich’s article and had tried the maneouvre on choking casualties, with successful results.

Word spread, and that summer the Journal of the American Medical Association published an editorial in which, with the surgeon’s permission, the technique was officially referred to for the first time as the “Heimlich Manoeuvre”. A year later, Heimlich wrote a peer-reviewed paper for the JAMA on his life-saving discovery. The technique became widely adopted nationally and internationally and is today explained via diagrams on posters in most US restaurants and is also taught in many schools, according to his son, Philip Heimlich.

The surgeon studied at Cornell University in upstate New York, and was also well known in the medical community for pioneering various surgical techniques and a device called the Heimlich valve that can be used for administering triage on chest wounds in the field, including in battle.

Heimlich’s son Philip, who lives near his father in Cincinnati, said the elder Heimlich was widowed lived in assisted accommodation for the elderly but was very fit for his age.

“He swam three or four times a week and went to the symphony and the ballet. I hear he performed his manoeuvre with great agility. I have always been very proud of my dad and I believe he is the person who has saved more lives than anyone living,” he said.

In the US just over 4,800 people die annually from choking through various causes, with around 3,000 of those believed to be from choking on food, according to the US National Safety Council. Between 175 and 200 people die a year in the UK from choking on food, according to the Office for National Statistics.

After her brush with death, Patty Ris wrote Dr Heimlich a note, saying: “God put me in this seat next to you,” she told the Cincinnati Enquirer.

Hurricane Lessons for Washington State

Hurricane Lessons for Washington State

What can we learn from Hurricanes

Hurricanes are pretty devastating storms that rip through the eastern seaboard leaving lots of property damage, and human suffering. Here in the Pacific Northwest the likelihood of a “storm” on the scale like a Category 5 is pretty rare, but we do have high winds that can and have done as much damage as a hurricane. However, what we really need to prepare for is an Earthquake!

Ready.gov is a great place to start to prepare your earthquake preparedness kit. Visit http://www.ready.gov/earthquakes for a more compete list of preparedness topics. Business leaders should also visit http://www.ready.gov/business

Before an Earthquake

The following are things you can do to protect yourself, your family and your property in the event of an earthquake.

  • To begin preparing, you should build an emergency kit and make a family communications plan.
  • Fasten shelves securely to walls.
  • Place large or heavy objects on lower shelves.
  • Store breakable items such as bottled foods, glass, and china in low, closed cabinets with latches.
  • Fasten heavy items such as pictures and mirrors securely to walls and away from beds, couches and anywhere people sit.
  • Brace overhead light fixtures and top heavy objects.
  • Repair defective electrical wiring and leaky gas connections. These are potential fire risks. Get appropriate professional help. Do not work with gas or electrical lines yourself.
  • Install flexible pipe fittings to avoid gas or water leaks. Flexible fittings are more resistant to breakage.
  • Secure your water heater, refrigerator, furnace and gas appliances by strapping them to the wall studs and bolting to the floor. If recommended by your gas company, have an automatic gas shut-off valve installed that is triggered by strong vibrations.
  • Repair any deep cracks in ceilings or foundations. Get expert advice if there are signs of structural defects.
  • Be sure the residence is firmly anchored to its foundation.
  • Store weed killers, pesticides, and flammable products securely in closed cabinets with latches and on bottom shelves.
  • Locate safe spots in each room under a sturdy table or against an inside wall. Reinforce this information by moving to these places during each drill.
  • Hold earthquake drills with your family members: Drop, cover and hold on.

After an Earthquake

  • When the shaking stops, look around to make sure it is safe to move. Then exit the building.
  • Expect aftershocks. These secondary shockwaves are usually less violent than the main quake but can be strong enough to do additional damage to weakened structures and can occur in the first hours, days, weeks, or even months after the quake.
  • Help injured or trapped persons. Remember to help your neighbors who may require special assistance such as infants, the elderly and people with access and functional needs. Give first aid where appropriate. Do not move seriously injured persons unless they are in immediate danger of further injury. Call for help.
  • Look for and extinguish small fires. Fire is the most common hazard after an earthquake.
  • Listen to a battery-operated radio or television for the latest emergency information.
  • Be aware of possible tsunamis if you live in coastal areas. These are also known as seismic sea waves (mistakenly called “tidal waves”). When local authorities issue a tsunami warning, assume that a series of dangerous waves is on the way. Stay away from the beach.
  • Use the telephone only for emergency calls.
  • Go to a designated public shelter if your home had been damaged and is no longer safe. Text SHELTER + your ZIP code to 43362 (4FEMA) to find the nearest shelter in your area (example: shelter 12345).
  • Stay away from damaged areas. Stay away unless your assistance has been specifically requested by police, fire, or relief organizations. Return home only when authorities say it is safe.
  • Be careful when driving after an earthquake and anticipate traffic light outages.
  • After it is determined that its’ safe to return, your safety should be your primary priority as you begin clean up and recovery.
  • Open cabinets cautiously. Beware of objects that can fall off shelves.
  • Find out how to keep food safe during and after and emergency by visiting: http://www.foodsafety.gov/keep/emergency/index.html
  • Put on long pants, a long-sleeved shirt, sturdy shoes and work gloves to protect against injury from broken objects.
  • Clean up spilled medicines, bleaches, gasoline or other flammable liquids immediately. Leave the area if you smell gas or fumes from other chemicals.
  • Inspect the entire length of chimneys for damage. Unnoticed damage could lead to a fire.
  • Inspect utilities.
    • Check for gas leaks. If you smell gas or hear blowing or hissing noise, open a window and quickly leave the building. Turn off the gas at the outside main valve if you can and call the gas company from a neighbor’s home. If you turn off the gas for any reason, it must be turned back on by a professional.
    • Look for electrical system damage. If you see sparks or broken or frayed wires, or if you smell hot insulation, turn off the electricity at the main fuse box or circuit breaker. If you have to step in water to get to the fuse box or circuit breaker, call an electrician first for advice.
    • Check for sewage and water lines damage. If you suspect sewage lines are damaged, avoid using the toilets and call a plumber. If water pipes are damaged, contact the water company and avoid using water from the tap. You can obtain safe water by melting ice cubes.