One speaks of hypothermia (hypothermia) when the normal body temperature of about 36-37 degrees Celsius is undercut for a longer period (from 30 minutes). This can be the case, for example, after long bathing or swimming in the sea. A typical sign is then blue lips and shivering. Frostbite is when the body temperature in certain parts of the body (e.g. fingers or toes) has fallen below freezing point. As a result, the cells die. Typical signs are mostly bluish to black fingers or toes.
What is hypothermia?
The first aid for hypothermia is heat preservation, i.e., cover or wrap patients with a wool blanket. Never put a rescue blanket directly on the skin, it will be useless due to lack of insulating effect. Click to enlarge. Hypothermia or hypothermia must be distinguished from frostbite. In hypothermia the core temperature of the body is reduced, in frostbite there is damage to the body tissues as a result of local exposure to cold. Hypothermia is when the body temperature drops below 37 degrees Celsius. There are two forms of hypothermia:
Acute hypothermia is a very rapid hypothermia, such as when a person is immersed in ice water. In such a case, a person can survive for a maximum of 60 minutes at a water temperature of 5 degrees Celsius. In subacute acute hypothermia, a drop in body temperature occurs only gradually over the course of hours, for example in the case of burial by a snow avalanche. Sufferers of this form of hypothermia become tired, lapse into sleep, and pass out. If the core body temperature continues to drop, death occurs.
Causes
Hypothermia or hypothermia and the frostbite that often accompanies it result primarily from a particularly low ambient temperature, the effects of which can be exacerbated by wind and humidity. Hypothermia can be favored by inadequate or damp clothing and insufficient exercise, as well as by too long a stay in cold water, an untrained circulatory system, a lack of body fat tissue, and a poor general physical condition. In hypothermia, the human body not only produces more heat, but also suppresses its release. Because the body extremities occupy a large part of the body surface, they have a special regulating function in hypothermia: the cold causes the blood vessels located there to contract; the supply of blood is thus throttled in order to supply primarily the torso area with the internal organs and to protect it from the consequences of hypothermia. In the event of hypothermia, this centering of the circulation is an effective means of self-protection of the organism with the negative side effect of increased susceptibility of the extremities to frostbite.
Symptoms, complaints, and signs
Symptoms of hypothermia and frostbite present differently depending on the severity of impairment due to exposure to cold. General or specific signs may occur. A typical symptom is decreased body temperature. While the symptoms of frostbite affect specific areas or parts of the body, the signs of hypothermia present more as a reaction of the entire body. Taking into account body temperature and other changes, the severity of hypothermia is divided into three phases. In mild hypothermia, the affected person shows shivering and shivering in the active phase (defense stage). In addition, the skin may appear pale. There may be an increased frequency of breathing and blood pressure with a body temperature of 34 to 36 degrees Celsius. In the exhaustion phase due to moderate hypothermia, blood pressure and pulse rate decrease at a body temperature between 30 and 34 degrees Celsius. In addition, muscle rigidity, blue-gray skin, and drowsiness or confusion may occur. Breathing becomes shallower and more irregular. In the third stage, the paralysis stage, the body temperature drops below 30 degrees Celsius. This can lead to unconsciousness or respiratory arrest as well as cardiovascular arrest. The severity of frostbite is assigned to three different degrees.First-degree frostbite is indicated by signs such as cooling, pale skin and pain in the slightly swollen areas. In the case of second-degree frostbite, the rewarmed tissue shows redness, swelling and blistering. If the affected tissue turns out to be already dead after some time, it is third-degree frostbite.
Course of the disease
In hypothermia and associated frostbite, the course depends on the severity of exposure to cold and treatment. There is a favorable prognosis if hypothermia is treated promptly and properly. If the body temperature is raised in a timely manner, hypothermia usually remains consequence-free. Unfortunately, hypothermia is often overlooked, especially when – for example, in an accident – other complications are in the foreground. If treatment of hypothermia is delayed, it can lead to terrible damage to the organs, which in extreme cases can result in death.
Complications
Hypothermia or frostbite should not be underestimated. Complications can occur with severe hypothermia, also known as hypothermia. Mild hypothermia, on the other hand, is easily treated. The same can be said for mild frostbite. Severe hypothermia or severe frostbite can lead to serious consequences. The extremities are particularly at risk. In case of severe hypothermia, cardiac arrhythmia may occur thanks to delayed treatment. In case of additional injuries accompanying hypothermia, death may occur in the worst case. This is especially the case if hypothermia is not noticed in time given the severity of the injuries. Accident patients who are involved in accidents during the cold months of the year must therefore be kept warm. This is hardly possible for trapped patients. Here, there is a risk of cardiovascular failure and death. In the case of cold-related damage, complications can vary depending on the degree of cold damage. In the case of blood-filled blisters and second-degree frostbite, there is an increased risk of infection if the blisters open. Third-degree frostbite often requires amputation of the affected limb. These often die. If the frostbitten body part is not amputated in time, there is a risk of fatal sepsis. Classic complications of hypothermia or frostbite include blackish skin discoloration, edema, chilblains, wound infections, thrombosis due to thickened blood, hyper- and parakeratosis, and tissue loss. Additional complications lie in improper or failure to administer first aid.
