MapHypotherm

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Author:
jakeschis
ID:
89090
Filename:
MapHypotherm
Updated:
2011-06-04 13:44:10
Tags:
MAP Immersion Hypothermia
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Description:
Map Final - Immersion Hypothermia
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  1. Four Phases of cold water immersion physiologic response.
    • 1. Cold Shock (0-2 min)
    • 2. Functional Disability (2-15)
    • 3. Hypothermia (>15-30)
    • 4. Peri-Rescue Collapse
  2. Cold Shock Response
    • cause: stimulation of truncal skin nerve endings. colder = stronger response
    • reflex:
    • 1. gasp
    • 2. hyperventilation (results in 5)
    • 3. hypertension
    • 4. tachycardia (you get an andrenaline rush)
    • 5. difficulty holding breath
  3. How to die from cold shock response.
    • 1. drown from gasping underwater
    • 2. faint from hyperventilation, then drown
    • 3. tachycardia increasing cardiac work can result in cardiac arrest if you have heart problems
  4. Funtional Disability Physiology
    • 1. difficulty swimming -- cold water more viscous, muscles cold
    • 2. loss of manual dexterity because of numbing
    • 3. muscle cramping
    • 4. swimming increases rate of heat loss* - die faster
  5. Hypothermia Death
    • cooling of central core temp in linear manner. really >30 min
    • 1. go unconscious (drown)
    • 2. cardiac arrest if you're out of water
  6. Hypothermia Physiology
    • 1. peripheral vasoconstriction
    • 2. brain (hypothal) sense cold = shiver
    • 3. physical impairments
    • 4. mental impairments (poor judgement)
    • 5. cold-induced diuresis (more central blood volume(ANP))
    • 3. core temp <35 deg C
    • 4. every organ system effected ( like multiple trauma)
  7. Hypothermia Pathophysiology
    • 1. dysrhythmia - really cold bradycardia, then cardiac arrest
    • 2. hypotension
    • 3. decreased metabolism
    • 4. loss of shivering, muscles too cold...increased rate of cooling now
    • 5. loss of consciousness
  8. Insulators and their effect on cooling rate.
    • 1. air between clothing and skin
    • 2. body fat
    • - linear relationship between cooling rate and body fat. - heat lost proportional to surface area
    • - amt of heat to lose proportional to weight
    • -large fat people cool slower, adults slower than kids
  9. Classification of Hypothermia
    • Mild - 32C-35C
    • Moderate - 28-32
    • --LOC, loss of shiver, dysrhythmmia
    • Severe - <28
    • --vital signs reduced or absent, cardiac arrest
    • --may seem dead, but can't assume if hypothermic
  10. Don't Drownproof in cold water, HELP position
    • because you immerse another 9% in cold water to remove more heat.
    • HELP position: fetal position, reduce surface area for heat loss, protect some of the high heat loss areas (axilla, groin (not neck))
  11. Swim for shore?
    • 1. it increases blood to arms, more heat loss
    • 2. maybe, you need to consider a lot of factors
    • -water temp, tide, distance, swimming ability, state of health, proximity of rescuers, signaling devices
  12. First Aid for Hypothermia
    • 1. get them out
    • 2. ABCs
    • - may have really low pulse
    • 3. be gentle - rough care cold cause cardiac arrest
    • 4. remove clothing, protect from wind, vapor barrier
    • 5. add heat if you have it
    • 6. no eating and drinking - may cause aspiration
    • 7. transport
  13. Pathophysiology of Drowning
    • 1. aspiration of water
    • 2. cough/ struggle to reach surface
    • 3. laryngospasm
    • 4. get hypoxemic
    • -brain - LOC
    • -muscles - laryngospasm stops, water gets in
    • - heart - V. fib
    • 5. reflex swallowing - lot of water in stomach, prone to vomiting
  14. Fresh vs Salt water
    • Fresh - denature protein in alveoli, they collapse
    • Salt - wash out surfactant, pulmonary edema and damage to alveolar-capillary membrane
  15. V/Q mismatch in both, treatment the same!
  16. Drowing in Cold Water
    • higher probability of resuscitation because:
    • -ability of tissues to survive hypoxia is better in cold water
    • -cooling of CNS, vital organs cools core temp.
  17. First Aid for drowning
    • 1. ABCs
    • 2. treat hypoxia - give 02
    • 3. transport
  18. Take Home Messages from Studies
    • 1. air is a good insulator of heat, water is a good conductor of heat. so get out of the water!
    • 2. heat flow through head is not disproportionate, but cooling rate does accelerate due to increase surface area in contact with water
    • 3. rough water is worse than calm water for hypothermia, more cold water contact, no warm water bubble

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