Frostbite
What is frostbite?
Frostbite is the freezing of body tissue, typically in the extremities such as fingers, toes, nose, or ears, caused by prolonged exposure to cold.
What is hypothermia?
Hypothermia occurs when the body’s core temperature drops below 95°F, usually due to prolonged exposure to cold environments.
What is some of the winter specific gear EMS personnel should have when responding to a winter emergency?
Insulated gloves, boots, and thermal layers are worn to prevent hypothermia or frostbite.
What is the most common cause of slips and falls in winter weather?
Ice and snow on sidewalks, driveways, and other walking surfaces.
When treating a patient who has fallen through ice and is experiencing hypothermia, what is the first priority?
The first priority is to prevent further heat loss by removing the patient from the cold water, getting them to a warmer environment, and removing wet clothing.
What are the early signs of frostbite?
Numbness, tingling, pale or waxy skin, and the skin feeling hard or cold to the touch.
What are some early symptoms of hypothermia?
Shivering, confusion, slurred speech, and fatigue are common early signs.
When responding to a cold weather emergency, how should EMS workers secure the patient?
Cover backboards with a blanket if possible, and layer warm blankets over patients as needed.
What can EMS personnel do to prevent slipping while responding to winter emergencies?
Wear non-slip footwear, use ice cleats, and stay alert to icy conditions when walking or carrying equipment.
How do you assess if ice is safe to walk on?
Ice should be at least 4 inches thick for walking and 5-7 inches thick for driving. Always check for visible cracks, water pooling, or uneven thickness.
What is the best way to treat frostbite in the field?
Warm the affected area slowly using warm (not hot) water or body heat, avoid rubbing, and keep the patient sheltered from the cold. Rapid transport.
How should EMS personnel treat a hypothermic patient in the field?
Move the patient to a warm environment, remove wet clothing, warm the patient using blankets, warm fluids (if conscious), and avoid rapid warming to prevent shock.
Which type of vehicle is most effective for snowy or icy conditions?
4-wheel-drive vehicles, snowmobiles, or tracked vehicles are best for navigating icy and snowy conditions.
What are the most common injuries from slips and falls in winter conditions?
Sprained or fractured ankles, wrists, and hip fractures. Head injuries are also common.
A patient who has fallen through ice is shivering, confused, and has a pale, cold appearance. What is the most appropriate field treatment to stabilize them before transport?
Warm the patient gradually with blankets, dry clothes, and warm (not hot) fluids if conscious. Avoid rapid rewarming methods, as they can cause shock or afterdrop. Prepare for transport to a medical facility as quickly as possible.
What can happen if frostbite is not treated properly?
Severe frostbite can lead to tissue necrosis, gangrene, and the need for amputation if not properly treated.
What can happen if hypothermia is not treated promptly?
It can lead to unconsciousness, organ failure, and death if not treated effectively and rapidly.
What is the recommended method for preventing hypothermia during outdoor rescues?
Limit time spent in cold, wet environments, keep victims dry, use layering techniques, and provide adequate shelter.
How should EMS workers handle a patient who has fallen on ice and possibly injured their spine or neck?
Avoid moving the patient unless there is immediate danger. Immobilize C-spine, backboard.
What is the best approach for EMS rescuers when retrieving someone who has fallen through the ice?
Rescuers should use ropes, poles, or extendable equipment to avoid putting themselves in danger. Only trained professionals should attempt the rescue.
What is the risk of rewarming frostbitten tissues too quickly?
Rewarming too quickly can cause further tissue damage due to “reperfusion injury,” where blood flow returns to the tissue and causes inflammation.
Why is it dangerous to rewarm a hypothermic patient too quickly?
Rewarming too quickly can cause “afterdrop,” where the colder blood from the extremities returns to the heart, potentially lowering core temperature further.
In Montana, how should EMS personnel prepare for a large-scale winter storm or avalanche rescue?
Establish a multi-agency coordination plan, equip responders with necessary winter gear,.
What precautions should be taken when transporting a patient who has fallen in snowy or icy conditions?
Use a team to stabilize the patient, ensure that the transport path is cleared of ice, and secure the patient on a sled or stretcher.
What immediate treatment is required for someone who has fallen through ice and been submerged in cold water?
Rewarming, including removal of wet clothes, dry blankets, and warm fluids (if conscious). Rapid transport.