The document discusses the physiological effects of cold water immersion and drowning. It describes the body's response to cold shock, including hyperventilation and potential cardiac arrhythmias. It also outlines the stages of drowning and provides recommendations for bystander rescue and victim management.
The document discusses the physiological effects of cold water immersion and drowning. It describes the body's response to cold shock, including hyperventilation and potential cardiac arrhythmias. It also outlines the stages of drowning and provides recommendations for bystander rescue and victim management.
The document discusses the physiological effects of cold water immersion and drowning. It describes the body's response to cold shock, including hyperventilation and potential cardiac arrhythmias. It also outlines the stages of drowning and provides recommendations for bystander rescue and victim management.
The document discusses the physiological effects of cold water immersion and drowning. It describes the body's response to cold shock, including hyperventilation and potential cardiac arrhythmias. It also outlines the stages of drowning and provides recommendations for bystander rescue and victim management.
ENVIRONMENT Introduction • Human body maintains a stable temperature of around 37 degree Celsius and is maintained in the range of 35.8 - 38.2 Degree Celsius.
• Hypothalamus receives sensory information from
peripheral and central thermoreceptors. • Core: consisting of organs within skull, abdomen and thorax • Shell: The skin
Hypothalamus control the amount of heat
generated and lost. Heat-promoting Mechanisms When the external temperature falls, heat promoting center is activated. This maintains core body temperature by: Constricting peripheral cutaneous blood vessels. Causing shivering- involuntary contractions of skeletal muscle, which generates heat. Increasing body’s metabolic rate. Behavioral changes upon decrease in body temperature:
• Putting on warmer clothes
• Drinking hot fluids • Increasing physical activity Heat-loss mechanisms Heat loss usually occurs via skin by SWEATS or CUTANEOUS VESSEL DILATION following:
• Radiation: Infrared waves
• Conduction: Direct contact with cool objects • Evaporation: water absorb heat & escape from body Hypothermia It is defined as core body temperature of less than 35’C. It has 3 categories: • Mild: 32-35 ‘ C • Moderate: 28-32 ‘C • Severe: <28 ‘C Hypothermia is a factor in following: • Older patients • Children • Medical conditions like Hypothyroidism or stroke • Alcoholic patients • Drowning • Patient suffering from Exhaustion • Injured patients • Decrease level of consciousness Stages of Hypothermia: • Conscious and Shivering • Decrease level of conscious and not shivering • Unconscious • Not breathing • Death Management • Mainstay of treatment is to prevent further heat loss. • Use foil blanket • Hot drinks • Warmer I/V fluids • Don’t allow to walk • Severe hypothermic patients need rewarming. Do not rub patient’s skin: This may lead to peripheral vasodilation, which worsens hypothermia. Heat-related illness This may result from: • EXTERNAL FACTORS • Sun • INTERNAL FACTORS • Drugs • Exercise Heat related illness occur as a result of:
• Multi-organ Dysfunction • Heat stress • Heat Exhaustion • Heat Stroke • Multi-organ Dysfunction HEAT RELATED FORM OF Progression Characterized by ILLNESS ILLNESS
HEAT STRESS Mild • Heat edema
• Heat syncope • Heat cramps
Moderate • Result of Fluid loss • Headache
HEAT EXHAUSTION
• Loss of electrolyte • Dizziness
imbalance • Nausea • Vomiting • Tachycardia • Hypotension • Sweating muscle pain cramps HEAT STROKE Severe • ALOC • Respiratory distress • Organ dysfunction • Liver/kidney failure • Arrhythmia/hypotension • Hot dry skin • Facial flushing • Vomit/diaarhea Heat stroke It has 2 types:-
• EXTERTIONAL: excessive heat production
especially in athletes and manual workers • NON-EXTERTIONAL: high external temperature especially in Elder, young or chronically ill Management Heat Stress • Remove patient from heat source • Cool the patient PASSIVELY • Replace fluid/electrolyte by isotonic fluids • Elevate edematous extremities Management Heat exhaustion • Fluid rehydration may be intra-venous • Cooling should be ACTIVELY • COLD WATER IMMERSION (for co-operative patients) • Remove patient’s clothing, if required • Fan the patient Heat stroke • Support ABCD • Cool the patient • Use ice packs in groin and axilla • Rehydration Introduction • Primary Respiratory Impairment from sub cutaneous immersion in a liquid. Pathophysiology 8. Loss of 7. HYPOXIA, 1. Water Enter Conscious HYPERCARBIC, Mouth APNOEA ACIDOTIC
6. NO GAS 2. Swallowed EXCHANGE
3. Inspiratory 4. Water 5. Dive is too high Aspirated LARYNGOSPASM Cold Shock • When immerse in cold water (10’C or less), cold shock occurs. • MECHANISM: Caused by stimulation of cutaneous cold thermoreceptors, result in excessive sympathetic nervous response. • RESULTS IN: Hyperventilation, Hypocapnia, tachycardia, hypertension EFFECT ON LUNGS: • Fragile alveolar capillary membranes are disrupted leading to increased permeability results in: • Pulmonary edema • Decrease gaseous exchange • Pulmonary shunting • Atelectasis • bronchospasm AUTONOMIC CONFLICT COLD WATER IMMERSION
FACE COLD & WET
CUTANEOUS & RECEPTORS Breath Hold
COLD SHOCK RESPONSE
DIVING RESPONCE Attempted Breath Hold
PARASYMPATHETIC SYMPATHETIC STIMULATION =
STIMULATION = Bradycardia Tachycardia
Break of Breath Hold
AUTONOMIC CONFLICT
ARRHYTHMIAS SAVE A VICTIM • Call, Reach, Throw, Wade and Row • Encourage victim to self rescue • Pass something that is buoyant • Be trained and equipped Management • Place victim on firm surface, shore or boat • Support Airway, Breathing & Circulation. • Suction MAJOR COMPLICATIONS: • Hypovolemia--- Remove horizontally & transport • Hypothermia--- Indirectly heat the patient
