Cold injuries:
Upon arriving on scene, perform EMCAP, noting potential threats, including scene temperature.
Form a general impression of the patient, noting LOA, positioning, work of breathing, and skin colour/condition.
Upon patient contact, perform the primary survey, assessing airway patency, respiratory rate, rhythm, and volume, and pulse for rate, rhythm, and strength, as well as cap refill. Make necessary corrections prior to moving forward.
Immediately following the primary survey, remove the patient from the cold environment. Be prepared for life/limb threats such as hypothermia, and frostbite.
Attempt to determine the duration of exposure, and type of exposure.
Perform a rapid body survey, only exposing areas as they are assessed, and covering them immediately after.
Have partner obtain baseline vital signs.
If hypothermia is suspected, determine if it is mild-moderate, or severe in nature.
If Frostbite is suspected, attempt to determine the severity/depth of the frostbite just as you would with burns.
Remove wet clothing and jewellery.
For mild-moderate hypothermia, wrap the patient in dry blankets and apply warm packs to the head/neck, axillae, and groin.
For Severe hypothermia, rewarming must be performed in hospital. Wrap the patient in dry blankets and keep them supine, avoiding sudden movements or aggressive suctioning, as these patients are prone to V-Fib. Monitor ECG closely.
For Frostbite, treat as you would a burn.
Initiate transport.
If possible, obtain HPI, PMHx, Medications, Allergies, and last ins/outs en-route to the ED.
Comments