When should you see a doctor?
If the affected person has been in a cool environment for a long time without adequate thermal protection, warming baths and a change of clothing are often sufficient. If he suffers from chills, freezes or complains of a general malaise, this should be further observed. If the patient’s health improves as a result of the self-help measures, a doctor is not needed. In these cases, a sufficient supply of heat can lead to complete freedom from symptoms within a few minutes or a few hours. Medical support and health assistance is necessary if the irregularities last longer or increase in intensity. If functional disorders are present, if the body temperature is very low, or if changes in the skin appearance are evident, a medical examination should be performed. Stiffening of the joints, an inability to move or restrictions in mobility should be presented to a physician. A particularly pale skin appearance, irregularities in the ability to react and a general feeling of illness are indications of a health disorder. Trembling of the limbs or the entire body, sensory disturbances, and a loss of internal strength are other signs that should be investigated and treated. Disturbances in general speech recognition, pain, and neurological deficits must be presented to a physician as soon as possible. Because permanent damage can occur in severe cases, emergency medical services should be alerted in acute cases.
Treatment and therapy
Timely and appropriate therapy greatly favor the course of hypothermia. Hypothermia therefore requires rapid action and consistent measures. In case of hypothermia, it is best to warm the body slowly in a warm room.A warming bath against hypothermia should be started lukewarm and in the course warmed up to a maximum of 38 degrees by slowly adding hot water. In the case of severe frostbite, the affected person should not move independently but should be transported; if blisters form, clinical treatment is essential. Existing blisters should not be opened under any circumstances, but should be covered with sterile material. Affected extremities should be elevated but not moved too much; too much pressure should be avoided. If possible, affected persons should warm the cold body parts on their own body, e.g. in the armpit, or have someone else warm them on their body. No ointments should be used for hypothermia or frostbite, and no medications should be administered except, if necessary, acetylsalicylic acid (e.g., “aspirin”)
Follow-up
Mild hypothermia may occur even after a short stay outdoors with inappropriate clothing. However, it is usually sufficient to stay in a sufficiently tempered room afterwards. After only a short time, the body temperature will regulate itself back to normal. In the case of moderately severe hypothermia, the affected person should be brought into a warm room and provided with a warming blanket. Hot drinks and a hot water bottle also help to bring the body temperature back into the normal range. When even mild frostbite occurs, alcohol should not be administered under any circumstances. Alcohol dilates the blood vessels, which leads to increased heat loss from the body and thus further promotes hypothermia. If a person suffering from frostbite is found outside, it is important to keep them awake. The emergency physician and ambulance must be notified. Until the rescue services arrive, the victim should be kept as warm as possible. This can be done by wrapping the person in a blanket or jacket. People who collapse on frozen water in winter are in acute danger of death. Rapid rescue is particularly important in this case. However, the rescuer should be careful not to put himself in danger. Until the emergency doctor arrives, the main thing here is also to keep the rescued person awake and as warm as possible.
What you can do yourself
In the case of mild hypothermia, which can occur even after a short stay in unsuitable clothing outdoors, it is usually enough to simply return to a sufficiently temperate room. The body temperature will then regulate itself. Sensitive persons can prevent the cooling of hands and feet in winter by using chemical heat pads. In moderately severe cases, the affected person should be taken to a warm room and wrapped in a blanket. Pouring hot drinks and a hot water bottle will also help to quickly raise the body temperature back to normal. Under no circumstances should alcohol be served at the first signs of frostbite while the person is still outdoors. Alcohol dilates the blood vessels, which causes the remaining body heat to be released even faster. Frostbitten persons found outdoors must be awakened and kept awake until the emergency physician or ambulance arrives. Wrapping them in a warm blanket or jacket is also strongly advised. Persons who collapse on the ice in winter are in acute danger of death and must be rescued immediately. In doing so, however, the rescuer must be absolutely careful not to put himself in danger. Once the person has been retrieved from the water, the same rule applies here: he or she should be kept awake and as warm as possible until the emergency physician arrives.
