Human Body

has a limited tolerance for temperature

extremes
maintains a relatively stable core
temperature, which represents a balance
between heat production and heat loss.
The normal core body temperature is
98.6oF or 37oC.
 Hypothermia

Hypothermia (hypo = less than normal +

thermia = generation of heat)
temperatures below 95°F or 35°C.
When external temperatures are too low or
the body’s heat production is inadequate
relative to the external demands, core
temperatures can drop.
can cause cardiac arrhythmias and
subsequent unconsciousness — a
condition that may stabilize with
rewarming.
 Hypothermia

Mild
Moderate
Severe
 Mild Hypothermia

classified as a body core temperature of

90-95°F or 32-35°C.
Expected symptoms include
o shivering

o lethargy and apathy

o compromised motor skills

 Moderate Hypothermia

Occurs with body core temperature of 83-

89°F or 28-31°C.
At this point
o shivering stops

o stupor (reduced cognitive function

o slow heart and respiratory rates

 Severe Hypothermia

Occurs when body core temperature go

below 82°F or 28°C.
At this point
o coma

o unconsciousness

o individuals may appear dead

Cold-Water Immersion

Water has the ability to conduct heat away

from the body 20-27 times faster than air.
cold-water immersion raise the suspicion
of potential hypothermia and prompt
rewarming efforts.
Rewarming Strategies

Remove the individual from the cold, and

place him in a dry, warm environment
away from wind.
Remove wet clothing, and replace with dry,
warm coverings to include the head, and
activate EMS.
Monitor breathing and heart rate, and be
prepared to perform CPR should either
become dangerously slow or stop and the
individual becomes unconscious.
Rewarming Strategies

When providing care, avoid rough handling

of hypothermic individuals.
o Rough handling may cause an irritable
heart to develop arrhythmias such as
ventricular fibrillation.
use of hot-water bottles or heating pads
applied to the chest, neck and groin to
optimize core warming.
Rewarming Strategies

Symptom severity and the person’s mental

status will largely determine the course of
further treatment.
Anyone presenting with a history of
confusion, lethargy, unconsciousness or
stupor should receive prompt medical
attention.
Calling EMS may enable faster recovery
(with more aggressive rewarming
techniques) and appropriate monitoring.
 Special Consideration: Core
Temperature After-Drop

The term “core temperature after-drop”

refers to a reduction in core temperature
after rewarming and is characterized by
clinical deterioration.
o The reason for this phenomenon is that as
peripheral tissues warm, vasodilation allows
cooler blood from the extremities to circulate
back into the body core. This may result in
additional core cooling and cardiac arrhythmias.
Rewarming efforts aimed at core temperature
elevation minimize the chances of the after-drop
phenomenon.
 Special Consideration: Core
Temperature After-Drop

When treating moderate to severe

hypothermia, focus on rewarming
strategies
o keep the individual horizontal

o activate EMS

o be prepared to initiate CPR

o eliminate any exertion by the individual

during or after care until evaluated by
medical personnel
 Hyperthermia

(hyper = above normal + thermia =

generation of heat)
occurs when the body is overheated and
the normal cooling mechanisms are
overwhelmed
can range from mild to life-threatening.
The body’s natural cooling mechanisms
include
o sweating

o peripheral vasodilation
 Hyperthermia

Sweating enables evaporative heat loss,

and peripheral vasodilation (seen as
flushing) brings blood to the body’s
surface, which enables cooling through
evaporative heat loss and other cooling
mechanisms
Personal factors or individuals at elevated
risk of hyperthermia include the following:

infants and children

obesity
people over 65 years of age
exertion/exercise
dehydration
health issues such as diarrhea that
predispose to dehydration
 Cooling Measures

4 primary mechanisms for heat loss

o Conduction

o Convection

o Evaporation

o Radiation

The process of breathing can also result in heat loss, but this
process is passive and doesn’t affect the first responder.
When trying to cool someone with hyperthermia, the use of
multiple methods simultaneously will have the greatest
effect.
Convection
is heat loss that occurs in response to the
movement of fluid or gas.
Cooling methods: Use a fan, air
conditioning vent or exposure to wind. It
works best if combined with a cool mist
spray to utilize evaporative heat loss
Evaporation
is heat absorbed by sweat that is then
released or removed from the body when
liquid phase-changes to gas as part of
evaporation.
Cooling methods: Sponge with cool water,
or use mist to maintain skin moisture. Key
areas are the head, neck and torso.
Radiation
is transfer of electromagnetic energy
(primarily in the infrared spectrum)
between two objects of different
temperatures.
The temperature difference between
objects will determine the direction of
heat transfer.
Radiation
Cooling methods: Remove from direct
sunlight, place in the shade or a cool room,
and remove heavy or unnecessary clothing.
Seek medical attention if:
symptoms are severe
history of heart problems or high blood
pressure exists
symptoms worsen or last longer than one
hour
 Heat Rash

commonly seen around the neck, groin,

elbow creases and beneath breasts
looks like small pimples and is caused by
excessive sweating
While seen in all ages, it is most common
in young children
Treatment is simple and involves cooling
and keeping areas dry
This rarely requires medical attention and
usually resolves on its own
 Heat Cramps

are muscle spasms resulting from

excessive fluid and electrolyte loss
are often associated with strenuous
activity and may be a sign of heat
exhaustion
 Heat Cramps

Immediate first-aid measures include the

following:
✓ Stop all activity, and rest in a cool place.

✓ Drink clear liquids, preferably with

electrolytes (sports drinks).
✓ Do not return to strenuous activity for
several hours.
✓ If symptoms do not resolve within about
an hour, seek medical attention.
 Heat Exhaustion

occurs as a result of excessive fluid and

electrolyte loss
Those most prone to heat exhaustion
o elderly

o people taking diuretics (medications

that cause fluid and electrolyte loss)
o people working or exercising in hot
environments where fluid and
electrolyte loss are most likely to
exceed the rate of replacement
Warning signs of heat exhaustion
• heavy sweating
• fatigue
• nausea/vomiting
• weakness
• headache
• fainting
• muscle cramps
Untreated, heat exhaustion can progress
to heat stroke and should therefore receive
prompt attention.
If symptoms are severe, call EMS
immediately, and perform cooling
measures until they arrive.
Immediate first-aid measures include the following:
• Remove from heat source.
• Rest.
• Place in a cool environment.
• Remove unnecessary clothing.
• Replacement of fluids and electrolytes — oral intake is
usually safe.
• Cooling methods: evaporation, conduction, convection
and radiation
— Sponge the head, neck and torso.
—Place the individual near an air-conditioning vent or
fan.
 Heat Stroke

is a life-threatening condition in which the

body’s temperature exceeds its ability to
effectively regulate cooling
Core temperatures may exceed 106°F or
41°C.
Signs and symptoms of heat stroke may
include the following:
• rapid pulse
• red, hot and often dry skin
• strange behavior
• hallucinations
• confusion
• seizures
• coma and death
Note:

Symptom onset may be rapid and

requires aggressive cooling and
immediate activation of EMS.
Immediate first-aid measures include the
following:
• Remove from heat source.
• Activate EMS.
• Keep the individual at rest.
• Place the individual in a cool environment and on
a cool surface.
• Remove unnecessary clothing.
• Replace fluids and electrolytes (IV fluids are
usually advised because airway management
may be compromised).
Immediate first-aid measures include the
following:
• Cooling methods: evaporation, conduction,
convection and radiation
— Apply cold packs to the head, neck, armpits
and groin.
— Cover the individual with water-soaked
towels or blankets (keep coverings wet
with additional cool water).
— Place the individual near an air-conditioning
vent or fan.
Continually monitor the individual for
airway compromise, seizure,
unconsciousness or cardiac arrest.